Monday, October 5, 2009
7:00-8:00 AM	Registration and Continental Breakfast
8:00-8:15 AM	Welcome and Overview
	Eugene Litvak, PhD
	This session will introduce attendees to the objectives of this Reengineering the Operating Room seminar.
8:15-8:30 AM	Introductions and Community Building
	Eugene Litvak, PhD
	During this session, attendees will share problems they have faced while running the operating room and managing surgical patient flow.
	Objective: Summarize problems that arise when managing the operating room
8:30-9:45 AM	Operations Management and Variability Methodology Overview
	Eugene Litvak, PhD
	The tools of operations management and variability methodology enable staff to significantly improve quality of care and patient throughput. This session will provide attendees with a brief overview of operations management and variability methodology.  Attendees will learn why reengineering the operating room is a key factor in improving hospital-wide efficiency and quality.
	Objectives: Describe operations management and variability concepts Understand why reengineering the operating room is a key factor in improving hospital-wide efficiency and quality
9:45-10:15 AM	Break
10:15-11:00 AM	Assessing Patient Flow and Hospital Operations
	Brad Prenney, MS,MPA
	During this session, faculty will present the steps required to conduct a hospital-wide patient flow assessment, explain the rationale for this system-wide evaluation, and introduce the key factors to consider when undertaking an improvement project of this scale. Faculty will also discuss how the interdependency of the operating room and other service areas create ripple effects felt throughout the hospital.
	Objectives: Explain the steps required to conduct a hospital-wide patient flow assessment Understand the rationale for a system-wide evaluation Identify factors to consider when undertaking improvement projects
11:00-12:30 PM	Variability in the Operating Room and Design Overview
	Michael Long, MD
	During this session, faculty will examine common organizational structures in the operating room that lead to multiple types of variability, affecting the delivery of care in the operating room and beyond. This session will also examine strategies, both past and present, for managing different types of variability in the operating room.
	Objectives: Identify common organizational structures in the operating room that lead to variability Classify types of variability existing in the operating room Describe an approach for managing multiple types of variability in the operating room Introduce OR design principles and three-phases of redesign
12:30-1:30 PM	Lunch
1:30-2:00 PM	Phase I: Reengineering the Operating Room to Improve Efficiency and Quality of Care Michael Long, MD, Eugene Litvak, PhD During this session, faculty will provide and discuss in detail Phase I of an actual OR redesign, that will help attendees create their own plan to manage variability in their operating rooms to increase efficiency and improve patient care. Faculty will also discuss obstacles commonly faced by hospital staff during a redesign. Objectives: Create a plan to eliminate variability in your hospital’s operating room Describe common obstacles faced during operating room redesigns, and explain how to overcome these obstacles
2:00–2:30 PM	Queuing Theory: The Basics Eugene Litvak, PhD
	During this session, faculty will introduce the group to the Queuing Theory as a means for managing patient demand within a fixed capacity environment.
	Objective: Obtain knowledge of the Queuing Theory
2:30–3:00 PM	Break
3:00–3:30 PM	Interactive Queuing Exercise Eugene Litvak, PhD (with participation from other faculty) A queuing activity will help drive the learning in this session. Participants will be provided with a small data set with multiple scenarios and queuing analyses for each scenario. Participants will be asked to assess the various queuing analyses and choose models to implement. Faculty will be available to help throughout the exercise. Objective: Ability to determine the number of unscheduled rooms and examine trade offs in wait time, utilization, etc.
3:30-4:00 PM	Exercise Debrief Eugene Litvak, PhD (with participation from other faculty) Following the exercise, everyone will reconvene to discuss results and speed bumps in the process. Questions about queuing, queuing outputs and tradeoffs involved in the design will be addressed.
	Objective: Understand queuing principles, outputs, and tradeoffs involve in the design.
4:00–4:30 PM	Phase I: Improvements at Cincinnati Children’s Hospital Medical Center (CCHMC-MVP Case Study) Frederick Ryckman, MD
	Participants will explore a case study about how Cincinnati Children’s Hospital Medical Center achieved such positive results through Phase I of OR Redesign. Challenges and best practices will be discussed during this session.
	Objectives: Understand how CCHMC was able to apply the principles of Phase I redesign and how the outcomes have impacted their work. Provide a real life example of how OR redesign can be transformational for a hospital.
