How to organize surgery scheduling

Surgery scheduling is hard – learn how to organize surgery scheduling with this short guide.

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If you manage multiple surgeons, I recommend using a surgical scheduling software. I organize surgery schedules by day, by provider, by surgery center following these guidelines. 

Surgical privileges

I would look at the surgical center credentialing / surgical privileges per surgeon. On top of this, I would consider the block times my surgeon has available at each one of those surgery centers.

Example surgical privileges matrix

ASCGNYMEETHNYEE
Surgeon A Alternate Mondays, 2-4 PMAlternate Tuesdays, 08-10 AMWednesday 12-1 PM, Every Thursday 8-10 AM, Last Monday 10-1 PM
Surgeon BEvery Tuesday 11-3 PMWednesday 12-1 PM, Every Thursday 8-10 AM, Last Monday 10-1 PMAlternate Mondays, 2-4 PM
Surgeon CWednesday 12-1 PM, Every Thursday 8-10 AM, Last Monday 10-1 PMAlternate Mondays, 2-4 PMAlternate Tuesdays, 08-10 AM
Surgical privileges matrix table

Surgery Type

First, I look at major vs minor surgeries. Major surgeries are almost always inpatient surgeries. Minor procedures tend to be day surgeries / outpatient surgeries. I group and process these two types of surgeries separately.

Medical priorities

The general idea is to group surgeries according to their priority.

First, I would look at surgery priorities as indicated by the surgeons in their surgery booking orders. These procedure priorities are typically – ROUTINE or URGENT or ASAP or STAT. The priority order would be thus:

  1. STAT – highest priority, Life threatening situation. 
  2. ASAP – next highest priority, evident fast progression of disease.
  3. URGENT – next highest priority, Potential fast progression of disease.
  4. ROUTINE – 

For STAT surgeries, you might have to coordinate with your surgery center schedulers to get the patient and the surgeon scheduling outside of their designated block times. Unless a surgery is requested as STAT, surgery scheduling typically takes 2-4 weeks. This is due to the various steps involved in a surgical scheduling workflow. 

Maximum Time Before Treatment

I focus on the STAT surgeries first. My goal is to get the patient and surgeon scheduled for the surgery at the earliest (same day or next). 

In these scenarios, oftentimes ASCs will have physicians available to handle the medical + specialist clearances, can perform urgent diagnostic testing (limited), and might be able to do some laboratory tests. In addition to this, insurance carriers will typically allow submitting prior authorizations within 72 hours of the procedure (STAT).

Next, I can focus on ASAP surgeries. 

I have a bit more time for these and can submit urgent orders for prior authorization, laboratory tests, imaging tests, medications, medical clearance, specialist clearance (if needed), COVID clearance etc. However, getting all these done in a week is a herculean effort. This is where a tight referral / partner network helps. I do not give priority to patient preferences for these referrals and choose facilities / providers from my referral network instead. This helps me ensure all surgical prerequisites are finished on time.

Then, I can focus on URGENT and finally, ROUTINE surgeries. 

Patient allergies

I would typically request patients with known drug or latex allergies to be scheduled first. This is to minimize the patient’s potential exposure to any allergens.

Surgery Durations

The general idea is that within each group created, I order surgeries according to their duration by the longest processing times rule. Here, I assign the highest priority to surgeries with the longest processing time. 

NOTE: The OR / surgery center can and might change my suggested times based on their own surgery scheduling logic as well. An OR might choose to have surgeries ordered first by Shortest Processing Time or First-Come, First Serve or Least Setup Time.  

Add similar surgeries

At this point, there may be some time left in the block time allotted to my surgeon. E.g. my surgeon might have a 2 hour block time on the day I am scheduling for. Meanwhile, based on my prioritizations as mentioned, I might be left with a 30 minute time slot. In these cases, I try to fit in similar surgeries regardless of their medical / surgical priorities. This helps the OR reduce their idle time and reduce repeating the surgery setup.

Backward project planning

Surgery scheduling success is all about good project management. I prefer to do backward project planning and have achieved success even with high surgical volumes. Once the surgical cases are set up by the grouping mentioned before, they are ready for bin packing. The surgery dates are fixed. So, I start from the end goal and plan backwards for finishing the pre-requisites. I immediately place orders for prior authorization, laboratory tests, imaging tests, medications, medical clearance, specialist clearance (if needed), COVID clearance etc and assign due dates + responsible person to each such task.

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