The Quest for Surgical Efficiency

The operating room is the engine of any surgical department. When it runs well, everyone benefits: patients, physicians, staff…and so do the center’s finances. But when inefficiencies go unchecked, health systems lose time, money, and capacity without even realizing it. At EyeQ, we hope to shine a light on where those losses occur and how to fix them.

 Take corneal transplants, for example. In our previous study of endothelial keratoplasty, a type of corneal transplant, we found that using "preloaded" cornea grafts (prepared by eye banks instead of by the surgeon in the operating room) shaved significant time off the procedure. Even though preloaded grafts carry a higher upfront price for the surgery center, the time saved was more valuable. And some payers reimburse for that expense, so the preloaded grafts offered a win-win for the surgery center.

When complex surgeries lose money… and no one notices

At a leading academic eye center, we asked a simple question: How much does surgery really cost? Not based on guesswork, RVUs, or reimbursements – but on real-time staff involvement, room usage, and material costs. This was harder to do than you might think. Most health systems do not have a great way of calculating costs, even from a resource as expensive and important as the operating room (OR).

In order to answer the question, we pioneered a string of studies using Time-Driven Activity-Based Costing (TDABC). In these studies, we uncovered a consistent pattern – one that many surgeons understand but had yet to quantify: the more complex the surgery, the greater the hidden financial loss.