How are OR managers spending their time?

By Stephen W. Earnhart, MS
Earnhart & Associates
Austin, TX

Have you ever tracked how you spend your time? While boring, it can be useful information to have.

Supply cost and personnel cost make up the majority of your expense items. I always have been a huge advocate of cutting back on staffing when and where you can. Since it often is difficult in the hectic pace of the operating room, every tool you can use to identify areas that you might consider outsourcing or eliminating is important.

We all know the expense of employee turn-around. Understanding what your staff are doing and the level of satisfaction associated with certain tasks can make a manager’s job easier in assigning certain responsibilities to individuals.

I thought that it would be interesting to see what some of my operating room associates do with their time. We set up a task sheet to track this information. I designed it to be very simple to use and with only a few parameters such as what we wanted to track, how much time was spent on it per week (you could do it daily, but it’s probably not as effective because it would become too time-consuming), and the level of satisfaction they got out of the issue.

In the box, above, are the results of 25 OR managers that tracked it for a month. A satisfaction score of "10" means it was a very satisfying time spent on the issue and the effort was worth the time, and a score of "1" was just one level above walking out the door. This is not very scientific, but revealing.

Since most of the managers work a 60-hour week, the total on this is fairly accurate. The obvious conclusion is that most managers enjoy interaction with just about anyone (even the dreaded vendors!) but abhor issues related to instruments, budgets and meetings, and surgical billing. Also note that most people spend lots of time on billing issues. We concluded that billing issues and the time spent on them is not a good thing. Outsource the billing — it is cheaper anyway!

I did find this to be a useful study — informal as it was — to help identify ways we could function better by recognizing those time-consuming areas and perhaps reassigning personnel who might obtain a higher satisfaction level from the task; hence, it could be done faster and perhaps better.

Try this with your staff members and see what you find out. You may need to change it to meet the needs of your techs and clinical staff. At your staff meeting, ask what issues should be included. Please e-mail me your responses to I would be very curious to see how they are different. Please specify whether you are an ambulatory surgery center, physician’s office, or based in a hospital.

[Editor’s note: Earnhart & Associates is an ambulatory surgery consulting firm specializing in all aspects of surgery center development and management. Do you have additional questions? Contact Earnhart at 3112 Windsor Road, Suite A-242, Austin, TX. 78703. E-mail: Web:]