The race for ASC efficiency and value: 4 ways to increase throughput and promote quality
Surgery is one of the most complex undertakings in all of healthcare.
It requires the surgeon, anesthesiologist and nurses to pay uncompromising attention to every detail as a care team. Just as every detail matters during surgery itself, a top-performing ASC environment must expand this same mindset to all operations. Every workflow associated with patient throughput, from pre-op to discharge, must be optimized for quality and patient outcomes while balancing operational efficiency. Although finding the right balance can be challenging, careful preparation and collaboration with aligned anesthesia teams can enable ASCs to succeed in the race toward achieving maximum results for their patients and operations. Fortunately, several initiatives that optimize efficiency and throughput can also help improve quality and clinical outcomes. These four strategies can drive your ASC toward improved quality and performance:
1) Establish front-end processes to mitigate risk and expedite throughput: Your ASC team can take several steps to ensure expediency and efficiency before the patient ever enters the facility. Patient selection, for instance, is especially important. Spending extra time up front to verify if patients are ideal candidates for the ASC environment rather than an inpatient setting can promote throughput, conserve resources and mitigate risk. For example, patients who have certain cardiac or respiratory conditions can be prone to delayed discharge or complications better addressed in an inpatient environment. Appropriate screening of high-risk patients will ensure they are in the optimal environment for their procedure, increasing both patient satisfaction and outcomes, while also reducing cost and risk.
2) Deploy an electronic health record (EHR): An EHR offers many benefits for ASCs including improved pharmacy reconciliation, legibility, compliance and quality data capture. In addition, an EHR provides a platform for standardization of clinical guidelines and processes to drive outcomes and patient safety. Leadership can push out changes via the EHR, thus allowing all clinicians across multiple locations to enact these changes immediately. Used in this way, the EHR can also promote a culture of continuous improvement, allowing teams to incorporate changes and access safety protocols in a nimble fashion.
3) Employ data analytics: Data analytics is particularly useful in the ASC environment, where margins can be thin and turnover measured in minutes. This is an area where even the smallest detail can help improve performance; capturing and analyzing these details gives leadership greater insight for making decisions. In addition, data analytics can reveal inconsistencies by facility, operating room (OR) or even clinician. If certain physicians or teams consistently have lower throughput, discussing their individual or collective data can help drive improvements such as proactive anesthesia techniques to minimize discharge delays and maximize throughput. On the other hand, if an OR room has exemplary throughput, one may be able to glean why the team’s performance is better and replicate successful processes across the entire organization.
4) Utilize anesthesia leadership to review current protocols: Because anesthesiologists are experts in perioperative care, they’re able to observe the entire care continuum with an eye toward improving quality and reducing costs. For example, periodic review and updating of preoperative testing guidelines can reduce unnecessary laboratory testing, increasing patient satisfaction and throughput while decreasing costs. Anesthesiologists can employ regional anesthesia options such as nerve blocks for surgery and/or postoperative pain control, thereby reducing the use of general anesthesia and narcotics, with their known side effects of nausea and vomiting potential over sedation and delayed discharge. An anesthesiologist can also review current drug usage and make recommendations regarding lower cost alternatives or generic options that are just as effective.
Trends such as value-based reimbursement have placed an even greater focus on quality and cost-effectiveness; however, health reform and healthcare consumerism have also increased the expectation of a better patient experience. While these four initiatives can enable significant improvements in value and efficiency, they can also promote patient satisfaction. Even if you have already implemented some of these strategies, it can be helpful to take a step back and determine how your organization can make further improvements in the race to improve quality. Any initiative, large or small, can have an impact − and ultimately make a difference inpatient care, patient satisfaction and efficiency.
About the author:
Dr. Patrick Forrest is president and CMO of PhyMed Healthcare Group. This article is the first part of a three-part series focused on best practices for ASCs as they look to improve operational efficiencies across several areas of their practice.
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