4 Critical Steps for Selection of a Quality ASC Anesthesia Group

Vicki Edelman, administrator of Blue Bell (Pa.) Surgery Center, shares four key steps to take to ensure an efficient ASC anesthesia group recruitment process.

1. Get buy-in from your physician group. Before you choose an anesthesia group, have an honest conversation with your physicians about their needs and recommendations for anesthesiologists. Many surgeons will have worked with anesthesiologists and anesthesia groups before, and they may have opinions about the groups you're interviewing. If you can pick an anesthesia group that your surgeons have previous, positive experience with, you will probably have fewer disagreements and complaints from both sides. "You want to have open communication between your group of surgeons and your anesthesia group," says Ms. Edelman. "If the anesthesiologist feels a case is not appropriate, you want people who can hold that conversation doctor-to-doctor and not go through your nursing staff."

2. Take your time on the interview process. You won't necessarily know if an anesthesia group is a good fit with your facility during the first meeting. Take the time to hold a few meetings and discuss your mission, goals and practice in-depth with the group, Ms. Edelman says. "It's important to interview a few groups so you know you're on the same page," she says. "You want to find out what their safety practice is, how they view quality and what they look at in terms of medical conditions, NPO status, previous medical histories and weight requirements when deciding a case."

You also want to look at the structure of the anesthesia group to determine how the anesthesiologists organize themselves. Ms. Edelman says she likes to see that an anesthesia group has a business-minded leader in charge of business issues and a medical director in charge of clinical practice. "That hierarchy tells me they have good structure to their organization, and people are [playing to their strengths]," she says. She also looks at the tenure of each anesthesiologist. If a group is full of relatively new anesthesiologists, they may not work well together or they may have high anesthesiologist turnover.

3. Be very clear about the terms of the contract. Don't assume you're on the same page about an issue if you don't include it in the contract, Ms. Edelman says. "You want to know the terms of your contract," she says. "If you have to terminate the relationship, you need the contract to have the anesthesia group out of the center within 90 days." Make sure your contract includes mandates to abide by state and federal ASC regulations, such as the length of time an anesthesiologist must stay in the center after treating the patient. "Some anesthesiologists don't want to stay until the last patient is discharged, and it's just a matter of safety," she says. "You need to make sure they agree with the bylaws."

You can also address the size of the anesthesia group in the contract. If you are planning to staff six anesthesiologists and 10 CRNAs, you don't want the group to keep adding providers in order to cover circumstances where a provider goes on vacation. "Often the surgery center gets bogged down by an anesthesia group saying, 'We want to credential this one and that one,'" she says. "It's expensive to constantly credential and re-credential, so those expectations are something to put in an agreement."

4. Discuss expectations about equipment purchase. Sometimes an anesthesia group will request an expensive piece of equipment your surgery center can't afford. "If you have an anesthesia group that comes in and wants a certain kind of scope for difficult intubations, and then the next group comes in and wants something different," that gets expensive, says Ms. Edelman. "Discuss equipment before you sign anything."

She says equipment purchase is one reason to invest in a great anesthesia group and make the effort to keep them in your center. If you keep the same group over a number of years, you will probably have to change your equipment less often, and your center will suffer less transitional stress. "Maintaining the stability of a group within your center is optimal," she says. "It's not good for the ASC to have two, three or four different groups within four years, because then the community and [other providers] see that you're not easy to work for and with."

Learn more about Blue Bell Surgery Center.

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