How to Evaluate the Efficiency and Quality of an ASC’s Anesthesia Services
Charles Militana, MD, director of ambulatory surgery centers at Melville, N.Y.-based North American Partners in Anesthesia, used that slogan from Faber College, the fictional institution at the center of the 1976 movie Animal House, to drive home the importance of knowing for sure how good an anesthesiology service really is.
During an Oct. 25 session at the 20th Annual Ambulatory Surgery Centers Conference in Chicago, Dr. Militana shared the four areas anesthesiology services should excel in, and how to tell if they’ve hit the mark.
1. Leadership. “The last thing you want is a hodgepodge of clinicians coming through” and lacking the leadership and accountability that comes from having one director, said Dr. Militana. An ASC should have a director of anesthesia that is aligned with the goals of the center and consistently adheres to a high standard of care.
The director should hold regular meetings with all the ASC staff helps to ensure everyone is on the same page, and provides a forum for staff to share relevant information or concerns. “At these meetings, it’s important everyone feels they can speak and share,” said Dr. Militana, so all relevant issues and raised and the addressed.
2. Efficiency. An anesthesiology staffing plan should take into account the number of concurrent anesthetizing locations in the ASC and then determining the most efficient staffing that would still guarantee patient safety. For example, an ASC with seven rooms might have six certified registered nurse anesthetists supervised by two physicians, and one physician in an endocrinology or other specialized suite, with an extra physician and CRNA on staff for vacation coverage.
The anesthesiology department should also be in charge of ensuring on-time starts for procedures, said Dr. Militana, and monitor patient transfer and turnover times, to keep efficiency at a maximum.
3. Quality Assurance. “The anesthesiology department should be a significant resource for quality assurance data collection,” said Dr. Militana. Types of cases, operating room times, complication rates and other metrics are easily tracked through the anesthesiology department.
This data then can, and should, be used to make improvements throughout the ASC, said Dr. Militana.
4. Patient Satisfaction. The anesthesiologist should also be tracking the number one patient complaint — post-operative and post-discharge nausea and vomiting, and taking steps to reduce the prevalence, said Dr. Militana. The anesthesiologist should also be able to anticipate post-operative pain requirements and utilize preemptive analgesia protocols, all of which have a significant impact on patient satisfaction.
“Remember — if the patients aren’t happy, the surgeons aren’t happy, and the ASC is not a success,” he said.
More Articles on Anesthesia Programs:
The SEDASYS System and the Future of Anesthesia Use During Colonoscopies
Operation Smile Names Anesthesiologist Dr. Richard Berlin Associate Chief Medical Officer
Hospital-Physician Compensation: What the Tuomey Ruling Means for Anesthesiologists
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