Becker's ASC Review

69 Using an ASC's Design & Dedicated Staff to Optimize the Patient Experience By Mary Rechtoris I n December 2015, New York City-based Memorial Sloan Kettering Cancer Center opened Josie Robertson Surgery Center as an efficient way to serve patients. "By moving less complex surgeries from the main hospital, we are able to optimize the experience for patients while increasing capacity to treat more complex patients at Memorial Hospital," says Brett Simon, MD, PhD, director of JRSC. Before serving patients, JRSC first had to obtain a certificate-of-need from the state of New York. Planners submitted the CON to the state on Dec. 23, 2011, and received approval in July 2012. e center worked closely with the New York's Department of Health's Public Health and Health Planning Council for months. "Five years ago, we reviewed the landscape for trends in cancer surgery and noted that as technology evolved and patients became more informed, stays were getting shorter and more care was being provided in the ambulatory settings," Dr. Simon says. Aer realizing outpatient surgery would be a beneficial option for patients, the planners devised a pilot plan. e plan consisted of: • Identifying candidate surgeries • Simplifying and standardizing clinical processes • Identifying viable patients Memorial Sloan Kettering Cancer Center launched a pilot program that provided care for more than 9,000 patients, allow- ing their ASC to be sufficiently prepared prior to opening. Since its inception four months ago, physicians at the center have performed nearly 2,000 cases, 35 percent of which consist of an overnight stay. Surgeons at the center perform mastec- tomies with immediate reconstruction, thyroid and parotid surgery, robotic and minimally invasive prostatectomies, ne- phrectomies and hysterectomies. "It is our goal to provide patients, their families and caregivers with a superlative experience," Dr. Simon says. JRSC is increas- ingly performing more complex surgeries, and can tackle these cases through a meticu- lously planned process. "We do this through a com- bination of patient and procedure selec- tion, and through careful management of patients on clearly defined pathways," Dr. Simon adds. e center ensures they set patients' expectations as well as provide patients with education tools about their procedure and recovery. Staff members perform a pre-operative evaluation and give patients instructions for the day of surgery through post-discharge support. "Our patients know what to expect and, as events play out as anticipated, it reinforces their confidence and provides stability in an otherwise very anxious time that comes from a new diagnosis of cancer and surgery," Dr. Simon says. "Giving patients clear goals postoperatively, even if its just to walk a certain distance or drink a certain amount by a particular time, allows them to participate in their recovery and focus on getting better, not on their illness." e ASC's structure was built specifically with the patient population in mind. When considering the facility's design, JRSC architects and designers analyzed patients undergoing outpatient cancer surgery ex- periences and accommodated their needs. e patient floors house a central oasis area where patients and families can relax. Art work adorns the walls, encouraging pa- tients to walk around and feel calm before and aer their procedures. "Since all we do here is ambulatory cancer surgery, all of our staff are focused on helping these patients recuperate and get home feeling confident and in control of their own recovery," Dr. Simon said. "ese factors together drive a very high level of patient satisfaction." n Why Denver Health is Experiencing an Exodus of Physicians By Tamara Rosin D enver Health Medical Center, the city's historic safety-net hospital and one of only a few Level I trauma centers in Colorado, is attempting to deal with a series of physician resigna- tions, according to the Denver Post. Most recently, three of Denver Health Medical Center's five neurosurgeons gave notice to leave the hospital by April 1. The hospital has also confirmed the head of emergency medicine and a top trauma surgeon will depart for other jobs. Last year, physicians at the head of the departments of medicine and surgery left the hospital and have yet to be replaced. Additionally, the chiefs of ophthalmology and oral surgery resigned, along with six hospitalists, according to the report. Some hospital staff have described the exodus of physicians as a crisis, voicing concerns regarding reduced operating room staffs, the hospital's ability to con- tinue serving the poor and the condition of its partnership with University of Colo- rado Hospital in Aurora, according to the report. At the same time, the community has questioned whether Denver Health Medical Center will be able to continue operating as a Level I trauma center. Arthur Gonzalez, CEO of the Denver Health Medical Center, stated in a memo that the University of Colorado will provide neurosurgeons to the hospital to enable it to continue operating as a Level I trauma center. He acknowledged, however, that the medical center "is go- ing through immense change" due to the Affordable Care Act. Mr. Gonzalez also said the hospital administration has recently implemented other changes, such as the dismissal of its chief clinical officer and agreeing not to alter its system for compensating physi- cians. The physicians that have resigned over the last year have cited different reasons for leaving, and "it would be inaccurate to paint all of these people with the same broad brush," said Mr. Gonzalez, accord- ing to the report. n Dr. Brett Simon

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