Optimizing the flow of a surgical patient through the operating room helps ensure the greatest value in the care of that patient. To achieve this optimized flow, the resources needed to provide care through the entire episode of care need to be coordinated. Coordinating these varied and often disintegrated resources is often nearly impossible without the dedicated time of multiple FTEs to manage the schedules and resources of the different segments of care. The starting point for the flow of a surgical patient is their placement on the operating room schedule. SureSELECT surveys and assesses all the resources needed for a specific patient’s care and provides the optimized placement on the operating room schedule to achieve optimal flow. Proprietary algorithms assure that all resources are available “just-in-time” throughout the patient’s care.

2. INTRODUCTION
 Variability management and improved patient flow through
surgery episode of care promises operational performance
improvement
 We demonstrated the improvement potential at MCF with
our MVP project (see Mayo Clinic Case Study)
 These improvements were very difficult to achieve and
sustain
 SureSELECT is proprietary software enabling a hospital to
execute variability and patient flow management strategies
through the entire episode of care for a surgical patient

3. END-TO-END PATIENT FLOW
 SureSELECT integrates the entire episode of
hospital care for a surgical patient
 Particularly suited to hospitals using variability
management and patient flow optimization
 Full implementation optimizes end-to-end
(admission to discharge

4. OPTIMIZED SURGERY CASE SCHEDULING
 The starting point for effecting optimized patient flow
is the decision about where and when to schedule a
surgical case
 SureSELECT allows the surgical team to make that
choice from a list of Optimized scheduling options
 By filling in a few basic details in three successive
windows, SureSELECT will interrogate all of the
resources needed for the entire episode of care and
present to surgical team all available places to
schedule a case

5. OPTIMIZED SURGERY CASE SCHEDULING
 Select patient and
case type

6. OPTIMIZED SURGERY CASE SCHEDULING
 SureSELECT will
auto select surgeon
and department
based on the
logged in user. The
department and
surgeon can be
overridden.
 Select procedure
from surgeon
specific preference
list.
 Enter case specific
estimated cut to
close times.

7. OPTIMIZED SURGERY CASE SCHEDULING
 Select search
range to get
available options
 Select from one
of the prioritize
optimize options
 A preview of
projected future
hospital resource
utilization is
available with just
a click of the
mouse
Options presented are customized to
the Hospital’s operational priorities
and resource availability

8. OPTIMIZED SURGERY CASE SCHEDULING
 A preview of the
surgeon and
operating room
calendar for the
day is presented.
Click Book It to
confirm booking.

9. CALENDAR INTEGRATION
 Fully integrates surgeon overall schedule(s) including travel, vacation and nonclinical work (Clinic Template, OR Appointment Book, Outlook calendar)
 Options for placement of a case on OR schedule considers surgeon overall
schedule
Surgeon
Landmann,
Landmann,
Landmann,
Landmann,
Landmann,
Landmann,
Landmann,
Landmann,
Landmann,
Room
Ron (M.D.)
Ron (M.D.)
Ron (M.D.)
Ron (M.D.) OR 408 4th Floor Surgery
Ron (M.D.)
Ron (M.D.)
Ron (M.D.) OR 408 4th Floor Surgery
Ron (M.D.)
Ron (M.D.)
Event Type
Unavailable
Clinic
Admin
Block Assignment
Admin
Clinic
Block Assignment
Clinic
Unavailable
Description
Unavailable
Clinic Duty
Admin Time
Block Assignment
Admin Time
Clinic Duty
Block Assignment
Clinic Duty
Unavailable
Week Type
Week All
Week All
Week All
Week All
Week All
Week All
Week All
Week All
Week All
Day of Week
Monday
Monday
Monday
Tuesday
Wednesday
Wednesday
Thursday
Friday
Friday
Start Time
7:00
13:30
15:30
7:00
7:00
10:00
7:00
10:00
14:00
End Time
8:30
15:30
17:00
19:00
10:00
17:00
17:00
12:00
17:00
Starting Day
11/15/2013
11/15/2013
11/15/2013
11/15/2013
11/15/2013
11/15/2013
11/15/2013
11/15/2013
11/15/2013
Ending Day
11/30/2013
11/30/2013
11/30/2013
11/30/2013
11/30/2013
11/30/2013
11/30/2013
11/30/2013
11/30/2013

