Surgical Directions Launches COO Guide to Perioperative Operational Improvements That Boost Financial Performance

Press Releases

May 20, 2026

CHICAGO, May 20, 2026 /PRNewswire/ — As hospitals confront labor shortages, reimbursement compression, inflationary supply costs, and rising patient acuity, Surgical Directions has released a new executive resource designed specifically for Chief Operating Officers: “COO Guide to Perioperative Operational Improvements That Boost Financial Performance.”

Authored by Joshua S. Miller, MD, Chair of the Board and Physician Managing Director, Barbara McClenathan, RN, BSN, MBA-HCM, CNOR, Vice President of Nursing, and Leslie Basham, President and CEO. The guide provides a structured, evidence-based framework for improving surgical operations in ways that directly strengthen hospital financial performance.

Surgical services often represent up to 70 percent of hospital revenue while also consuming significant labor and capital resources. When perioperative operations lack alignment, hospitals experience lost capacity, surgeon dissatisfaction, staff burnout, and margin erosion. When optimized, those same services become a powerful engine for sustainable financial improvement.

“This is not about cutting services,” said Dr. Miller. “It is about disciplined governance, smarter utilization, workforce alignment, and predictive analytics that allow hospitals to unlock the financial strength already embedded in their surgical operations.”

What the COO Guide Delivers

The guide outlines eight operational levers that translate directly into measurable financial outcomes:

1. Multidisciplinary Surgical Governance

Establishing a Surgical Services Executive Committee with shared physician and administrative leadership reduces variability, accelerates corrective action, and strengthens accountability.

Financial impact: Governance alignment reduces inefficiencies created by variability, enables faster corrective action, and improves trust between clinical and operational leaders.

2. OR Scheduling and Utilization Optimization

With operating room time costing approximately $80 per minute, unused prime time represents lost revenue. Structured block governance and predictive scheduling have demonstrated OR utilization improvements exceeding 20% in hospitals applying disciplined oversight.

Financial Impact: Increasing OR capacity and access by optimizing utilization and scheduling improves OR revenue.

3. First Case On-Time Starts and Turnover Efficiency

Small gains in timeliness compound across the day, increasing case capacity and reducing overtime costs.

Financial Impact: Even modest improvements in turnover time can add cases per day, reduce overtime, and improve staff satisfaction.

4. Using Robotics and AI to Optimize Standards of Care

Artificial intelligence and robotics are enabling more standardized, data-driven care by reducing clinical variability and improving precision across surgical and perioperative workflows and decision-making. As adoption expands, hospitals are moving toward a more predictive, high-reliability model of care delivery.

Financial Impact: By improving efficiency, reducing complications, and optimizing resource utilization, AI and robotic technologies lower cost per case, decrease length of stay, and strengthen overall margin performance.

5. Workforce Optimization and Engagement

Labor is the largest controllable perioperative expense. Standardized staffing models and cross-training reduce variability and burnout. Keeping your staff positively engaged reduces acquisition and locum costs while most importantly improving patient care.

Financial Impact: A positively engaged and standardized workforce reduces turnover, lowers labor costs, and improves overall perioperative performance

6. Supply and Instrumentation Management

Many perioperative inefficiencies stem from breakdowns in supply chain and instrumentation management rather than operating room capacity. Delays in instrument availability, inaccurate preference cards, and limited visibility into supplies disrupt case flow and lead to avoidable delays and cancellations. By standardizing preference cards, improving supply visibility, and aligning sterile processing with OR demand, hospitals can eliminate bottlenecks and enable more consistent, reliable throughput.

Financial Impact: These improvements directly lower cost per case by reducing unnecessary supply utilization, minimizing rework, and limiting reliance on expedited vendor support, while simultaneously improving overall perioperative margin performance.

7. Case Mix & Service Line Optimization

Optimizing case mix, ensuring the right procedures are performed in the appropriate setting, such as shifting lower acuity cases to ASCs while reserving hospital ORs for more complex cases, is critical to improving efficiency and profitability. Service line optimization must be closely aligned with case mix strategy to ensure resources are directed toward the highest-value care and sustainable growth opportunities.

Financial Impact: By aligning surgeon access and scheduling with case mix optimization, organizations can maximize surgical access and resource utilization while supporting stronger financial and operational outcomes. Data-driven access rules improve volume while reducing overtime and anesthesiology subsidy pressure.

8. Continuous Measurement and Benchmarking

Focused KPI dashboards reinforce accountability and sustain performance improvement over time.

Financial Impact: By consistently measuring each area, you know when your improvements will positively impact your finances. Conversely, when there are changes that negatively impact your goals, you see them before they become financial issues.

Designed to Complement CEO and CFO Strategy Guides

The new COO Guide builds upon Surgical Directions’ widely referenced executive resources centered on financial improvements each area can make. Together, these resources provide coordinated executive-level strategy across the C-suite:

A Hospital CEO’s Guide to OR Financial Improvement – CEOs gain enterprise alignment and cultural transformation frameworks.
CFO-focused rapid impact OR profitability checklists – CFOs receive rapid-impact financial levers tied directly to operational metrics.
COO Guide to Perioperative Operational Improvements That Boost Financial Performance – COOs now have a detailed operational roadmap linking daily execution to measurable margin improvement.

Barbara McClenathan noted, “Operational excellence in surgical services is inseparable from financial performance. When governance, staffing, access, and analytics are aligned, hospitals strengthen access, protect quality, and stabilize the workforce while improving margins.”

A Strategic Asset, not a Cost Center

The guide reinforces a core principle: perioperative services should not be treated as a cost center to be managed, but as a strategic asset to be optimized.

Hospitals that establish strong governance, improve utilization discipline, standardize workforce models, and leverage predictive analytics can unlock meaningful financial improvement.

About Surgical Directions

Surgical Directions is a healthcare solutions company specializing in perioperative and procedural care, sterile processing, anesthesiology, and radiology services. With a unique clinician-led model and proprietary analytics platform, Merlin™, the firm empowers hospitals and provider groups to drive measurable improvements in access, efficiency, and financial performance. From supply chain optimization to governance redesign, Surgical Directions delivers peer-to-peer partnership and clinical expertise that helps clients provide quality care and improve margins. Learn more at www.surgicaldirections.com.