As anesthesia staffing pressures continue to challenge ASCs, some leaders are looking for ways to build more stable teams while maintaining greater control over costs and care delivery.
For Lori Pagan, CEO of Fort Wayne, Ind.-based Orthopaedics NorthEast, that has meant sticking with an employed anesthesia model. Her center has maintained an in-house team of anesthesiologists and CRNAs for years and recently added certified anesthesiologist assistants to the mix as staffing remains tight.
Ms. Pagan recently joined Becker’s to discuss the center’s evolving anesthesia care team, its approach to increasingly complex cases and why she sees value in keeping anesthesia in-house.
Editor’s note: This response has been lightly edited for clarity and length.
Question: How is your center balancing teams composed of anesthesiologists, CRNAs and/or certified anesthesiologist assistants?
Lori Pagan: We continue to use a medical direction model. Anesthesiologists, CRNAs and certified anesthesiologist assistants each practice to the full extent of their roles within that model. This gives us a consistent approach to care while making effective use of every member of the team.
Q: What does your anesthesia care team model look like, and has it changed in the last few years?
LP: Our care team includes anesthesiologists, CRNAs and certified anesthesiologist assistants. We began hiring AAs this year and are integrating them into our established medical direction model as anesthesia staffing remains tight in our market.
Q: As more complex cases move into ASCs, how is that changing your staffing and practice model?
LP: We have strengthened our preoperative anesthesia protocols and testing. Patients go through our preoperative optimization clinic, which works with our hospitalist group, and anesthesia reviews their charts before surgery. That process helps us determine which patients are appropriate for the ASC and which should have their procedures at our orthopedic hospital. Selecting the right setting is essential as case complexity increases.
Q: What’s one thing you’d tell another ASC leader who is rethinking their anesthesia strategy?
LP: Consider the value of building and retaining an anesthesia team that is closely aligned with your surgical practice. We have employed our anesthesia clinicians for many years and have an experienced team with very little turnover. Having that resource in-house gives us greater consistency in care and more control over staffing and costs.
At the Becker’s 32nd Annual Meeting: The Business and Operations of ASCs, taking place October 29-31 in Chicago, ASC leaders, surgeons and healthcare executives will explore strategies to drive growth, enhance operational performance, navigate reimbursement challenges and prepare for the future of ambulatory surgery. Apply for complimentary registration now.
