Strong Perioperative Start Times and Utilization Improvements Made at UABHS

Guidehouse partnership focuses on optimizing key processes, efficiencies, and throughput across the continuum of care


In 2015, the University of Alabama at Birmingham Health System (UABHS) had prioritized the need for process improvements in its perioperative continuum of care. Operationally, the perioperative continuum requires multidisciplinary, cross-functional teams to maneuver within a complex, fast-paced hospital environment. The perioperative continuum provides surgical care for patients through pre-operative, intra-operative, and post-operative processes. These processes are sequential where each activity sequence sets the pace for the efficiency and effectiveness of subsequent activities.

UABHS perioperative services was experiencing day-to-day challenges in creating the safest, most efficient, and productive surgical environment. As a result, its perioperative continuum faced issues related to patient flow/throughput, quality of care, and stakeholder satisfaction (i.e., patient, physician, and staff).


Guidehouse Inc. provided an assessment of the health system’s perioperative services and identified areas that would benefit from support solutions. Over the course of 18 months, Guidehouse used a comprehensive, systematic approach to design and implement multidisciplinary team-based strategies to improve clinical, quality and service outcomes. In coordination with UAB perioperative leadership, the Guidehouse team specifically focused on:

  • Redesigning the perioperative governance structure
  • Aligning the culture in the perioperative process to adapt to the rapidly shifting priorities in the perioperative settings
  • Implementing performance measures paired with meaningful clinical data to drive sustainable change in the perioperative operational model and practice
  • Implementing a surgical scheduling model that aligns surgical cases and resource demands
  • Optimizing patient throughput/flow issues across the perioperative continuum

Our perioperative partnership with Guidehouse focused on optimizing our key processes, efficiencies, and throughput across the continuum of care. The success of this partnership significantly changed and increased our ability to provide an optimal pre- and post-surgical patient experience that supports the continuum of perioperative medicine care.

Brenda Carlisle, MSHA, RN, CENP
Vice President Clinical Operations
University of Alabama at Birmingham Health System


UABHS Impact

This collaborative and interdisciplinary project was the strongest demonstration of UAB mindset that there is no limit to what can be accomplished if it doesn’t matter who gets the credit. Everyone participated and contributed to make this project a real success.

Juhan Paiste, MD, MBA
Associate Professor/Interim Chair
UABHS Department of Anesthesiology and Perioperative Medicine

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