Our committee consists of a chair (MD), departmental administrator, 4 MD surgeons, practice administrator, OR director (RN), OR scheduling administrative assistant, one MD anesthesiologist (1), one resident physician (MD), and QA representative. The operating room consists of 3 rooms, running about 4300 cases per year.
The committee is tasked with creating policy (e.g. OR start time, block time), determining metrics to follow (e.g. turnaround time, complications, utilization), and advising on capital spending (new equipment). We encourage frank, collegial discussion and egos are left at the door. The process began with the basics, developing goals for the committee, agendas for meetings, reporting, and so on. It took about 3 meetings before we were satisfied with the organizational structure and it has been successful in improving OR performance and patient and surgeon satisfaction. It remains a work in progress, though.
In our tertiary care setting, each visit typically includes one or more specific tests before the patients are seen. The problem is that while the MD can order these tests when a follow-up visit is planned, the patients do not know what tests they might need and legally cannot order or schedule tests themselves.
The person in question is resistant to change and believes that our role/prominence as a tertiary care organization should cause the patients to come to us solely for that reason. Our goal is to build bridges to community physicians and educating them about our research and clinical capabilities. Convincing the division director to proceed along these lines remains frustrating, but the group’s suggestions are very helpful. Thanks to everyone for your comments.
Bottlenecks in care are frustrating for patients. Staff can be used to identify and rectify them, which improves efficiency and patient experience simultaneously.
We have a standing “Operating Room Committee” composed of physicians, nurses, and administrators that sets rules, priorities and metrics. The consensus decision process incorporates the stakeholders and the execution team.
Although it may eventually become necessary or advantageous to merge, I might hold off on a decision pending the fate of federal health care legislation currently under negotiation. Large “healthy” organizations may not be quite as healthy afterwards or others may emerge that are better able to adapt.