Becker's Hospital Review

Executive Briefing: The Changing Anesthesia Landscape circumstances. Not only does that drive patient outcomes, but quality-based care can bolster financial outcomes as well. TeamHealth has an advantage here over hospital-employed anesthesiologists and smaller anesthesiology practices, Dr. Pease says, because it manages more than 250 anesthesiologists and 1,100 certified nurse anesthetists and anesthesiologist assistants at about 50 facilities across the country. That enables TeamHealth to draw upon five years of data from over a million patient encounters performed in a wide geographic span, eclipsing the mere 1,000 to 5,000 analyzed in most anesthesia studies, she says. TeamHealth's enormous bank of quality outcome data helps change physician behavior and allows TeamHealth to create benchmarks on hundreds of quality measures. Having a quality outcome database that is compliant, 100 percent validated and able to be risk-stratified is critical in developing predictive modeling programs for future anesthesia practice models. "We track every anesthetic that we administer nationwide. We're currently collecting over 250,000 anesthetics annually into our database," Dr. Pease says. "The whole purpose is to track quality and evaluate outcomes. If you can't measure outcomes and give individual feedback to providers, then you can't change behavior, fix system issues and improve patient care." Scope of care. Dr. Pease began her career as an anesthesiologist assistant and practiced for eight years as she went back to medical school and became an anesthesiologist. After receiving her MD, she went into private practice for 10 years, becoming the owner and operator of her own practice. Like many anesthesiologists in small hospital practices, she found she spent far more of her time centered on running the business and struggling to report quality measures than seeing and caring for her patients. TeamHealth is able to relieve most of these administrative burdens for providers so they can focus on patient care, she says. Dr. Pease believes buying into economies of scale will play a much larger role for hospitals contracting anesthesiology services, as will relying more heavily on mid-level clinicians like AAs and CRNAs. There are critics in the industry who argue such practices risk breaching 79 tions that may occur during the perioperative course of a patient's hospital stay. "I think advanced practice clinicians are going to be critical to our future," she says. "I went back [to school for my MD] because I loved what I "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 Chron's disease exacerbation, an anesthesiologist can manage hard-to-treat inpatient pain to improve the patient's hospital experience." - Dr. Sonya Pease the appropriate scope of care for these professionals, but she says anesthesiologists like herself should view advanced practitioners as professional colleagues who are able to expand our anesthesia resources to meet the demands of healthcare today. This allows physicians to allot their time on the most complex cases that require their expertise and focus more on medical diagnosis, disease treatment and management and prevention of complica- was doing [as an anesthesiologist assistant] and I wanted to have a deeper, broader knowledge to handle more complex cases. All of [TeamHealth's] anesthesia practices incorporate the anesthesia care team model that utilizes anesthesiologists working with AAs and CRNAs. It's a model we very much believe in." n TeamHealth is one of the largest suppliers of outsourced healthcare professional staffing and administrative services to hospitals and other healthcare groups in the United States. Founded by emergency physicians in 1979, TeamHealth remains a physician-led, patientfocused organization committed to strengthening hospitals, supporting physicians and improving healthcare through high-quality management, staffing and support services. TeamHealth's more than 5,600 affiliated healthcare professionals provide emergency medicine, hospital medicine, anesthesia and pediatric staffing and management services to more than 540 civilian and military hospitals, clinics, and physician groups in 45 states.

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