Block time should be one of the most strategic levers in perioperative operations — a core tool for aligning surgical capacity with patient demand. How OR time is allocated directly impacts access, efficiency, and revenue. In theory, it’s simple: give the right amount of time to the right surgeons to match case volume. But in practice, it’s anything but.
Just raising the topic of changing block allocation can spark tension. Because, when it comes to adjusting blocks, reassigning time, or even discussing utilization metrics, things get... political. Why? Because the data behind these decisions isn’t trusted, and everyone knows it.
Two sides of the same story
From an OR leader’s desk
OR directors are expected to balance operating room capacity, support growth, improve throughput, manage open time, and maintain strong relationships with surgeons. So, when utilization reports show idle block time, consistently late starts, or surgeons with standout or straggling case efficiency, OR directors see opportunity for improvement — perhaps by releasing time, adjusting schedules, or reallocating blocks.
But those conversations are rarely easy. Surgeons, especially those on the losing end of time re-allocation, may question the numbers. Discussions can get tense. And even well-supported recommendations can lead to frustration or, worse, surgeons taking cases elsewhere. The question is: why does it have to be so hard?
Check out our case study on How Houston Methodist Built Team Trust and Cut Costs with Data Accuracy and reduced errors by 93.8% to drive coordination and prioritize patient care.
From the surgeon’s office
Now flip the script. Surgeons are often blindsided by the data presented to them. They see reports flagging them for underutilization or inefficiency and think: “That’s not the full story.”
Maybe the patient arrived late. Maybe anesthesia ran behind. Or the case was canceled due to an issue they couldn’t control. Yet now, they're being flagged as inefficient. And now their block is on the line. So they push back, protecting themselves from decisions based on inputs they don’t trust.
This isn’t actually a people problem; it’s a data problem
This dynamic is historically the result of a system that relies heavily on subjective, manually-entered, and inconsistent data, which neither surgeons nor OR leaders fully trust. Today’s block management often draws from EHR timestamps that vary in accuracy, padded duration estimates, or business rules that overlook clinical complexity. As a result, both operational leaders and clinicians are left trying to act on information they can’t confidently stand behind. This creates a loop:
- Leaders hesitate to take action for fear of alienating surgeons
- Surgeons resist proposed changes, unsure of how the conclusions were reached
- Schedulers are caught in the middle, trying to meet everyone’s needs with limited visibility
Everyone is working hard, but not always in sync. And when trust in the data is shaky, even well-meaning efforts can lead to tension and consequences:
- Block reallocation proposals are met with pushback
- Surgeons hold onto time they don’t use “just in case”
- Collaboration between clinical and operational teams suffers
- Misalignment contributes to bias and burnout
What needs to change?
Before anyone can talk about block reallocation or efficiency, hospitals need to fix the foundation on which those decisions rest. If we want to change the conversation, we have to first change the quality of the information behind it. In our next post, we’ll explore how objective, observed, ground-truth data can restore trust, create shared visibility, and make scheduling a collaborative process again.
Check out our case study on How Houston Methodist Built Team Trust and Cut Costs with Data Accuracy and reduced errors by 93.8% to drive coordination and prioritize patient care.