Despite the OR contributing roughly 60% of hospital revenue, perioperative teams still face familiar frustrations. Schedules that look good in the morning unravel by midday. Cases run long, rooms sit idle, and staff are left scrambling to adjust.

Like many hospitals, Houston Methodist used its EHR for simplistic case duration forecasts based on a small sample of past surgeries. In many cases, schedulers overrode predictions with surgeon estimates — a sign that the available data was unreliable.