Brenda Munns Flagstaff AZ    munnsb@nahealth.com

BLOCK SCHEDULING


POLICY

Physicians have an option of "block scheduling."  Block scheduling 
establishes a hold on a surgical suite for the utilization of the specific 
physician or group of physicians.

DEFINITION   N/A

PROCEDURE  

1.	Blocks are established on first come, first serve basis.  For 
      multiple block requests on the same day, a blind draw will be 
      performed by the Surgery Services Director and Chief of 
      Department.

2.	The hours available to be blocked are:  

       0730-1130
       1200-1500
       These increments can be blocked separately or in combination.

3.	Blocks may be utilized by specific individuals or medical groups.

4.	Blocks will be opened for first come, first serve scheduling 3 
      working days prior to the date of the block (weekends will be 
      counted as one working day).  
      a.	For blocks occurring on Monday, blocks will be released 
            to open scheduling on the prior Thursday at 0700.  
      b.	For blocks occurring on Tuesday, blocks will be released 
            on the prior Friday at 0700.  
      c.	For blocks occurring on Wednesday, blocks will be 
            released on the prior Friday at 1700.

5.	Physicians may release established blocks or any part of a block 
      to "open scheduling" at any time.  If an established complete 
      block is not utilized, and has not been released by the physician 
      3 working days prior to the block day, utilization will be 
      calculated at 0%.

6.	Block utilization review will occur monthly at the Surgery 
      Administration Committee, with reports issued quarterly to the 
      Surgical Committee.

7.	If a physician has scheduled a case for a full block and 
      completes the block ahead of schedule, the physician will be 
      credited for utilizing the block fully.

8.	Utilization must be maintained at 70% monthly.  If utilization falls 
      below 70% for the quarter, a warning will be issued at quarterly 
      report.  If improvement does not occur by the next quarterly 
      report, 50% of the block may be relinquished for a minimum of 
      3 months.

9.	If the utilization in any given quarter falls below 50%, the 
      Surgery Administration Committee may cancel that block for a 
      minimum of 3 months.

10.	Utilization is calculated from anesthesia start time to anesthesia 
      stop time, plus 30 minutes average for set up and break down 
      for each procedure.  For example, anesthesia start - 0730; 
      surgery start - 0745; surgery stop - 0900; anesthesia stop - 
      0910; 15 minutes pre-anesthesia time; 15 minutes post 
      anesthesia time = 2 hours, 10 minutes utilized.  The utilization 
      is calculated by the OR Coordinator.

11.	During the calculation of times the following circumstances will 
      be factored into the utilization findings:
      a.	Physician blocks are moved to different rooms, and both 
            will receive utilization credit.
      b.	The block is bumped by an emergency case.  The time will 
            not be counted as non-utilization.
      c.	The block physician is the second primary surgeon or the 
            assistant, and the time will be counted toward utilization.
      d.	Excessive turnover times.


12.	If a scheduled case in a block is canceled, the block surgeon or 
      group may insert another case into that block provided it does 
      not create a staff, instrument, or equipment conflict.  If the 
      cancellation occurs the day of surgery, the time will be counted 
      as utilized.