Individual Hospital

IHO approaches are scientifically grounded and have been successfully applied with dramatic financial and quality of care improvement results at numerous leading hospitals. For more information about IHO programs and services, please contact us.

University Health Network (Phase I-II)

• Created additional operating capacity to 105-110% and cleared surgical backlog from 4300 down to 3200 cases; performed over 1,000 additional surgical cases during the COVID pandemic 
• Created the opportunity for UHN to perform over 3000 additional elective surgeries
• High compliance with wait time for urgent/emergent surgeries by an additional 13% to 20% for UHN hospitals (significantly reduce patient mortality and length of stay)
• Improved patient placement in the preferred unit/bed
• Provided strategies to optimally ramp surgical activities back up to reduce the provincial backlog  
• Well-positioned the Surgery Leadership team to manage the COVID pandemic 
• Related Articles:
  • How Hospitals Can Save Lives and Themselves Lessons on Patient Flow From the COVID-19 Pandemic
  • How surgical smoothing could help ease the medical backlog created by COVID-19
  • COVID-19 surgery delays can be done without overburdening workers, say experts

Mayo Clinic, Jacksonville, Florida (Phase I)

• Surgical case volume increased by 4%
• Surgical minutes and OR utilization increased 5% each
• Average OR overtime staffing decreased 27%
• 84% compliance with waiting time limits for emergent and urgent care
• No reported incidences of not being able to access OR in a timely manner
• Annual staff turnover cost reduced by $1.07 million
• OR annual net revenue increased by $5 million
• Article: Re-engineering the Operating Room Using Variability Methodology to Improve Health Care Value

Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio (Phases I-III)

• Weekday OR waiting time for emergent/urgent surgical cases reduced by 28% (despite an increase in case volume of 24%) (Phase I)
• Weekend OR waiting time decreased by 34% despite an increase in volume of 37%) (Phase I)
• OR overtime reduced by 57% (Phase I)
• Surgical throughput increased by 5% (an equivalent of an additional OR) (Phase I)
• Multi-year 7% increase in annual surgical throughput without adding new ORs (Phase II & III)
• $115 million increase in annual revenue/cost savings (Phase II & III)
• Over $100 million in avoided capital cost (Phase II & III)

The Ottawa Hospital, Ottawa, Ontario (Phase I)

• Improved access for patients needing emergency surgery within 24 hours from 60% to 90%
• Reduced mortality rate for patients requiring urgent surgery from 3.9% to 3%, resulting in 40 lives saved
• Achieved efficiency gain equivalent to $9million by decreasing length of stay and better use of beds
• Reduced surgery cancellations due to bed shortages from more than 600 per year to zero
• Reduced Neurosurgery inpatient census from 46 to 33, resulting in a savings of 13 beds
• Related Articles
  • More cost-effective health care needed
  • Association of delay of urgent or emergency surgery with mortality and use of health care resources: a propensity score–matched observational cohort study

The Johns Hopkins Hospital, Baltimore, Maryland (Phase I)

• Waiting time for emergent/urgent surgical cases decreased by 39%
• Throughput increased by 5 cases per day in the main ORs and by 4 cases per day in their outpatient facility
• Overtime decreased by 6.6%
• Relative increase in surgical volume resulting in annual $4 million increase in incremental margin

Boston Medical Center, Boston, MA (Phase I and Phase II in one unit)

• Surgical throughput increased by 10%
• Emergency Department ambulance diversions reduced by 20%
• 2.8 hour wait in one of the state’s busiest EDs compared to 4-5+ hours for most academic hospitals in Boston
• Annual number of postponed or cancelled elective surgeries reduced by 99.5%
• Reduction in nursing stress levels: 30 minute reduction (6%) in nurse hours per patient day in the step-down unit, resulting in $130,000 annualized reduction in nursing costs