Becker's Hospital Review

Executive Briefing: The Changing Anesthesia Landscape 78 Sponsored by The Future of Anesthesiology: 3 Key Observations By Jim McLaughlin A nesthesiology may put some people to sleep, but the specialty is about to get a wakeup call. Sonya Pease, MD, CMO for anesthesia services at Knoxville-based TeamHealth, says anesthesiologists' role in care delivery is poised to expand beyond the operating room. Perioperative leadership. The biggest change in anesthesiology today is that anesthesiologists are being groomed to become perioperative directors, says Dr. Pease, an anesthesiologist herself. From their vantage point, working with physicians and nurses of multiple specialties at all stages of surgery and recovery, she says anesthesiologists can coordinate episodes of care for patients in the pre-, post- and intraoperative phases, helping to lessen patients' risk factors and improve their outcomes. is running high, then we know your chances of having a complication after surgery are higher." Predicting and preventing or lessening those complications can also help to keep ORs running on schedule and prevent last-minute cancelations and delays. Half of many hospitals' revenue comes from surgery, she says, and surgery makes up 60 to 70 percent of most hospital budgets. With such a large chunk of the hospital's budget at stake, excellent perioperative leadership is a must. If anesthesiologists can help reduce risks of readmittance, longer hospital stays or less satisfied patients, then they can protect millions in hospitals' already threatened revenue streams and even boost income through raising value-based purchasing multipliers thanks to satisfied patients. Half of many hospitals' revenue comes from surgery...and surgery makes up 60 to 70 percent of most hospital budgets. With such a large chunk of the hospital's budget at stake, excellent preoperative leadership is a must. "What we're really good at is recognizing risk factors," she says. "If you want your kidney taken out, you want to make sure you're optimized prior to surgery. There are things we can do in the preoperative setting that will help. It's a known fact that medical care becomes more expensive if a patient has a complication during surgery. If you're diabetic and your blood sugar Dr. Sonya Pease "In the near-future world, the value-based purchasing modifier will apply to all providers of all specialties by 2017, and 30 percent of the value-based purchasing modifier will be based on patient satisfaction. In anesthesiology, we know pain and how to treat it, and the number one factor for patients' dissatisfaction in hospitals is uncontrolled pain," Dr. Pease says. Outside the OR. "We as anesthesiologists are not just involved in surgery anymore. If a patient is admitted to the hospital with a sickle cell disease attack or Crohn's disease exacerbation, an anesthesiologist can manage hard-to-treat inpatient pain to improve the patient's hospital experience," Dr. Pease says. When surgery is necessary, anesthesiologists are able to consult with patients to help them prepare for surgery and reduce risk factors. Simple recommendations such as quitting smoking just eight weeks before surgery can drop the risk of post-operative pneumonia by sometimes up to 50 percent, she says, making for shorter hospital stays and better quality care. Meeting with a perioperative anesthesiologist before undergoing a procedure allows for better management and treatment for conditions like sleep apnea, pulmonary disease and chronic pain management syndromes. Blood management protocols can also be implemented prior to the day of surgery and can benefit patients tremendously by decreasing the risk of blood transfusions and potential complications associated with blood transfusions. Benefits of scale. Just like any other medical specialty, leaders in anesthesiology rely on evidence-based best practices to determine the best drugs and techniques to use for different clinical

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