Data driven decision making in the OR

With rising healthcare costs and staff burnout, healthcare providers are increasingly motivated to find innovative solutions to improve operating room efficiency and financial performance. But without sufficient data, deciding what solutions to implement can quickly become a matter of feelings and alliances, leading to hospital politics and further strain on resources. Data-driven decision-making (1) in healthcare is essential to align stakeholders and achieve operational excellence.


With operating rooms (ORs) representing 33% (2) of total hospital costs, they offer one of the greatest potential areas of improvement when it comes to both finances and burden on the team. Solutions to improve operational excellence in the operating room can generate financial savings that impact the entire hospital ecosystem. A top-down approach is rarely the most effective to identify improvements because no two operating room environments, processes, or surgeons are the same. Solutions created for larger systems often fail to serve the unique needs of operating rooms in smaller hospitals or Ambulatory Surgery Centers (ASCs). Gathering and analyzing the proper data can help identify the best workflows and infrastructure that will meet the needs of each environment and optimize OR performance (3).


When it comes to improving processes and financial performance, surgeons, OR managers, and CEOs share the same goals, but often have differing opinions on how to achieve those goals. Surgeons, nurses, and OR managers are often in a unique place to observe and suggest potential solutions to improve efficiency. But testing new changes to process, staff allocation, materials, new equipment, or case mix can be a costly and time-consuming process. Hospital managers must balance the desire to empower their team’s ideas with the need to justify committing resources. And in an environment already tapped for time, OR team members rarely have the capacity to gather the necessary data to create a comprehensive and compelling business case for their potential solution. Without the proper data, final decisions come down to gut feelings, resulting in complicated stakeholder politics and unnecessary stress on decision-makers if the solutions do not work as expected. 

Surgical data science (4) is leading the way in guiding these healthcare industry advancements. Process digital twins offer an innovative way for teams to simulate the impact of potential changes in workflows before implementing these scenarios. By capturing data from several surgeries over a number of days, collects data specific to individual operating rooms. This granular data can then be used to create a digital model of the processes, work allocation, equipment used, and other factors of a particular operating room. This operating room process digital twin serves as a sandbox for healthcare providers to virtually test hypotheses and potential solutions. The resulting projections from these simulations output hard data that can provide a foundation for conversation between team members to fully weigh the advantages and disadvantages of each scenario before adopting and implementing the solution in the real world. Using an activity-based costing model, the team can use the information from the process digital twin simulations to also determine financial impact if they were to implement these scenarios. The resulting data empowers conversations in which stakeholders can align on the best data-driven solutions to create a plan based on facts, not feelings.


An example of this can be observed in the peer-reviewed article Perioperative Operating Room Efficiency Can Make Simultaneous Bilateral Total Hip Arthroplasty Cost-effective: A Proposal for a Value-sharing Model (5), published in the Journal of Arthroplasty (6). This article shares the results of a study where partnered with Professor Kristoff Corten (7) to evaluate two different workflows’ time, cost, and revenue implications using a process digital twin simulation. This provided the hospital and surgeon with a clear understanding of the impacts of bilateral total hip arthroplasty, compared with two separate serial surgeries, demonstrating the effectiveness of one over the other. By comparing the cost-effectiveness and quality of the approach, the data gathered helped build a compelling business case and align stakeholders. 

Seeing the potential to both improve the patient experience and the overall financial performance of the hospital, Professor Corten worked with to simulate a process digital twin to study the two approaches. The resulting data showed that a serial bilateral procedure offered the following benefits:

  • A total time savings of 18% per case
  • A total cost savings of 14% per case
  • An annual time savings of 5 days per year, providing an opportunity to add additional cases
  • No effect on patient safety

In summary, the resulting data showed a serial bilateral procedure was faster, more cost effective, and efficient without sacrificing the quality of care. Finally, Professor Corten had the data to align stakeholders on the benefits of this new approach. The resulting numbers also sparked further conversations on how to appropriately incentivize efficiency and prevent further delays in implementing efficiency solutions.


While process digital twins offer a safe way to test hypotheses, the impacts of an operating room digital twin extend beyond these initial implementations. Once the twin has been set up, it creates an opportunity to identify additional areas for growth. As a leader in analyzing operating room efficiency, has amassed a library of data from operating rooms across the globe that provides a comparison model and insight into solutions that have helped other similar operating rooms achieve operational excellence. This data is grounded in established principles of operational excellence that can be tailored to the unique needs of your operating room. Our medical engineers work with your team to walk them through all the potential areas for growth and identify the best areas to start. Further measurements after implementation can provide evidence if the simulation was successful, and insight into future modifications to continuously improve efficiency. 


A data-driven approach allows healthcare providers to achieve their objectives and support better decision-making. Process digital twin technology coupled with virtual simulations empowers healthcare teams to tailor solutions to specific situations and environments while reducing the need for trial and error. This data-driven approach allows for alignment between stakeholders on the best options to increase process efficiency, team ergonomics, patient experience, and financial performance in the operating room, ultimately supporting the quadruple aim.  

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