On March 23, Somnia Anesthesia Services hosted a Webinar titled, "Improving Operating Room and Anesthesia Efficiency in Your Hospital," which highlighted how anesthesia efficiency can affect OR efficiencies and a hospital's revenues.
Ms. Shumelda next provided examples of how St. Mary's, a community hospital in the Seton Health network, addressed anesthesia and OR efficiency issues to improve how their ORs were running.
St. Mary's had seen a change in its case mix, with more surgeries performed in an outpatient setting (including physician offices and ASCs) and was dealing with an inflexible anesthesia group which caused anesthesia cases to stagnate. Issues with an inefficient pre-admission testing process and delayed OR turnaround times also contributed to decreased surgeon satisfaction and low productivity.
Bringing in a new anesthesia group that shared the mission and vision of the hospital was essential to St. Mary's OR improvements. Here are a few key areas the hospital was able to improve with the help of aligned and dedicated anesthesia leadership:
Ms. Shumelda discussed areas to monitor and measure efficiencies, including cases after 5 p.m., weekend and holiday cases, overtime and cancellations and reschedules. SCIP scores also improved due to coordinating service better with the anesthesia group.
Dr. Goldstein next highlighted the following six steps to running an efficient department of anesthesia:
Integrating the anesthesia team into the culture of the OR and improving efficiency and on-time starts were also noted as important aspects to improving a hospital's bottom line. Dr. Goldstein noted the importance of an efficient, cost-effective anesthesia staffing model and dedicated leadership to this process.
Dr. Goldstein concluded by stressing the important of a clinical quality excellence program within an OR, as it drives OR efficiency. Good quality reporting, he said, can track trends within the OR and ensure that the department is meeting expectations. It should be aligned and integrated within the hospital's values and be an ongoing, 24/7 process. He noted the benefits of a good CQE program include exceeding clinical standards, professional development, performance improvement and customer satisfaction.
To download a copy of the presentation and video recording of the Webinar, please click here.
Speakers were Debra Shumelda, director perioperative services of St. Mary's Hospital in Troy, N.Y., and Robert Goldstein, MD, executive vice president and chief medical officer of Somnia Anesthesia Services.
Dr. Goldstein began the presentation saying that the OR generates 70 percent of a hospital's revenue. He highlighted the following areas as having a major impact on OR efficiency:
- Anesthesia team efficiency and availability
- Variability in surgical practice
- OR scheduling
- Patient flow, including pre-operative testing, patient transportation, OR turnaround and post-op care
- Quality management tracking and trending
Ms. Shumelda next provided examples of how St. Mary's, a community hospital in the Seton Health network, addressed anesthesia and OR efficiency issues to improve how their ORs were running.
St. Mary's had seen a change in its case mix, with more surgeries performed in an outpatient setting (including physician offices and ASCs) and was dealing with an inflexible anesthesia group which caused anesthesia cases to stagnate. Issues with an inefficient pre-admission testing process and delayed OR turnaround times also contributed to decreased surgeon satisfaction and low productivity.
Bringing in a new anesthesia group that shared the mission and vision of the hospital was essential to St. Mary's OR improvements. Here are a few key areas the hospital was able to improve with the help of aligned and dedicated anesthesia leadership:
- Scheduling efficiency — St. Mary's identified and coordinated key resources for surgeons and created a block scheduling policy that included measurements and reporting of block scheduling usage. The hospital improved its real-time scheduling to help accommodate add-on cases. Collaborative OR schedule management between the hospital and the anesthesia group and an improved "bumping" protocol helped facilitate holidays, weekends and emergency cases.
- PAT process — By improving pre-admission testing, St. Mary's could reduce delays and cancellations. St. Mary's standardized testing with anesthesia groups improved patient education, specifically regarding NPO and medication instructions. Anesthesiologists interviewed patients and reviewed charts prior to the date of surgery and the patient's history and physicians were made available prior to the day of surgery.
- OR turnover and post-op — St. Mary's assigned one surgical specialty each day to the OR to maximize staff efficiencies and cross-trained nurses to handle pre- and post-op patients so they could relieve nurses throughout the unit. Regional blocks were performed in the pre-op area, and the hospital improved post-op pain management to maximize efficiency there. Working as a team to turn over ORs also helped to improve St. Mary's efficiencies.
Ms. Shumelda discussed areas to monitor and measure efficiencies, including cases after 5 p.m., weekend and holiday cases, overtime and cancellations and reschedules. SCIP scores also improved due to coordinating service better with the anesthesia group.
Dr. Goldstein next highlighted the following six steps to running an efficient department of anesthesia:
- Step 1: Define purpose of the anesthesia department
- Step 2: Determine end users
- Step 3: Define what is important to end user
- Step 4: Provide quality that meets their needs
- Step 5: Measure performance
- Step: 6 Make changes and monitor performance
Integrating the anesthesia team into the culture of the OR and improving efficiency and on-time starts were also noted as important aspects to improving a hospital's bottom line. Dr. Goldstein noted the importance of an efficient, cost-effective anesthesia staffing model and dedicated leadership to this process.
Dr. Goldstein concluded by stressing the important of a clinical quality excellence program within an OR, as it drives OR efficiency. Good quality reporting, he said, can track trends within the OR and ensure that the department is meeting expectations. It should be aligned and integrated within the hospital's values and be an ongoing, 24/7 process. He noted the benefits of a good CQE program include exceeding clinical standards, professional development, performance improvement and customer satisfaction.
To download a copy of the presentation and video recording of the Webinar, please click here.