Tackling the Surgical Backlog

Executive Dialogues Tackling the Surgical Backlog
Executive Dialogue | Tackling the Surgical Backlog: Optimizing perioperative performance in today’s resource-constrained environment

Executive Dialogue

Optimizing perioperative performance in today’s resource-constrained environment

Millions of elective surgeries and other nonurgent procedures were delayed during the pandemic, and these delayed surgeries have had a significant financial impact. Many hospitals are struggling amid staffing shortages, inpatient bed availability and operating room (OR) capacity to expand patients’ access to surgical care and clear the backlog in cases. Hospitals and health systems are striving to optimize OR efficiency while also enhancing the patient experience and improving outcomes. This executive dialogue looks at how health leaders are expanding and monitoring the use of existing OR capacity, using anesthesiologists and surgical teams to improve perioperative performance and exploring new practice models.

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Strategies to Optimize Perioperative Performance

  • Strengthen surgery operations governance models and partnerships with clinical leadership for more efficient management of blocks to maximize ability to care for patients.
  • Adopt different delivery models around nursing on inpatient side to help improve both bed capacity and availability for training in other areas including perioperative services.
  • Employ flexible health system programs to fill immediate, short-term and long-term assignments in nursing and other specialties and expand training programs.
  • Shift some of surgical load to ambulatory surgical centers and explore the potential of shifting procedures to weekends or evening hours during the week if staffing allows.
  • Develop care pathways for same-day discharges for appropriate procedures, deploy discharge lounges and expand outpatient recovery areas to increase bed capacity.
  • Utilize anesthesiologists in leadership positions to manage operating room schedules and efficiency, prehabilitation, preoperative assessment and surgical optimization.
  • Proactively reach out and incentivize surgeons to release block time.


Angela Beck

Angela Beck, MHA, BSN, R.N.

Associate Chief Operating Officer

Michigan Medicine

Miguel Benet

Miguel Benet, M.D., MPH, FACHE

Senior Vice President of Clinical Operations

Community Health Systems

Benjamin Carter

Benjamin Carter, CPA, FHFMA

Executive Vice President and Chief Operating Officer

Trinity Health

Brynda Collins

Brynda Collins, MBA, BSN, R.N., CNOR

Chief Surgical and Procedural Operations

Keck Medicine of USC

Joanne Conroy

Joanne Conroy, M.D.

CEO and President

Dartmouth Health

Matthew Griffin

Matthew Griffin, M.D., MBA, FACEP

Chief Medical Officer

St. Mary Mercy Hospital

Cynthia Kelleher

Cynthia Kelleher, MBA, MPH

President and CEO

University of Maryland Rehabilitation & Orthopaedic Institute

John Keogh

John Keogh, M.D., CPE

Executive Director Perioperative and Periprocedural Services

Hospital of the University of Pennsylvania

Riana Kielly

Riana Kielly, MSN-L, R.N., NE-BC

Chief Operating Officer

HonorHealth John C. Lincoln Medical Center

Joshua Kooistra

Joshua Kooistra, D.O.

Senior Vice President, Chief Medical Officer Hospital Care

Corewell Health West

Amy McCombs

Amy McCombs, MSN, R.N., CCRN, CNML, CIC

Chief Operating Officer

Renown Health

Joseph Moffa

Joseph Moffa, MSN, BS, R.N., NE-BC, CCRN, ATCN

Chief Administrative Officer for Perioperative and Procedural Services

Hospital of the University of Pennsylvania

Jill Muir

Jill Muir, DNP, MS, R.N., CCM, NE-BC

Chief Nursing Officer

Penn Highlands Dubois and Brookville

Mary Dale Peterson

Mary Dale Peterson, M.D., MSHCA, FASA, FACHE

Executive Vice President and Chief Operating Officer

Driscoll Children’s Hospital

Kim Post

Kim Post, DNP, MBA, R.N., NEA-BC

Executive Vice President, Chief Operations Officer


Lisa Risser


Corporate Senior Vice President, Ancillary Operations

Scripps Health

Loren Rufino

Loren Rufino

Senior Vice President, Perioperative Services

Inova Health System

Suzanna Hoppszallern

Suzanna Hoppszallern

Senior Editor

American Hospital Association


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