Becker's Hospital Review

18 Executive Briefing: Hospital-ASC Joint Ventures tem" ensuring a patient's airway status was communicated to the entire healthcare team and that the necessary intubation equip- ment was readily available in all of the health system's six hos- pitals. The new protocol went live in February 2012. It focused on three key factors: identifying a patient as difficult to intubate, communicating a patient's DTI status to all medical staff via blue wrist band and medical chart notation and ensuring equipment was standardized throughout the six hospitals in a manner identi- cal to a "code" cart. "The medical staff's teamwork has greatly benefited our patients who have tenuous airways," says Dr. Loskove. "It is this type of leadership, collaboration and alignment with hospital goals that is central to the success of any initiative." At Baptist Hospital, Dr. Abraham has also spearheaded initia- tives to produce better outcomes. One of those projects involves improving blood management and reducing blood transfusions. He says anesthesiologists, oncologists, gastroenterologists and other specialists have collaborated with the hospital and physi- cians on the medical staff to make patient outcomes better while simultaneously reducing costs. They have worked to lower transfusion triggers and increase blood conservation. They have also started looking to test pa- tients scheduled for elective surgery for anemia and self-salvag- ing, or collecting the patient's own blood with machines during procedures and giving it back to them. "I think we've done a good job with reducing transfusions, and our outcomes are better because our patients are having fewer complications with transfusions," he says. "And we've also been able to shorten our length of stay." Learning to trust and accept change: Challenges for physician-led initiatives Despite the positive outcome, Dr. Blomberg says hospital employ- ees and administrators weren't necessarily comfortable with the OR revamping initiative at first, even though they weren't happy with the existing protocols at that time. "Everybody's scared of change," he says. "They're scared of un- certainty." Dr. Blomberg says he and the other committee members were able to get people on board by making sure everyone was in- volved in the initiative. "We didn't just use physician leaders, nursing leaders and hospi- tal leaders," he says. "We had the frontline staff become involved in task forces as well. By getting all of these individuals on the task forces, the individuals on the ground and not just the leaders, we really had motivation. We really had buy-in." In spearheading the airway status notification system, Dr. Los- kove found that a lack of trust between physicians and hospital administrators posed a challenge. He says physicians will say administrators don't understand what clinicians are trying to do, while administrators can be skeptical of whether the resources physicians request are truly necessary. That's where physician leaders come in. "Look at my role as an anesthesiologist," he says. "If we're going to change the OR mod- el to be more cost-effective…there's certainly going to be some growing pains along the way. The surgeons trust me that we're doing all this for the patients' best interests and [their] best inter- ests. It's just going to take a little bit to get there. To hear that from an administrator, I'm not so sure that would work." Conclusion Ultimately, Dr. Blomberg says hospitals and physicians need to work together to benefit their patients. "Physicians and hospitals have to align first and foremost for the patients," he says. "You have to have everybody at the table and try to align their interests as best as possible. They have to be on the same page, because patients suffer if they're not." n "The role of the physician leader is to understand both sides of the approach and serve as a mediator between the physicians and administrators." — Joseph Loskove, MD, Sheridan Healthcare Regional Director and Chief of Anesthesia for Memorial Healthcare System Sheridan Healthcare, INC. is a national hospital-based, multi-specialty outsourced services company that provides anesthesiology, radiology, emer- gency medicine, neonatology and other pediatric subspecialties.Sheridan, its subsidiaries and affiliates currently operate in 25 states and employ more than 2,800 providers. In addition to physician and allied health services, Sheridan also provides support, training and management in non-clinical areas.

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