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Driving performance in surgical services at Nash UNC Health Care

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Performance improvement consulting help to increase efficiency across the surgical continuum


Surgical Services at Nash UNC Health Care was looking to improve processes and return to efficient performance at their Nash General and Nash Day facilities. After struggling with surgical volumes due to several years of service line market changes and a decline in physician referrals, they needed to become more efficient and fiscally sound.


Nash UNC Health Care partnered with Philips to conduct a staff and leadership assessment to understand operational issues and develop processes and strategies to enhance surgical services efficiencies. After the initial assessment period, administrators at Nash UNC Health Care engaged Philips for a 12-week Phase One surgical services performance improvement project to positively impact patient throughput across the surgical continuum.

As a result of the performance improvement changes, Nash General Hospital was able to:

Website graphic Nash UNC GENERAL

As a result of the performance improvement changes, Nash Day Hospital was able to:

Website graphic Nash UNC DAY

A comprehensive and collaborative approach to process improvement in surgical services 



During the initial assessment, Philips consultants analyzed multiple data sources to determine current state performance, understand department flow, and define the current baseline for analysis to support the creation of actionable recommendations. Data sources used included staff interviews, scheduled case durations, block schedule, on-site observations, and industry best practices.


Assessment recommendations 

Based on the assessment, a three-phase approach was proposed to provide comprehensive ongoing leadership and change management coaching:


  • Phase One: Focus on data management
  • Phase Two: Focus on operational performance
  • Phase Three: Focus on program management


The goal was to continuously improve surgical services performance, effectively deploy change, achieve annual and longer-term performance targets, and innovate for expected future growth.


Phase One performance improvement project  

Nash UNC Health Care leadership team committed to a short 12-week Phase One surgical services performance improvement project focused on data management. 


Phase One deliverables included:  

  • Redesign Epic dashboard with defined KPIs and drive improvement to reduce room turnover time (TOT), improve first case on-time starts (FCOTS), and reduce day of surgery (DOS) cancellation and/or delays
  • Resolve data integrity issues within data mapping
  • Optimize doctor preference cards to ensure proper resource allocation and case and procedure durations 
  • Map data fields for enhanced inventory management and charge capture
  • Propose future state staffing models to align with key operational improvements 



To assure staff involvement and ‘buy-in’, performance improvement activities were carried out by four separate workgroups: FCOTS, room TOT, cancellations and delays, and doctor preference card redesign. Each group was tasked to build current states, figure out the problems, and come up with counter-measures to develop a solid future state. Facilitated by a Philips subject matter expert, each workgroup then created new policy statements and defined how changes would potentially impact staff.


Knowing how to drive toward best practices was a key takeaway for all the staff. An understanding of how to strive for, achieve and sustain each KPI, put them on track for continued success. By giving them the tools they need to succeed, Nash UNC Health Care can now measure performance improvement and sustain ongoing change management of same.


Additional customization within the electronic system, validation of data, and streamlined future state processes sustains the drive toward improvements with KPIs. Adherence to KPIs keep the surgeons happy and the day flowing smoothly.



Design and implementation efforts were focused on efficient patient flow through the surgical continuum. Greater transparencies were created regarding data definitions/calculations, surgical scheduling, and doctor preference card maintenance within the electronic system. 

As a result of the performance improvement changes, Nash General Hospital was able to:

Website graphic Nash UNC GENERAL

As a result of the performance improvement changes, Nash Day Hospital was able to:

Website graphic Nash UNC DAY


Results from case studies are not predictive of results in other cases. Results in other cases may vary.

Nash UNC Health Care, part of the non-profit UNC Health Care system, is a 403-bed medical center located in Rocky Mount, North Carolina. Nash General Hospital is an all private-room inpatient care center with eight operating rooms, while Nash Day Hospital is an outpatient surgery center with five operating rooms.

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Meet our team

Beth Fuller

Peggy Clifton, RN, MSHA, BSN

Senior Consulting Manager

Peggy brings over 30 years of nursing leadership and consulting experience. A solutions-oriented and results-driven professional, she has managed end-to-end engagements with healthcare clients to introduce a variety of process improvements, systems optimization, workflow standardization, and other performance enhancements. She has implemented key initiatives impacting patient throughput, workflow efficiencies, and capacity management for large healthcare systems.

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