10. CALENDAR INTEGRATION
 Changes to non-OR calendar automatically identifies cases that need to be
moved and presents these in a “Reschedule Bin” where they can be easily run
through the Case Scheduling module

11. CALENDAR INTEGRATION
 Vacated OR Block immediately reassigned and available based on Block
Reassignment rules
Days Before
Starting Day
Ending Day
Physician
Block Release Type
OR 408 4th Floor Surgery
Room
Landmann, Ron (M.D.)
Surgeon
Bowers, Steven (M.D.)
Release To
5
11/15/2013
12/31/2013
Department
OR 408 4th Floor Surgery
Landmann, Ron (M.D.)
General Surgery
2
11/15/2013
12/31/2013
Swing Room
OR 408 4th Floor Surgery
Landmann, Ron (M.D.)
ALL
1
11/15/2013
12/31/2013
Physician
OR 405 4th Floor Surgery
Bowers, Steven (M.D.)
Landmann, Ron (M.D.)
5
11/15/2013
12/31/2013
Department
OR 405 4th Floor Surgery
Bowers, Steven (M.D.)
General Surgery
2
11/15/2013
12/31/2013
Swing Room
OR 405 4th Floor Surgery
Bowers, Steven (M.D.)
ALL
1
11/15/2013
12/31/2013
Physician
OR 105 1st Floor Surgery
Bowers, Steven (M.D.)
Landmann, Ron (M.D.)
5
11/15/2013
12/31/2013
Department
OR 105 1st Floor Surgery
Bowers, Steven (M.D.)
General Surgery
2
11/15/2013
12/31/2013
Swing Room
OR 105 1st Floor Surgery
Bowers, Steven (M.D.)
ALL
1
11/15/2013
12/31/2013

12. CALENDAR INTEGRATION
 All events delivered to MS Outlook

13. OPERATING ROOM RESOURCE MANAGEMENT
 All resources needed in Operating Room for a particular case are interrogated
to assure no conflict on day of case

14. OPERATING ROOM RESOURCE MANAGEMENT
 Operation Room options and limited availability equipment

15. OPERATING ROOM RESOURCE MANAGEMENT
 Post OR Hospital Resources

16. OPERATING ROOM RESOURCE MANAGEMENT
 Uploaded Surgical schedule for any day can be analyzed and conflicts found
days in advance allowing rescheduling or acquiring additional resources well in
advance
Conflict
Description
Mastectomy
Total SLNB
Dissection
Axillary Nodes
Mastectomy
Total SLNB
Surgeon Conflict
Dissection
Axillary Nodes
Surgeon Conflict
Room Conflict
LINX Procedure
Surgeon
Room
Start Time
End Time
Duratio
n
Resource
Description
Conflict Start
Time
Conflict End
Time
Conflict
Duration
McLaughlin,
Sarah (M.D.)
OR 103 1st
Floor Surgery
11/19/13 7:30 11/19/13 20:00
750
Breast Biopsy or
McLaughlin,
Lumpectomy w/ Seed
Sarah (M.D.)
Localization SLNB Poss A
11/19/13 9:30
11/19/13 10:30
60
McLaughlin,
Sarah (M.D.)
OR 103 1st
Floor Surgery
11/19/13 7:30 11/19/13 20:00
750
Breast Biopsy or
McLaughlin,
Lumpectomy w/ Seed
Sarah (M.D.)
Localization SLNB Poss A
11/19/13 11:15 11/19/13 12:15
60
12/5/13 8:30
90
OR 408 4th
LINX Procedure
Floor Surgery
12/5/13 7:05
5
Landmann, Ron OR 408 4th
(M.D.)
Floor Surgery
12/5/13 9:00
12/5/13 8:35

17. OPERATING ROOM RESOURCE MANAGEMENT
 Emergency Leave Booking Task-1a (Enter Dates and description)

18. OPERATING ROOM RESOURCE MANAGEMENT
 Emergency Leave
Booking Task-1b Review
Conflicts
 Emergency Leave Booking
Task-1c Review Block
Release

19. OPERATING ROOM RESOURCE MANAGEMENT
 Emergency Leave Booking Task-2 Search and reschedule affected procedures

20. HOSPITAL PREDICTIVE CENSUS AND RESOURCE MANAGEMENT
 Based on surgical
schedule, utilization of downstream
resources can be predicted
(PACU, ICU, In-Patient Bed)
 All resources needed for entire
episode of surgical care can be
anticipated and managed including
diagnosis specific equipment /
supplies / staff
 Any expected or elective admission
to hospital can included to give
more complete picture of Hospital
resource demand

