SIP Intelligent Surgical Scheduling ProcessJune 16, 2004

Minutes from meeting:

The Best Practice Surgical Scheduling process is beginning to take shape. During our last meeting we made these contributions to our process:

  1. Once the decision has been made between the patient and the Physician to proceed with a surgical procedure, UWMC will follow a standardized approach (allowing for those exceptions that are appropriate) for the surgery scheduling process that will provide the maximum information possible to accurately prepare for this event.
  2. A Patient Care Coordinator will schedule all cases for the departments, both inpatient and outpatient surgical cases. The exception will be for those emergent cases that do not allow for PCC scheduling on off hours or week ends. These cases will be addressed in a different manner to be described.
  3. The Patient Care Coordinator will use a standard Surgery Worksheet, filling in all the information for the surgical case to be successful. Essential elements of the worksheet are: Accurate case type identified with the accurate preference list*, CPT and ICD9 designation. The worksheet will be faxed to the scheduling office, in addition to the PCC entering the elements necessary for ESI. This worksheet will allow the Surgical Services additional information about supplies/equipment/implants/patient preparation via physician orders that will be necessary for the patients preparation.
  4. Surgical time estimates for the case will be given by the surgeon and the definition of surgical time will be: The time from the incision to case close.

Other time elements will be entered by the scheduler, and will consist of an average of the prior 10 cases with time measured from when the patient enters the room to incision. The two times together will comprise the surgical time estimate.

Additionally we agreed to these definitions:

If a case cancels, on day of surgery or after the block has been frozen will not allow for substitution. Services will not be held accountable for this block estimate time.

Booked blocked time is automatically released by the service (returned to the OR) one hour after a case cancellation. A surgeon may move his patients to fill a gap in his/her schedule if it occurs prior to the 0730 closure time day before case is to occur.

Barring any surgical complications, a case that is more than 45 minutes over estimated incision to dressing, will be considered over time.

* When possible the department will identify the appropriate Preference list that goes with the case type identified, and this will be an automatic process.

Preference list changes should be addressed within 48 hours of request by the RN3 of the service.

Release time process

Amount of time that is allowed for releasing minutes of case time, that gives credit to the service. 10% is allowed without counting against utilization of service. Above 10% release time, on a 3 month rolling average, is considered chronic under utilized block time and reduces the utilization % by the proportion of increased release above 10%.

Case type designation:

Life/Limb Threatening – must come to the O.R. within 15 – 30 minutes

Emergent – must come to the O.R. within 30 minutes – 2 hours.

Urgent – must come to the O.R. within 2 – 12 hours

Case Time-the time a patient enters the operating room until they exit the room.

TBA-To Be Announced

OBT-Out of Block Time

SOBT-Scheduled Out of Block Time

PMBT- afternoon Block Time

We reviewed the TBA criteria that Donna Anderson gave us and accepted this document.

Next steps are listed on the agenda.

SIP1 Agenda: June 29, 2005 4pm-5:30 pm in Surgical Pavilion Conference Room

Review minutes.

  1. Preference list process. Which services can accurately attach the preference list to the case name? What will be the other process for when this will not work?
  1. Financial Clearance process. How will this affect our scheduling process?
  1. Multiple surgeon scheduling process.
  1. Complex patient scheduling process. SCCA case scheduling?
  1. Preference list change process, timing?
  1. Closure of the schedule at 48 hours?
  1. Feedback loop for the Surgeon/ PCC for scheduling estimates.
  1. Urgent / emergent case scheduling process.