In perioperative services, the biggest wins do not always come from the boldest investments. Sometimes it is a restructured committee, a new cadence of cross-functional meetings, or a standardized supply pack that quietly reshapes how an entire department operates. The challenge is that those gains are easy to overlook — until the data makes them impossible to ignore.

Becker’s asked five perioperative leaders to share the workflow change that delivered unexpected gains at their organizations. Their answers can offer a practical playbook for leaders looking to find untapped performance in the systems they already have.

The leaders featured below are speaking at Becker’s Perioperative Summit, set for Sept. 14-15 at the Hilton Chicago.

If you would like to join the event as a speaker, please contact Scott King at sking@beckershealthcare.com.

As part of an ongoing series, Becker’s is connecting with healthcare leaders who will speak at the event to get their perspectives on key issues in the industry.

Editor’s note: Responses have been lightly edited for clarity and length.

Question: What workflow change delivered unexpected gains?

Neil Tanna, MD. Senior Vice President of System Perioperative Services and Strategy for Northwell Health (New Hyde Park, N.Y.): One of the most impactful workflow changes wasn’t a new technology or a restructured surgical schedule, it was something far simpler: bringing ambulatory practice managers to the table with hospital-based perioperative leadership.

We established a cadence of intimate, frequent meetings between these two groups. These weren’t large-scale committee meetings or quarterly reviews. They were small, focused, and continuous conversations that created a shared line of sight into real-time perioperative data.

The gains were both measurable and, frankly, unexpected in their breadth. By bridging the gap between the ambulatory practices that generate surgical volume and the perioperative teams that execute it, we saw improvements across multiple key metrics, including:

• Improved block utilization

• Stronger financial case performance

• Fewer same-day cancellations

• Better first-case on-time starts

What made this so powerful was the compounding effect of consistency. No single meeting produced a breakthrough. But over time, these regular touchpoints built trust, created accountability, and fostered a shared ownership of outcomes that neither side could achieve independently. Changes were appreciated not because they were dramatic, but because they were durable.

Stephen Estime, MD. Associate Chair of Anesthesiology and Critical Care for UChicago Medicine: The workflow change that delivered unexpected gains was the rollout of a new time and task capture system among faculty to better account for after-hours work. Resistance was anticipated to last the better part of a year because entrenched scheduling habits in academic medicine rarely yield quickly. Adoption was faster than anticipated, though friction has not disappeared entirely as it rarely does with any system change.

What faded more quickly than expected was the intensity of that friction, largely because faculty recognized it as a more accurate accounting of their time than what preceded it. The gains were richer than expected: granular visibility into how workload is distributed across sections, how after-hours burden shifts over time, and which faculty are consistently carrying disproportionate load. That kind of data expands the ability to answer questions and to better understand the questions worth asking. Patterns that simply could not be seen before, whether in workload distribution or after-hours burden, are now visible and actionable.

Courtney Pearson. Assistant Vice President of Operations for the Perioperative Service Line for MedStar Health (Columbia, Md.): One workflow change that delivered significant and somewhat unexpected gains was the intentional redesign of our Block Committee structure by narrowing the group at the table and empowering the leaders closest to the work. By shifting accountability to those directly managing block performance and daily operational flow, we accelerated decision-making, reduced unnecessary escalation, and improved responsiveness to real-time perioperative demands.

This approach not only drove measurable improvements in block utilization and operational efficiency, but also strengthened ownership, accountability and engagement across the team. From a leadership perspective, it reinforced the value of aligning governance with operational expertise to drive sustainable system-wide performance improvement.

Christopher Hart. Vice President of Perioperative Services for Peconic Bay Medical Center (Riverhead, N.Y.): At Peconic Bay Medical Center, we had focused our staffing on intraoperative care and direct patient support in the past. Being in a community hospital setting we are faced with certain financial restraints and wanted to ensure quality was our primary focus. It was noticed that our throughput, case preparedness and case length averages were longer than expected compared to our peers.

Thorough evaluation noted a need to improve support services (materials, sterile processing, turnover techs, etc.). By improving our operational support, our nurses were able to focus on direct patient care and remain in their respective care area without distractions.  These changes dramatically improved our overall block utilization and reduced how late into the evening we are operating on elective and add-on case volume without sacrificing our quality.

Nikki Washington, DNP, RN. Director of Surgical Services of St. Joseph’s Medical Center (Stockton, Calif.): Standardizing our robotic packs, addressing both supplies and instrumentation, was initially a cost-containment effort focused on reducing waste and improving case efficiency. While direct supply savings were achieved, the more impactful and unexpected outcome was a measurable increase in operational throughput. By eliminating unnecessary supplies and optimizing instrumentation, we reduced variability, streamlined setup, and improved turnover performance, enabling additional cases to be performed within existing block time.

In a high-cost robotic environment where fixed expenses dominate, even marginal utilization gains translate into disproportionate financial returns, improving contribution margin per block and strengthening overall ROI. What began as an efficiency initiative ultimately became a scalable strategy for both cost control and revenue expansion, aligning clinical workflow optimization with financial performance.

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