21. REAL-TIME ANALYTICS AND SMART EVOLUTION
 Data related to all aspects of the path of care generates custom metrics and
dashboard(s)
 Data used to refine allocation and flow design allowing evolution toward further
optimized flow
Surgeon
Block Owner
Operation Room
Asbun, Horacio (M.D.)
Asbun, Horacio (M.D.)
Bagaria, Sanjay (M.D.)
Bagaria, Sanjay (M.D.)
Bagaria, Sanjay (M.D.)
Bagaria, Sanjay (M.D.)
Bagaria, Sanjay (M.D.)
Bagaria, Sanjay (M.D.)
Landmann, Ron (M.D.)
Bowers, Steven (M.D.)
Open Room
Open Room
Open Room
Stauffer, John (M.D.)
Open Room
Open Room
Bagaria, Sanjay (M.D.)
Open Room
Bagaria, Sanjay (M.D.)
Open Room
OR 408
OR 408
OR 105
OR 105
OR 105
OR 405
OR 105
OR 105
Procedure
4th Floor Surgery
4th Floor Surgery
1st Floor Surgery
1st Floor Surgery
1st Floor Surgery
4th Floor Surgery
1st Floor Surgery
1st Floor Surgery
Laparoscopic Whipple
Laparoscopic Whipple
Excision Mass Lower Extremity
Excision Melanoma, Lower Extremity, SLNB
Excision Melanoma, Upper Extremity, SLNB
Laparoscopic Adrenalectomy
Laparoscopic Cholecystectomy w/ Cholangiogram
Laparoscopic Hernia Repair, Umbilical
Mastectomy Total SLNB Dissection Axillary
OR 105 1st Floor Surgery Nodes
Mastectomy Total SLNB Dissection Axillary
OR 105 1st Floor Surgery Nodes
Cut to
Close
506
506
90
120
90
180
90
120
Room
Time
536
536
120
150
120
210
120
150
11/26/2013
12/3/2013
1/2/2014
12/2/2013
12/2/2013
11/25/2013
12/16/2013
12/2/2013
Cut Start
Time
7:15
7:15
7:30
10:45
16:05
8:15
8:30
13:25
Close
Time
15:41
15:41
9:00
12:45
17:35
11:15
10:00
15:25
90
120
12/2/2013
8:30
10:00
120
150
12/16/2013
10:45
12:45
Day
Example Block Compliance
Total
Procedures
Surgeon's
Block
Open Room
Other
Surgeon's
Block
Owner Percent
Asbun, Horacio (M.D.)
7
5
0
2
Bagaria, Sanjay (M.D.)
11
1
8
2
Bowers, Steven (M.D.)
30
20
8
Devine, Rick (M.D)
0
0
Landmann, Ron (M.D.)
17
McLaughlin, Sarah (M.D.)
Open Room
Percent
Other Surgeon's
Percent
71%
0%
29%
11/1/2013
1/1/2014
9%
73%
18%
11/1/2013
1/1/2014
2
67%
27%
7%
11/1/2013
1/1/2014
0
0
0%
0%
0%
11/1/2013
1/1/2014
14
0
3
82%
0%
18%
11/1/2013
1/1/2014
6
6
0
0
100%
0%
0%
11/1/2013
1/1/2014
Landmann, Ron (M.D.)
3
3
0
0
100%
0%
0%
11/1/2013
1/1/2014
Stauffer, John (M.D.)
11
6
2
3
55%
18%
27%
11/1/2013
1/1/2014
Colibaseanu, Dorin (M.D.)
7
4
0
3
57%
0%
43%
11/1/2013
1/1/2014
Merchea, Amit (M.D.)
4
2
1
1
50%
25%
25%
11/1/2013
1/1/2014
Surgeon
Starting Date
Ending
Date

22. DATA FEED AND CUSTOM BUILD
 Initial data entry and build simplified through import
templates / wizards
 Data loaded into Excel spreadsheet(s) for drag-anddrop import
 Entire system can be purged and rebuilt in minutes
 Each spreadsheet designed to include the hospital
specific flow management rules and requirement

23. SureSELECT
 Optimizes within segments of care and across entire
episode of care