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Improving organizational operations in the OR



A medium-sized hospital in the Netherlands has operating room complexes in three different locations. The hospital’s ambition was to professionalize its organizational operations in the operating rooms (OR). The main issue was lack of insight. It was unclear how efficient the hospital's performance was.

On the one hand, there was no evidence to check whether time and resources were used efficiently. On the other hand, the cooperation between the different doctors, surgeons and specialists was not yet optimal. The board asked IG&H to help the OR-organization to get in-depth insights into the most important key performance indicators (KPIs) and provide a vision on where and how to improve.

The hospital board and OR management could not evaluate OR performance relating to the most important KPIs. For instance, in a location with eight ORs, the hospital did not have enough insight into what was happening where and for how long. In the day-to-day, this translated into questions such as:


  • Is the schedule starting too late?

  • Are procedures finished too early, leading to lost time?

  • What role does this play in relating to KPIs?

  • How do we best leverage the time of specialists?

Quantifying within context IG&H, together with the OR management, created insight into several important KPIs. For many medical specialists and employees, this was the first time they got to know and talk about their performance on important KPIs like occupation and utilization.

We looked at the numbers together with the staff, taking a deep dive to understand if performance was reflected correctly. In the end, transparency was the most important item that increased. People were energized because the conversation shifted from dwelling on misaligned schedules or missed opportunities to a more proactive How we can improve?

Improved conversations, job satisfaction and margin

Thanks to a more transparent atmosphere and setting up rules to ‘play the game’ better, staff were having very different conversations with one another. Across roles and disciplines, the organization now had the tools to have a productive conversation. IG&H started ‘experimenting’ together with the hospital by exploring how to utilize OR time better, such as through multi-disciplinary teams. Next to this, we guided the OR-leadership team together with the medical management in creating an open dialogue to discuss the improvement areas.

With the insights and the improved atmosphere, we were able to jointly optimize the OR processes step-by-step. The new way of working positively affected employee satisfaction, as old disagreements were finally expressed and resolved. A major mindset change involved the staff becoming open to trying new approaches. The hospital was now empowered to measure performance before, make small adjustments and then measure it again afterward to see whether there were efficiency improvements. Essentially, this understanding helped the organization tap into a fluent and efficient way of working.

To secure the new way of working we taught the teams our continuous improvement methods, which are still used today. A more collaborative atmosphere in the OR led to healthier and strengthened relationships between the departments and employees. In addition to increased transparency, the utilization rate of the different OR-locations has increased by 2%, resulting in a recurring margin improvement of half a million euros per year.

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