Perioperative Productivity Management

Summary

Productivity management is an essential capability for perioperative nursing staff. With 50 percent to 80 percent of a hospital’s costs in labor, staffing dollars are a consistent target for improving cost management. As a result, productivity measures often are developed to hold directors accountable for their staffing needs and expenses. Key operational decisions, such as hiring and vacancy review, are dependent on productivity performance.

Schedules often are built and maintained without a clear relationship to case volume and minutes, leading to missed opportunities for flexing or hours adjustments. As a result, total staff worked hours can become fixed from week to week. Without a perioperative tool to measure operating room (OR) work and productivity accurately, OR staffing is typically understated or overstated, which can create unnecessary problems and an inaccurate picture of overall productivity.

Introduction/Background

Managing inpatient productivity is paramount to maintaining an organization’s financial success. With approximately 60 percent of a hospital’s profitability generally coming from surgery, a well-run perioperative service line can impact a hospital’s profitability significantly. But perioperative directors are at a disadvantage when measuring productivity with a modified inpatient productivity tool. With this in mind, BRG professionals developed a tool that would capture various OR department functions and translate these into measurable data to form an overall productivity target.

Key Metrics

The key metric in a variable department such as the operating room is the ratio of the total worked hours (worked FTEs) to the total units of service (volume and, in this case, OR minutes). The resulting number is known as the department’s worked hours per unit of service (WHPUOS). In productivity measurements, the department’s actual WHPUOS is compared to the predefined goal (target) WHPUOS. Following this logic, a perfect score of 100 percent productivity means the department operated at the same number of worked hours per OR minute as the target.

Establishing a Productivity Target

The total numbers of worked hours and OR minutes are vital productivity metrics in determining a target. Setting the productivity target as a ratio allows for a variable department to apply the same ratio across changes in volume. Even if volume increases or decreases, the same number of worked hours applies to each OR minute. Even more important, this allows leadership and management to tailor the number of staffed worked hours effectively to each pay period, week, and even single-day caseload. As a result, establishing a productivity mark helps maintain responsibility to the organization’s bottom line.