Maximizing Operational Efficiency Using an In-House Ambulatory Surgery Model at an Academic Medical Center

Abstract

Given the rising costs of healthcare delivery and reimbursement constraints, large academic medical centers (AMCs) must improve efficiency while delivering high-quality care. With standardized cases and high volumes, ambulatory surgery is a high-value target for efficiency improvement. Mining a data set of more than 7,500 cases consisting of the three highest-volume ambulatory procedures in orthopedics, otolaryngology-head and neck surgery, and urology, we analyzed process times and wait times involved in patient flow. We examined differences among delayed versus early versus on-time cases, as well as differences in scheduled start times, day of the week, and each individual operating room. Our analysis found statistically and clinically significant differences in registration and setup wait times when comparing delayed versus early versus on-time cases. We then developed recommendations to increase value-added time. Using activity-based cost accounting, we created a model to quantify economic impact. Hospitals can adopt these methods to identify operational bottlenecks and employ our financial model to forecast changes in revenue. Application of this model can position AMCs for success in an increasingly competitive landscape.

Impact of the COVID-19 pandemic on the workflow of an ambulatory endoscopy center: an assessment by discrete event simulation

“…All these studies were done in academic medical centers in an hospital outpatient department (HOPD) setting, which has different levels of reimbursement and often with the participation of trainees. 11,12,15 In this study, incorporation of recommended post-COVID-19 related workflow modifications adversely impacted the efficiency and utilization of an AEC across a wide array of performance indicators and with significant financial implications. Although done in the setting of a community-based stand-alone AEC, the baseline results of this study are generally similar to the results published by other authors in terms of waiting time and staff utilization.…”