Issue link: https://beckershealthcare.uberflip.com/i/148059
Executive Briefing: Protecting OR Revenue Single-path scheduling. In many ORs, the case scheduling process is disorganized and inefficient. OR staff and surgeons fail to capture complete information on patients for scheduled procedures. Better-performing ORs create a "single pathway" for the scheduling process to ensure quality, remove variability and prevent errors. Develop a standardized fax form (or IT/IS module) with required fields for patient identifier, specific procedure information, patient comorbidities and other critical details. Standardized scheduling processes ensure that OR staff are able to identify and manage all patient risk factors ahead of surgery. 47 lapses without finger-pointing and put energy into fixing broken processes. In addition, anonymous error reporting helps ensure that safety events are brought to light so that staff can identify root causes and prevent future recurrences. OVE YOUR BOTTOM LINE. Pre-surgical testing. In most ORs, pre-surgical evaluation is incomplete, expensive or both. In better-performing hospitals, the SSEC creates pre-surgical testing and patient management protocols specific to disease, procedure, comorbidities and other risk factors. Integrating case management, anesthesia and hospitalists into presurgical processes is important to improving clinical outcomes. Welldesigned testing and preparation protocols help ensure patients are optimized for their procedure and for a speedy recovery. Daily huddle. In better-performing ORs, a multidisciplinary caregiver group takes 20 to 30 minutes every afternoon to review the next day's schedule. The purpose of this "daily huddle" is to verify patient preparation, reschedule patients who are not ready for surgery and flag any potential problems with the schedule, equipment, etc. An effective huddle not perioperative consistently helps hospitals improve their only increases patient safety, it also reduces case delays and cancellations and the past seven years, our consultants have changed the ensures the schedule runs as smoothly as possible. Case Study: CarolinaEast Implementing the four strategies described above can have a significant impact on both a hospital OR and its surgeon partners. CarolinaEast Health System runs a 12-room hospital OR (10 rooms currently operational) and a six-room outpatient surgery center in New Bern, N.C. In 2009, the surgical services department was facing declining case volume and high surgeon dissatisfaction. In 2010, CarolinaEast took a series of steps to turn around OR performance. Interventions included creating a physician-led SSEC to run the OR, strengthening the block schedule system, creating a protocol-driven pre-admission testing center and implementing a daily huddle. The OR also implemented several safety initiatives. In less than a year, OR utilization at CarolinaEast increased from 48 to 73 percent. After one year, average monthly case volume had increased approximately 8 percent. Better patient management and safety processes led to improved quality metrics. Patients were better prepared for surgery and length of stay decreased. From the surgeon perspective, schedule access and practice efficiency improved markedly. Surgeon complaints declined, and surgeons started steering more cases to the OR. ctions' consultants deliver sustainable operational t through measurable results and culture change. mportantly, improved the bottom line for more than 4. Create the systems and academic mmunity-based hospitals to large quaternary culture of safety For the typical hospital, Medicare HAC penalties ur multi-disciplinary teams of anesthesia, nursing and could amount to $250,000 or more per year. The key to avoiding errors and nts typically help hospitals increase embed safety in OR processes. preventable complications is to profitability by 0 per ORTackle the issue from several angles: by improving: Financial synergy Hospitals like CarolinaEast are well positioned to thrive in the evolving surgery market. Strong surgical quality metrics help maintain revenue under quality-driven payment models. In addition, higher utilization creates a leaner cost structure, enabling ORs to do well under shared savings arrangements. Surgeons benefit as well. Many well-run ORs have leveraged Checklists. Implementing the World Health Organization's Surgiquality gains to negotiate payer contractual bonuses for surgeons, cal Safety Checklist as part of the universal safety protocols ensatisfaction thatBlock use safe processes 100 percent of anesthesia staffing models improvements allow surgeons to optimize their proQ staff time Q RN and the time. In and efficiency sures r time many ORs, safety checklists spend Q Materials/supply have been instrumental in incrementalductivity. These gains reinforce surgeon satisfaction, engagement Q Profitable reducing OR volume and loyalty, driving strong OR revenue and volume. n sentinel events and improving quality metrics. cut time Q Labor spend Q Improving OR leadership starts Crew resource management.levels from the aviation indus- William Panza, MD, is a board-certified anesthesiologist who Q Anesthesia service Adapted try, CRM is a set of principles that support clear communication practices in New Bern, N.C. Dr. Panza is also a consultant with focused on learning from mistakes, not assigning blame. Modeled reached at (312) 870-5600. cuss yourabout risks. CRM flattens hierarchies and empowers all as tellto Surgical Directions, a physician-led consulting firm that helps hosspecific issues within Perioperative Services as well staff you about pital ORs improve clinical outcomes, financial performance and take responsibility for patient safety.similar situations. Contact us to schedule s used by other organizations to address patient and staff satisfaction. Robert Dahl is senior vice president n conference call surgery departments also needdesign a path to operational excellence! Hospital to review your situation and to foster a "just culture" and chief operating officer at Surgical Directions. They can be ive consultants help youjust cultureyour bottom linehonest about quality quality outcomes, by leadership, a enhance allows staff to be through improved tive process and overall operational improvement. ve & anesthesia essment · interim management Surgical Directions is the nation's premier Perioperative and Anesthesia Services consulting firm. We are led by nationally recognized anesthesiologists, surgeons, CRNAs and surgical services professionals who passionately help our clients improve their perioperative and anesthesia services through operational, financial and cultural transformation. We typically showcase between $250,000 to $500,000 of financial improvement per operating room within twelve months of each engagement based upon proper allocation of existing resources, non-labor cost savings and improved revenues through a strategic growth planning. 12.870.5600 www.surgicaldirections.com The Surgical Directions team provides hands-on assistance with an assessment of existing services, gap analysis of existing state versus benchmark and implementation of recommendations to improve overall service levels. We have extensive experience with: • rganizational design, strategic planning, man power/medical staff development strategy, scheduling optimization, pre-admission testing optimization, O supply chain management/materials management, central sterile processing, information systems design, staffing, OR management, inter/intra-operative work flow and throughput efficiencies, physician relations, anesthesia contracts and negotiations, revenue cycle management, and facility planning. Over the past decade, we have successfully helped more than 500+ hospitals. Our client hospitals enjoy a sustainable competitive advantage by providing improved clinical outcomes, increased surgical and procedural volumes, a reduced cost structure and improved physician/staff/patient satisfaction.