When our recent spate of scheduling woes persisted, we decided to pilot a program. We hosted a one-day seminar for our physician schedulers during which we showed them around our facility, introduced them to key contacts and demonstrated how their jobs affected us on a daily basis. Here's how we did it.

• Spread the word. We suggested several dates to give schedulers the opportunity to save a date that worked best for them. E-vites were sent a month or two in advance, followed by frequent reminders as the seminar approached. The response rate surprised us. Each of the 75 spots we allotted for the two scheduled classes filled quickly.
• Meet and greet. The schedulers gathered in our outpatient department's lobby on the morning of the seminar. We served coffee and donuts, introduced ourselves and explained the reasoning behind the event. We emphasized that it wasn't an indictment of their performance; we simply wanted to show them where their surgeons operate, introduce them to the people with whom they schedule cases and review our posting protocols. After our guests had their fill of sugar and caffeine, we handed out the bunny suits they'd be wearing during the OR tour (see picture). The group's excitement was palpable. They were really having a great time.
• Keep it real. We led groups of about 20 on a tour of the entire surgical circuit. We ensured they saw clinical areas during our busiest time instead of touring empty ORs later in the day. They needed to see staff in real-life action, the organized chaos that makes a surgical suite tick. Pulling back the curtain on our day-to-day hammered home the importance of scheduling cases accurately.

When the schedulers saw how one procedure followed the next in clockwork fashion, they got a feel for how much we rely on accurate case posting. They saw firsthand that one glitch in the scheduling process throws off our entire surgical flow.

Our tour guides asked their groups about the surgeons they schedule for, the types of cases they post and the equipment they request. During the tour, they pointed out where their surgeons operate and the equipment they use. We showed them the difference between general and neuro ORs, and why the staffing and equipment requirements for a case often determine the type and size of the room that hosts it.

The groups swung by supply rooms, saw supply carts and learned how supply requests are filled. We also walked them through central sterile, where they watched instrument reprocessing in real time as our guides explained how last-minute schedule changes jeopardized our ability to deliver required instrumentation to the ORs on time.

The tours were eye-opening. Our guests, for example, were shocked at the size of operating microscopes. They'd assumed they resembled the tabletop models used in high school biology classes. More importantly, the behind-the-scenes look reinforced the impact their jobs have on ours. For example, they saw that fulfilling supply requests is part of a larger process, and any cancelled cases or cases posted incorrectly gums up our carefully coordinated clinical routines.

• Go back to school. After the morning tours and a catered lunch, the schedulers moved onto a classroom session. Our perioperative clinical director spoke to the group about their roles in making our jobs easier, backing his claims with data gleaned from operative reports. He showed them block time fulfillment for each of their surgeons, including the number of cases cancelled within 24 hours of their scheduled times, how many of those cancellations resulted in ORs going unused and the financial impact each cancelled case had on our surgical services budget.

We also surprised the group with our tracking of a number of patients who happened to have the same name, and whose need for surgery happened to mysteriously disappear immediately before their scheduled cases. We knew these phantom patients were being used to hold surgeons' block times; the schedulers didn't know that we were on to them. That made a few of them squirm.

Each scheduler received a three-ring binder containing spreadsheets, graphs, pie charts, you name it, that compared the posting performances of each surgeon-scheduler pairing. We also provided examples of cases that were posted incorrectly, including the case number, the operating surgeon and the scheduler who posted it. The breakdowns highlighted what was wrong with the postings, from inaccurate procedure codes to incorrect equipment requests. We didn't present the errors to embarrass; we simply wanted to help the group learn by reviewing the common errors we see.

Daily chatter
The feedback from the schedulers has been overwhelmingly positive. So much so that we now invite the group back for quarterly luncheons to update them on their case-posting performance.

We also use this time to foster relationships with those who directly influence our workday. Now that the schedulers feel comfortable with our staff and have our pager numbers and e-mail addresses, scheduling issues are resolved long before they become problems on the day of surgery.