Addressing Staff Burnout in ORs Through Improved Efficiency
By Matt Phillion
According to new data from health technology company Proximie, 80% of senior operating room (OR) staff report daily or weekly late finishes due to inefficient scheduling and overrunning procedures. Nearly three-quarters (73%) say they’ve lost team members in the past two years because of pressure and poor work-life balance. We know hospital staff are burning out, and the numbers show that inefficiencies in the OR are a key reason for it.
It’s not just a work satisfaction or efficiency issue, either: U.S. hospital staffing levels are still 10.5% below pre-pandemic levels, and that makes it a safety issue as well. The list of challenges is extensive: OR delays and staff turnover leads to longer wait times, more canceled procedures, and lowering patient conditions.
“Our inability as an industry to act on the data that hospitals have means we’re almost shooting in the dark,” says Dr. Nadine Hachach-Haram, CEO and founder of Proximie. “It’s really hard to understand what areas we can optimize to reduce burnout and improve morale.”
The report was informed by 100 OR leaders in the U.S. and U.K. to get a more global perspective of the challenges before them.
“The inefficiencies we see in the OR—it’s not just common, it’s systemic,” she says.
The industry already faces a massive challenge with the number of surgical cancelations occurring, 7.2 million cancelations in the U.S. alone costing $32 billion.
“When we surveyed these respondents about methods needed to reduce time wasted, they said that 30% of OR staff spend time fixing preventable issues: scheduling, equipment failure, calling to check if the recovery bed is ready,” says Hachach-Haram.
These are all processes that are incredibly manual but could be automated, she notes.
“Seventy percent of responders said that real-time data collection would improve workflow,” Hachach-Haram says. “They also want to not rely on outdated manual systems.”
This is an opportunity for both technical innovation and improved employee satisfaction can overlap, she explains.
“When we talk about workflow or staff burnout, these don’t just cost time, they cost people. When staff are experiencing late finishes, over-running cases, poor scheduling, 70% of leaders lost team members because of this, exacerbating an already big workforce challenge,” says Hachach-Haram.
We need to take a step back and look at the complete picture, Hachach-Haram says.
“A lot of teams are stretched thin, constantly troubleshooting, and this impacts morale, communication, team cohesion. Staff leaving has a domino effect,” she says. “If we’re able to bring in systems that automate tasks and reduce friction, it has an impact. These staff want to drive excellent care and deliver excellent care, but they also want to get home on time. They want to operate at the top of their license but also have a work-life balance. That’s what came to bear from the report.”
A more detailed view
Proximie partnered with a specific health system to take a deeper, more granular look at both the problem of OR burnout, and potential solutions.
“We’re incredibly grateful to the system that partnered with us,” says Hachach-Haram. “They have 60 operating rooms, and we were able to analyze about 700 hours of OR footage, and 10,000 data points to identify inefficiencies.”
What they found was that significant time was lost due to preventable issues. This can lead to inconsistent turnover preparation, late finishes, frustrated staff, and inefficient workflows.
“It goes up the chain to leadership,” she says. “What we then found as we analyzed this data was we could provide real-time insights to streamline workflows, which can lead to a 24% opportunity to improve efficiency.”
By improving efficiency, Hachach-Haram says, they found they could open the door for 9,000 more surgeries across those 60 ORs, to the tune of $90 million in revenue.
“They were also finishing on time, cases were getting done, and staff were getting home. It was a double positive,” Hachach-Haram says. “You’re both the benefit of more revenue for the system but also enhancing and improving the environment for teams on the ground.”
One specific efficiency increase was automating documentation, so nurses didn’t have to type out basic details like the time the case started and the time it finished.
“With 30% of their time doing administrative tasks, if you can take those tasks off them, they can be practicing at the top of their license. You have happier staff, which leads to more retention and more cases,” says Hachach-Haram.
Change can be tough in healthcare, particularly when it comes to technology, Hachach-Haram notes.
“Culturally, surgery has been built on tradition and hierarchy,” she says. “You can feel these systems are slow to change but if you’re able to immediately demonstrate value it’s easier to win the adoption of the technology.”
Like the administrative tasks of documentation.
“If you are able to walk into an OR and say to a nurse, we can take all that data input off of you, that already gets you in the door,” says Hachach-Haram. “I’m very passionate about end user design in our implementation. We work very closely with frontliners to define problems and work toward a solution.”
It’s important to not simply add tech for tech’s sake, Hachach-Haram explains. Tech has a roll in all of this but never stray too far from the impact it has on those professionals on the front lines of care.
“Start with the low-hanging fruit like manual data entry. It reduces unnecessary stress,” says Hachach-Haram. “We’re capturing this data so we can track the different phases of the case, the steps, and then automate notifications to the appropriate ward or recover or PACU.”
Sixty-one percent of U.K. nurses reported they are too busy to provide the level of care they want to provide. How can organizations help them improve that number?
“When we started, it was working through collaboration to be able to drive efficiency. But once we’re in, let’s see what else we can do to help,” says Hachach-Haram. “We can help you collate all the siloed data you have in your OR. You’ve got data on cameras, in the record, petabytes of data every day but nobody is making anything of it. We can now collect that data to drive insights on performance. Help you with op notes and coding, with automation for follow-up appointments. And all that automation means you’re optimizing your workflow and doing this in environments where it’s hard to staff.”
This is just scratching the surface, Hachach-Haram says.
“What does the future of a smart, intelligent OR look like? A real-time, data-driven OR with a copilot calling up the latest imaging or notes discussing what you need. It’s all about that pattern recognition,” says Hachach-Haram.
The uniqueness of ORs
ORs are a hugely expensive asset to a hospital, considering the real estate they take up, the staffing they require, the expertise, the equipment, and the lives of the patients themselves.
“It’s also a uniquely data-rich environment,” says Hachach-Haram. “But we don’t really capture much of it. Historically there’s an op note at the end of surgery, but those hours of an operation are gone. It’s almost a blank space we’re not really using.”
Meanwhile, ORs are also a huge revenue driver.
“We saw this during COVID when operations stopped. Organizations went into the red,” she says. “Hospitals are very mission-driven, have highly skilled staff, are team-based, and deliver high-stakes care to patients, but there are 5 billion people around the world who lack access to surgery. It’s a space that is ripe for innovation.”
However, it’s not an easy space to innovate in, she notes, and requires a systematic approach that offers a difference in how processes are automated, staff are trained, and quality is enhanced.
“The OR is a very complex environment with multiple stakeholders,” says Hachach-Haram.
Different point solutions try to solve individual problems, but there is a need for a systematic solution that addresses the workforce, productivity, quality, and safety.
“Surgical challenges are global,” says Hachach-Haram. “They look and feel the same across the world. We want to address those needs everywhere.”
Matt Phillion is a freelance writer covering healthcare, cybersecurity, and more. He can be reached at matthew.phillion@gmail.com.