For a new facility, once you have a reasonably accurate list of anticipat-
ed cases, you can create a ramp-up schedule (see the sample on the fac-
ing page) where you start small — opening partial rooms a few days per
week — until you "ramp up" to a full capacity when the maximum num-
ber of rooms are opened on the maximum number of days.
Base block times on data, not tradition. Once you've taken a
closer look at your scheduling blocks, you'll likely want to rework
them. This is particularly challenging for established facilities where
doctors aren't going to want to hear about losing time. Look, we all
know certain physicians who have delusions of grandeur, so you must
use tact and diplomacy when scaling back scheduled block times. It's a
tough balancing act. You want to accommodate your surgeons as much
as possible while at the same time not letting them keep those giant
blocks if they don't sufficiently fill them.
Surgeons who run over their block time are also a problem. It's not
uncommon for surgeons' offices to book a 20-minute knee
arthroscopy that actually takes 45 minutes so they can book more
procedures. One caveat: Some physicians may argue they're not in the
room the entire time. Be clear that it doesn't matter who's in the
room; it's still the physician's patient, and as a facility, we can't gener-
ate revenue until everyone is out of the room.
Set clear expectations
If you want to run an efficient surgical facility, you need to make sure
everyone understands exactly what's expected of them schedule-wise.
If you schedule add-on cases before the normal starting time and an
anesthesiologist gives some push back about early start times, don't
be afraid to say, "Your contract clearly states you're to be 'available
4
Staffing
S
2 0 • O U T PA T I E N T S U R G E R Y M A G A Z I N E • S E P T E M B E R 2 0 1 9