Like many health systems, The Medical University of South Carolina (MUSC) Health has experienced rapid growth in surgical demand. Its main ORs were already running at consistently high utilization, leaving little room to absorb delays, variability, or inefficiencies. While additional ORs were planned, leadership needed a near-term way to increase patient access and improve throughput within an already constrained footprint.
At the same time, visibility into OR performance was limited. Teams relied on manually entered EHR timestamps that were often questioned by physicians and lacked the detail needed to explain where time was actually being lost.
To improve operating room utilization, MUSC turned to Apella for a trusted, real-time understanding of what was actually happening inside the OR.
Implementation with no OR downtime
MUSC approached implementation with a clear priority: introduce new technology without disrupting surgical operations. Apella was integrated directly with MUSC’s EHR and deployed in alignment with existing workflows. Installation occurred outside of peak hours, and rooms were brought online without impacting surgical throughput. This meant:
- No OR downtime
- No added documentation burden for staff
- Immediate access to real-time operational data
Rather than slowing operations, MUSC began generating value almost immediately after go-live.
Rapid organic adoption across teams
Adoption of new tools in the operating room hinges on trust, which MUSC leadership prioritized from day one. Clinicians were involved early to ensure they saw the value of the platform in solving their daily operational challenges. A governance committee with surgeon champions shaped how the technology would be used and what guardrails were put in place.
In addition, adoption across perioperative teams was organic rather than mandated, and they began using Apella because it made their day-to-day work easier and more coordinated. Within a few weeks:
- 100% weekday adoption among charge nurses
- User base nearly doubled as pre-op, post-op, and anesthesia teams requested access
- Apella became a shared source of truth across teams
Learn how MUSC accelerated speed to impact in the OR.
Read the case study
Operational opportunities identified
Within weeks of go-live, MUSC saw a step-change in data quality and operational clarity. Apella’s timestamps were:
- 6x more accurate than manual EHR entry
- Delivered in under 1 minute vs. delays of up to 45 minutes
This eliminated skepticism around data and enabled faster, more aligned decision-making.
More importantly, within the first 60 days, MUSC identified three major drivers of OR inefficiency — many of which challenged long-held assumptions about where time was being lost.
1) Turnover efficiency
Delays were widely believed to be driven by cleaning time. Instead, the data revealed that idle time between cleaning and setup—often 10–15 minutes—was the primary contributor, pointing to a coordination gap across teams.
2) Scheduling accuracy
Variability in case duration had been understood directionally, but not quantified. Apella revealed that ~28% of cases were under-scheduled and ~20% over-scheduled by more than 30 minutes, clarifying the extent to which scheduling was contributing to both delays and unused OR time.
3) Recoverable capacity
Despite high utilization, recurring “white space” showed that meaningful capacity already existed within the schedule, particularly at the end of the day, challenging the assumption that additional rooms were the only path to increased access.
These insights reinforced a critical shift: without objective, granular data, teams risk focusing on the wrong problems. With a clearer understanding of what was actually driving inefficiency, MUSC leadership could redirect efforts toward the areas with the potential for greatest impact.
Why speed-to-value matters for hospital efficiency
Improving OR access and utilization starts with a true understanding of how existing time is actually used. By moving from assumptions to real-time, ground-truth data, MUSC was able to:
- Identify the true drivers of inefficiency
- Align teams around a trusted source of truth
- Begin driving improvements within weeks — not months
Read the full case study to see how MUSC translated real-time visibility into operational impact — within just 60 days.
Learn how MUSC accelerated speed to impact in the OR.
Read the case study