An OR block is a fixed cost wearing a schedule. Whether you fill it with twelve cases or seven, the facility time, staff, and your surgical day are spent. That's why block utilization is the highest-leverage operational number in surgical ophthalmology — and why the practices that measure it honestly outperform the ones that go by feel.
Measure it without flattering yourself
Utilization = used block time ÷ allocated block time, measured wheels-in to wheels-out plus standard turnover. Two honesty rules: count released-late time against yourself (a block released the day before doesn't get backfilled by the facility), and track first-case on-time starts separately — a 25-minute late start repeats itself across every case that follows. Most eye care practices that measure for the first time find they're running 70–80% while believing they're 'always full.'
Sequence cases deliberately
Cataract-heavy blocks reward pattern consistency: group same-lens, same-approach cases to cut turnover decisions, schedule the complex cases (dense lenses, pseudoexfoliation, small pupils, anxious patients) where a delay damages least — typically late in the block — and put the most predictable cases first to protect the on-time start. If you run femto or premium workflows, batch them; alternating tech setups burns minutes every switch.
Attack turnover time
Turnover isn't cleaning time, it's coordination time: the next patient dilated and verified, consent confirmed, lens in the room, paperwork done. Parallel-processing — a preop nurse finalizing patient three while patient two is draped — comes from having the right support staff, not faster surgeons. Practices running sub-8-minute cataract turnovers all share one trait: nobody is doing two roles at once during the block.
Fill the leaks
The two big leaks are late cancellations and timid booking. The first has a known fix — the confirmation and clearance system from our cancellation playbook, plus a standby list that backfills within 48 hours. The second is subtler: schedulers who book conservatively 'to be safe' lock in underutilization. Give your scheduler target cases-per-block by case mix and the authority to book to it.
Review monthly, adjust quarterly
A one-page monthly report — utilization by block, on-time start rate, cancellation backfill rate, cases per block trend — tells you whether to fix process or adjust allocation. Persistently under 75% with a healthy clinic usually means your block allocation exceeds demand; persistently over 95% with a growing backlog means it's time to add time.
Assembling that report and running the standby and confirmation lists is exactly the administrative layer many optometry and ophthalmology groups now hand to an eye care virtual assistant at a flat $10/hour — the surgeon's block gets managed like the asset it is, without another salaried seat at the front desk.
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