long cases together and short cases together. For example, we sched-
ule all of our short cases for Monday afternoon because we know
we're going to be able to flip them.
Hybrid room flips. You can use different types of room flipping
for different situations. When available, a full team can flip in a
new room. If a second anesthesia provider is not available, a full sec-
ond team of facility staff may set up in a new room with the anes-
thetist flipping along with the surgeon. Finally, if the case duration is
longer or staff are not available, you can use a partial room flip where
just one staff member sets up a new room while the procedure is going
on in the first.
Staff mentality. The most important part of our success has
been a mindset shift amongst our staff. Staff used to go home
early if they were lucky enough to get a short room, while their
unhappy co-workers had to finish out a long night in the OR. While
this worked out great for staff when they had the short room, nobody
liked the days they had the long rooms. Our protocols changed to
keep staff in the facility to flip cases in the late room once the early
rooms finish. This helped us transition from a me-first mentality
where some staff had easy days and some had incredibly hard ones,
to a team-first mentality where everyone works together so that
nobody has to have a terrible day. Over the course of 2 years, the
number of ORs running past 5 p.m. fell from 26% to 9%.
Why'd we wait so long?
It's been 2 years since we started room flipping. It has let our sur-
geons do more cases, but to do so within the hours that we could pro-
vide staff. We dramatically increased our daytime block utilization
5
4
A P R I L 2 0 1 7 • O U T PA T I E N TS U R G E R Y. N E T • 2 5
