Becker's Hospital Review

83 Executive Briefing: Growing OR Case Volume Sponsored by R ecent research from Health Care Management Review confirms what hospital executives have known for years: Hospitals in markets with many ambulatory surgery cen- ters have disturbingly high exit rates. When surgeons migrate cases to ASCs, hospital net income is in danger. Executives and trustees often don't know how to respond. How can hospital ORs compete with surgeon-owned ASCs? The key is to understand the surgeon point of view. Surgeons today are struggling with lower personal case volumes, lower pay- ment and lower income. Most are spending more time in the of- fice to generate cases. All surgeons are subject to higher quality requirements. Simply put, ORs that help surgeons overcome these problems are able to win significant case volume back from ASCs. These ORs not only hold their own against smaller centers, they are of- ten able to drive ASC volume down to the point of forcing com- petitors to exit. To transform your OR into a competitive surgical services provider, focus on three core strategies: 1. Help surgeons be more productive ASCs excel at treating surgeons like customers. Surgeons are able to access the schedule easily, start surgeries promptly and end their day on time. To compete, hospital ORs must provide the same level of efficiency and service. Here's how: Make scheduling easier. In most hospital ORs, the block time system is poorly designed. Short blocks and lax rules create large, un-fillable gaps in the schedule. Surgeons have a hard time scheduling cases even though utilization is low. To fix this prob- lem, set a minimum block length of eight hours and require physi- cians to maintain 75 percent utilization. Hospitals that strengthen block rules are able to provide more surgeons with "premium ac- cess" to OR time. Help surgeons optimize patients for surgery. Surgeons devote sig- nificant time and resources to preparing patients for surgery and coordinating clearances. Leading hospitals have created protocol- driven preadmission testing departments that assume responsi- bility for patient preparation. Enhancing your PAT processes will save surgeons time and give them greater assurance of a good outcome. Surgeons respond by bringing more cases to your OR. Get surgeons in and out quickly. Delays and cancellations are frustrating for surgeons. Enhancing your PAT process will reduce late starts and canceled cases by ensuring patients are ready for their procedure. In addition, several innovative ORs have insti- tuted a daily huddle — a brief afternoon meeting involving anes- thesia, nursing and other stakeholders. Participants examine up- coming cases, verify patient clearance and resolve any problems that could disrupt surgeons' schedules. Speed up turnover. Long gaps between cases are a major source of surgeon dissatisfaction. Typically, the problem is that OR staff take a slow "step-after-step" approach to breakdown and setup. Hospital ORs can often match ASC turnover efficiency by replac- ing sequential steps with parallel processes. Dedicated turnover teams can streamline processes even more. In addition, enhance anesthesia service standards and nursing incentives to encour- age workday efficiency. These operational improvements have many collateral benefits. Improving quality through better PAT will boost your OR in the eyes of primary care physicians, leading to more referrals. And block time utilization standards discourage surgeons from taking all their profitable cases to ASCs, creating a better payer mix. 2. Help surgeons fulfill their aspirations One reason ASCs are successful is that they represent a financial opportunity for surgeon investors. To compete with ASCs, hospitals must provide surgeons with rival opportunities to increase income. Has Your Surgery Department Lost Business to ASCs? 3 Strategies Thriving ORs Are Using to Win Back Case Volume By Jeffry Peters, President and CEO, Surgical Directions ASCs excel at treating surgeons like customers. To compete, hospital ORs must provide the same level of efficiency and service. & anesthesia assessment · interim management 312.870.5600 www.SurgicalDirections.com Services – Nursing Managers and Directors Services – Nurse Educators Services – Business Managers Processing Department – Managers and Directors provide you with leadership that will insure stability of transition.

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