Alvarez & Marsal

Challenge: After enjoying years of surgical volume growth, Florida Hospital Memorial System, a 250-bed community hospital, saw operating room (OR) volumes stagnate and decline by almost 20 percent in 2005. An increase in local competition had a significant impact on the hospital's finances and strategy. The health system was about to break ground on a full replacement hospital, effectively doubling surgical capacity. But its success depended on a rapid return to sustained surgical growth.

Approach: Alvarez & Marsal ImPART GROUP conducted a rigorous perioperative review, using its OR Assessment Methodology. We identified a range of problem drivers, including a decline in physician satisfaction levels; limited management role for anesthesia and physician leaders; span of control challenges and ineffective performance monitoring techniques; inflexible resource allocation policies; increased medical volume, creating bed access issues; increased breadth of surgical services, leading to increased resource segmentation; absence of rigorous staffing model; and highly inconsistent scheduling and PAT processes and results. A&M ImPART GROUP quickly focused on achieving improvements in key service levels and consistency of care markers, including start times, prime-time utilization, scheduling accuracy and consistency, and surgeon satisfaction. Working with a team of 12 surgeons and anesthesiologists to make dramatic changes in management structure and approach, responsiveness and results, we created a set of metrics, which were reported in real time, providing immediate, highly credible and actionable feedback.

Results Achieved: The hospital realized substantial improvements in surgeon satisfaction, an increase of 15 percent year-over-year in on-campus ASC volume, a return to prior levels of main OR volumes, reduction in overtime and agency usage through implementation of a rigorous staffing model and an increase in on-time starts to more than 70 percent.