Becker's Hospital Review

15 CLINICAL LEADERSHIP Data, cross-training, and pipeline development: How health systems are rethinking OR staffing By Scott King T he operating room has always demanded precision — and now that same precision is being applied to the workforce that makes surgical care possible. Across the country, perioperative leaders are moving away from static, fixed staffing models toward dynamic, data-driven approaches that align resources more closely to real surgical demand. At the same time, cross-training initiatives are building the kind of operational resilience that helps ORs absorb volume swings, cover gaps, and maintain quality care without defaulting on costly overtime. And with workforce shortages — particularly in anesthesia — showing no signs of easing, long-term pipeline development has become just as strategic a priority as day-to-day scheduling. Becker's asked eight healthcare leaders how OR staffing models are evolving. Editor's note: Responses have been lightly edited for clarity and length. Question: How are OR staffing models evolving? Neil Tanna, MD. Senior Vice President of System Perioperative Services and Strategy for Northwell Health (New Hyde Park, N.Y.): Operating staffing models are rapidly evolving from static rosters to dynamic, data-driven approaches, largely in response to persistent workforce shortages and the critical need to combat burnout. We are increasingly leveraging predictive analytics, flexible scheduling, and cross-training initiatives to optimize OR utilization, enhance staff retention and ensure resilient perioperative care. Chris Hunt. Associate Vice President of Perioperative Services for MultiCare (Tacoma, Wash.): While required minimum staffing levels largely remain the same, there is greater financial pressure to only cover the bare minimum. is leaves a lot of the preparatory and improvement work unfunded, which results in the ORs running less efficiently and effectively. On the positive, there are some very useful AI tools available that not only optimize staffing to demand, but also provide insights into matching staff experience to the specific cases and service lines on the daily schedule. Emily Tchiblakian, BSN, RN. Vice President of Perioperative and Cardiovascular Service Lines for Sentara (Norfolk, Va.): Interesting topic because the staffing model for Perioperative services is very dependent on the nursing, first assistant and surgical technologist education programs and the proximity to the hospital. While some hospitals have a healthy blend of RN and ST, other hospitals have a RN concentration staff. e most valuable change to the staffing model is the ability to leverage technology to generate a schedule. When the right teams work together, the results are seen through efficiency metrics, and co-worker and patient satisfaction. Daniel Elinskas, MSN, RN. Associate Director of Surgical Services for St. Mary's Health (Evansville, Ind.): Operating room staffing models in community hospitals are evolving from a traditional fixed ratio to a more flexible core-plus-flex model. By reviewing real-time data as a team one to two days in advance about case load, case sequence, supply needs and staffing requirements, we can dynamically adjust staffing levels from anesthesia providers to Central Sterile Processing team members by reducing overtime in many cases and filling gaps in staffing. is oen leverages cross-training staff to help cover PACU, preop and the OR itself. Michael Lewis, MD. Chair of Anesthesiology, Pain Management and Perioperative Medicine Department for Henry Ford Health System; Professor and Chair of Michigan State University College of Human Medicine; Anesthesiology Professor for Wayne State University (Grand Rapids, Mich., and Detroit): Anesthesia workforce shortages are reshaping care delivery models across the country, but restructuring who supervises who does not solve the underlying problem. e pipeline isn't producing enough providers: physicians, CRNAs, or certified anesthesiologist assistants. Real solutions require investment upstream: expanding training capacity, improving retention and making anesthesiology an attractive career path for the next generation of clinicians. Aubrey Pepper, DNP, RN. Senior Director of Nursing Surgical Services for St. Jude Children's Research Hospital (Memphis, Tenn.): OR staffing models are evolving toward greater flexibility, cross- training and team-based coverage to meet the growing complexity and unpredictability of surgical care. Cross-training perioperative staff across multiple specialties and roles helps ensure continuity of care, strengthens operational resilience, and allows organizations to respond more effectively to fluctuations in volume, acuity, and staffing availability. At the same time, long-term workforce planning has become increasingly important, including building strong partnerships with colleges, nursing programs and surgical technology training programs to create sustainable talent pipelines. Investing in both workforce agility and future workforce development is essential to maintaining safe, high quality perioperative care for children and families. Jennifer Drudy, BSN, RN. Vice President of Perioperative Services for Centra (Lynchburg, Va.): OR staffing models have evolved significantly as advances in data analytics provide us with greater visibility into true staffing needs across the perioperative environment. With access to more accurate block utilization, case duration accuracy and volume trend data, we have been able to align our staffing resources more precisely to surgical schedules rather than relying on traditional fixed day or evening shis. Due to this we have been able to transition to a more flexible staffing model that supports variable start times and coverage aligned to our block activity. is has improved our operational efficiency, reduced unnecessary labor expenses, and better supported staff work- life balance while maintaining high-quality patient care. e ability to match staffing resources more effectively to procedural demand has also been a significant satisfier for both staff and physicians, creating a more predictable, efficient, and collaborative working environment. Jeffrey Matthews, MD. Chair of Department of Surgery, Surgeon- in-Chief, and Dallas B. Phemister Distinguished Service Professor at UChicago Medicine (Chicago): OR staffing models are evolving to enhance flexibility and deepen subspecialty expertise. At the University of Chicago, our staff are cross-training to be able to perform multiple roles, while developing advanced competencies in at least two subspecialty service areas plus trauma. is multi-skilled approach enhances coverage during peak times or staff shortages while prioritizing consistent specialty team assignments for quality and efficiency. Innovative approaches to recruitment, retention, and professional development of key personnel such as CRNAs are proving essential. Utilization of surgical first assistants for specialized skills such as robotics is improving operational execution and surgeon satisfaction. AI-driven scheduling and workflow analytics promise to further optimize staff assignments, capacity management and surgical throughput. n

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