AI brings more time, less burnout to the OR

At WakeMed Health and Hospitals, a 919-bed teaching health system serving the Raleigh, NC region, time is of the essence. With a number of emergency centers and a wide range of adult and pediatric specialty services on offer, the operating rooms (OR) across the system are in high demand, and limited availability must be used efficiently. 

However, like with most health systems, WakeMed was experiencing some issues with maximizing its OR time, explained Chief Medical Officer Charles Harr, MD, MBA, in a recent invitation-only media roundtable hosted by LeanTaaS. Scheduling blocks in the critical “blue time” hours during the day were going unused, and surgeons had trouble finding slots that fit with their office hours and patient needs, he explained. 

“When I came here as CMO, I had some younger surgeons complaining to me that their more senior colleagues weren’t starting their cases until 9 or 10 in the morning,” he said. “They were having some office politics issues with scheduling surgeries earlier in case they caused delays for the more senior staff.”   

“The newer folks may have only had one or two cases, but they were having to stay around until the end of the day with big gaps in their schedules.  It had the potential to cause a lot of issues that contribute to things like burnout.” 

The challenges were compounded in October of 2023 when WakeMed switched to a new anesthesia services provider. Financial and contracting issues surrounding the move led to significant reductions in room capacity. 

“We went from about 21 OR rooms open a day to around 13 or 14,” said Harr. “We can’t afford to let any time in those rooms go to waste, and we can’t afford to waste any of the time we have with our new anesthesiologists. They aren’t just important to the traditional OR environment: we’re doing more and more procedures with anesthesia in other settings, such as the catheterization lab, the endoscopy suite, and the ICU. We have a children’s hospital, too, where they often require sedation during MRIs and other testing.”   

“We started looking at ways we could tell the story of where our time was going and make sure we were being as efficient as possible for both our surgical staff and our patients so we could avoid choke points throughout the day.” 

WakeMed decided to bring artificial intelligence into the equation, allowing surgeons at the health system to gain more visibility into the OR schedule, choose times that worked best for their needs, get more accurate estimates of case completion time, and reduce frustrations with colleagues. 

“It’s been very empowering for the surgeons since we started putting the numbers in front of the surgeons and showing them how they could manage their time better,” Harr noted. “In the past, they often felt like they were asking ‘pretty please’ of the schedulers to see if they could fit in a patient or get a time they wanted. That can lead to those power imbalances based on seniority or between specialties, which we don’t want to see.”   

“With more control and visibility, those negative dynamics are gone. The people who have started using the tool are getting their cases done and going home early – that’s really been motivating to those who are somewhat more reluctant to start using technologies.” 

The results have been as positive for patients as for the rest of the WakeMed team.   

“Our on-time starts have increased from 70% on average to 92%, which obviously has benefits across the board.  Patients are even more unhappy with delays than the surgical teams, so anything we can do to avoid that is a good thing,” said Harr.   

“By optimizing our scheduling, we’ve actually increased overall capacity by 22%, or an additional 60 hours of time per work week. That’s like opening six extra rooms during the primetime hours during the day.  In addition, we’ve been able to increase volume among our employed and independent physicians by 11.5% between 2018 and 2021. Obviously, everything changed during the pandemic, but that’s a valuable gain that we can build on in the future.” 

Harr believes that AI is already playing a crucial role in helping health systems manage operational challenges and meet the needs of both patients and staff in a complicated financial environment. 

“There’s no getting around the fact that time is money in any hospital ecosystem,” he said.  “We’ve got more of both things now that we’re using AI to optimize how we manage our scheduling.  If we can use artificial intelligence to get more cases completed while making sure our surgeons and staff are less tired, less stressed, and get home predictably, it seems like a no-brainer to me.”   

Jennifer Bresnick is a journalist and freelance content creator with a decade of experience in the health IT industry.  Her work has focused on leveraging innovative technology tools to create value, improve health equity, and achieve the promises of the learning health system.  She can be reached at jennifer@inklesscreative.com.