4:30-5:00	Phase I: Operating Room Improvements at Boston Medical Center (BMC-MVP Case Study) John Chessare, MD, MPH Participants will explore a case study about how Boston Medical Center worked to eliminate variability in its OR.  Obstacles encountered during Phase I redesign will be discussed, as well as BMC’s strategies for overcoming those obstacles in order to increase their throughput and results. Objectives: Understand how BMC was able to apply the principles of Phase I redesign and how the outcomes have impacted their work since then. Provide a real life example of how OR redesign can be transformational for a hospital.

5:00-5:30 PM	Summary and Q&A
5:30-6:30 PM	Cocktail Networking Reception

Tuesday, October 6, 2009
7:00-8:00 AM	Registration and Continental Breakfast
8:00–8:45 AM	Phases 1: Implementation and Challenges Sandeep Green Vaswani, MBA
	Several details of Phase I operating room redesign will be discussed in this session: incorporation of work-ins, block utilization and re-allocation, and examples of practice changes required of various staff groups. Attendees will learn about typical implementation challenges and strategies to prepare for and address these challenges.
	Objectives: Highlight key implementation steps and challenges. Learn how some hospitals have addressed these challenges.
8:45–9:30 AM	Phase II & III: Reengineering the Operating Room to Improve Efficiency and Quality of Care
	Michael Long, MD
	During this session, faculty will provide and discuss in detail Phases II and III of an actual OR redesign, that will help attendees create their own plan to manage variability in their operating rooms to increase efficiency and improve patient care. Faculty will also discuss obstacles commonly faced by hospital staff during a redesign.
	Objectives: Create a plan to eliminate variability in your hospital’s operating room Describe common obstacles faced during operating room redesigns, and explain how to overcome these obstacles
9:30-10:00 AM	Break
10:00–10:30 AM	Phase II: Operating Room Improvements at Cincinnati Children’s Hospital Medical Center (CCHMC-MVP Case Study)
	Frederick Ryckman, MD
	Now that participants have an understanding of Phase I OR redesign, and know how CCHMC was able to implement this in their organization, they will continue to explore CCHMC’s experience and learn about its Phase II OR improvements. Objectives: Provide a real life example of how Phase II of OR redesign was implemented at CCHMC.
10:30-11:00 AM	Phase II: Operating Room Improvements at Boston Medical Center (BMC-MVP Case Study)
	John Chessare, MD, MPH
	Participants will explore a case study about how Boston Medical Center redesigned flow by reducing artificial variability in surgical scheduling during Phase II of OR redesign.
	Objective: Describe the effects surgical scheduling has on artificial variability and flow.
11:00-11:15 AM	Leadership discussion
	Frederick Ryckman, MD and John Chessare, MD
11:15-12:00 PM	Perioperative Improvements and Link to Variability
	Marilyn Rudolph, RN, BSN, MBA
	During this session, faculty will present the key factors in managing perioperative variability and improving patient flow.  Perioperative improvements will be identified and their relationship to variability discussed.
	Objectives: Describe key considerations to help manage perioperative variability and improve patient flow Identify perioperative improvements and their relationship to variability
12:00-1:00 PM	Lunch
1:00-2:00PM	Measuring Operating Room Improvement and Return on Investment
	Eugene Litvak, PhD and Adam Rutenberg, MBA, MA
	Now that you’ve learned how to reengineer your operating room and streamline patient flow, how do you predict the cost reduction and quality improvements that will result? This session will describe how to measure resulting financial and quality improvements and will help you to understand the total return on the investment associated with your operating room redesign. Participants who complete a brief list of data items needed to estimate financial benefit from one part of OR redesign implementation will have their data analyzed during this interactive session, which will create great shared learning opportunities.
	Objectives: Understand the type of data you need to measure your improvement. Use the data you’ve collected to predict what type of financial and quality results you should anticipate
2:00-3:00 PM	Challenges to Implementation & Q&A
	Faculty Panel
	This session touches on the technical, political and process-related challenges hospitals face while implementing improvements in their operating room.
	Objective: Identify the technical, political, and process-related challenges hospitals face while redesigning their operating room
3:00 PM	Adjourn