By Garrett, Account Executive

Note from the author: Hello, I'm Garrett, an Account Executive here at Surgimate. I want this blog to reflect what we're actually hearing from surgical leaders, including C-suite, surgeons, and schedulers, about what is most important to them when it comes to OR block time management. This blog is proudly written by me. Please enjoy 🙂

Working at Surgimate, I'm fortunate enough to work with a wide variety of leadership within the surgical community. From C-suite members like CEOs, CFOs, and COOs (you get the point), to Director roles within Operations, Finance, and Technology, to clinical folks like nurses, PAs, and MD/DOs, all the way to the individual schedulers and coordinators responsible for protecting practice revenue and keeping providers' OR time as full as possible.

Every one of those roles wants the same thing from the OR, even if for different reasons. Surgeons want their block time used. The CFO wants the revenue it represents. Schedulers want simpler workflows and fewer last-minute scrambles. And patients want their surgery sooner. With everyone pulling in the same direction, you'd expect OR time to be one of the easier things to get right.

So why is it that when I meet with folks across every role within surgical practices, one of the largest recurring themes I hear is that block time utilization is lower than it should be, even when the block time schedule looks full? In this blog, we'll cover why clear definitions matter, how to make your surgical pipeline visible, and how to build an environment that reduces wasted time in the OR.

Start with clear definitions

Before you can compare block performance across surgeons or facilities, you need to make sure everyone is measuring it the same way. A 2023 analysis in the British Journal of Anaesthesia showed how the way utilization metrics are calculated and aggregated can distort conclusions about operating room performance.¹ Without a consistent definition, utilization numbers across different sites can mean different things. Two numbers may look the same, but they may not be measuring the same thing.

It's important to first agree on which minutes count toward utilization, how cancellations and turnover are handled, and which system is the source of truth. Once everyone is speaking the same language, the numbers can start telling a story you can actually use to take action.

Make your surgical pipeline visible

Understanding open OR time is only useful when you have cases prepared to fill it. For example, a block that looks full three weeks out can still go partially unused if authorizations, clearances, or patient requirements go unnoticed. To protect your pipeline, it's important to have answers to these questions:

• Is there demand to fill the schedule?
• If so, which cases are ready?
• Which scheduled cases are at risk, and why?
• When and how can unused time be released or refilled?
• Which constraints sit with the practice, patient, payer, surgeon, or facility?

The last question is important because understanding where a constraint sits tells you who can take control and fix it.

Build an operating cadence

Visibility only helps if there's someone there to act on it. Consistent readiness and capacity reviews with clear ownership are vital. If there are cases with exceptions that can easily be resolved, like a missing clearance or an expired authorization, those should be the priority focus. When time is likely to go unused, make the decision point explicit: who decides, by when, and whether the time will be released, refilled, or rescheduled.

After the date, close the loop by reviewing why time went unused or why a case was canceled or changed. A 2025 study at a U.S. safety-net hospital grouped surgical cancellations into scheduling, patient, social, treatment-change, facility, and medical-professional factors.² A framework like that is a useful way to sort your own reasons for lost capacity, though as a single-institution study it shouldn't be treated as a benchmark for every surgical practice. Over time, the trends in your own data should shape workflow design, release rules, and capacity conversations with your facilities.

Set realistic expectations

Better visibility into case readiness can absolutely support higher block time utilization, but it isn't the only factor. Performed-case volume also depends on demand, clinical decisions, patient choice, staffing, and facility constraints. Establish a baseline, then measure your practice's results against its own starting point rather than an industry average.

Surgimate connects your order-to-OR workflow to your block schedule, so leaders and coordinators can see how cases are progressing and where risk is building while there's still time to act. Visibility into every case, all in one place, gives you the power to protect your OR time and keep patient care on track.

Connect your block schedule to the cases intended to fill it.

References

• Zhang, C., & Pandit, J. J. (2023). Getting operating theatre metrics right to underpin quality improvement: Understanding limitations of NHS Model Hospital calculations. British Journal of Anaesthesia, 131(1), 130–134. doi:10.1016/j.bja.2023.03.032. Read source.
• Srivastava, S., Gandhi, S., Romero Medina, S., Tewfik, G., Chaudhury, F., & Narula, N. (2025). Surgical case cancellations at a safety net hospital: Implications for patient care and resource management. World Journal of Surgery, 49(9), 2493–2500. doi:10.1002/wjs.70007. Read source.