At ASCs, smooth and efficient procedures and positive patient experiences all contribute to success in the eyes of clinical staff and patients. Anesthesiology teams play a critical role in helping to drive ASC performance and growth, in close partnership with surgeons and staff.
Becker’s ASC Review recently spoke with Jay Mesrobian, MD, chief clinical officer and national medical director of anesthesiology at TeamHealth, to learn why it’s crucial for ASCs to select the right anesthesiology partner.
Anesthesiology fosters efficiency and patient satisfaction at ASCs
When TeamHealth anesthesiologists work in an ASC, they focus on four key areas. The first is implementing standardized clinical care pathways based on best practices.
“We look at what we can do in terms of anesthesia care to improve surgical outcomes,” Dr. Mesrobian said. “We want to ensure that patients have minimal complications based on clinical protocols. After a procedure, patients must be able to get up and participate in therapy or other forms of rehabilitation. Most importantly, they need to get home safely.” The anesthesiology team also plays a central role in patient safety by using the right protocols and anesthetics that reduce complications, minimize narcotic use and decrease issues associated with being overanesthetized.
TeamHealth anesthesiologists’ second area of focus is clinical operations. These experts understand how to implement standard protocols and staffing models in an ASC to increase operating room utilization. That means turning rooms over quickly, as well as starting cases on time with minimal delays or cancellations.
In the ASC setting, the third important pillar for TeamHealth is the patient experience. “We provide our anesthesiologists with tools and training to communicate effectively with patients,” Dr. Mesrobian said. “The goal is to improve the patient’s comfort. Patient experience is a huge issue for all facilities but especially for ASCs. It’s vital that the anesthesiology group contributes to that.”
Finally, the fourth focus area for TeamHealth clinicians is management and leadership. TeamHealth anesthesiology leaders establish a consistent presence in the ASC, coordinate with all the anesthesiology team members and collaborate with the surgeons and nurses.
Operating room efficiencies improve clinical outcomes and patient safety.
Staffing is a key contributor to operating room efficiency. Many ASCs have seen significant improvements by investing in an extra anesthetist or anesthesiologist to help with case preparation, patient assessment and room turnover.
“The initial reaction might be to question whether an extra person is needed,” Dr. Mesrobian said. “But ultimately, doing this allows teams to prepare the next patients and attend to any postoperative complications that may arise.”
ASC efficiency requires laser focus in two areas: on-time starts for procedures and turnaround times. To ensure on-time starts, anesthesia providers must assess, prepare and communicate with patients in advance of the surgery date.
Dr. Mesrobian offered the example of peripheral nerve blocks, which are important and routine at ASCs. “You need an anesthesiology team that can do those well before the actual start time of the case,” he said. “When the surgeon arrives, he or she should be able to walk in and answer any last questions for the patient and then head to the operating room.”
Any downtime in the operating room is wasted time for an ASC. The goal is to minimize turnaround time, which includes the amount of time it takes to treat one patient, get the room ready for another procedure and prepare the next patient for surgery.
“We strive to perform as many processes in parallel as possible in anesthesiology,” Dr. Mesrobian said. “By doing things in parallel, rather than in sequence, we can minimize downtime between cases.” These best practices lead to less time in the operating room, and for patients, less time under anesthesia and less exposure to narcotics — all of which improve clinical outcomes and patient safety.
“Our objective is to ensure that patients feel that their pain is well controlled, but they also are alert and don’t feel nauseous,” Dr. Mesrobian said. “In orthopedic surgery centers, in particular, you want patients up and ambulating as soon as possible so they can start their rehabilitation. Anesthesia care especially pain control and the minimization of clinical complications — is a huge contributor to a patient’s overall outcome.”
Choosing the right anesthesiology partner promotes ASC growth.
Anesthesiology teams impact ASC growth in multiple ways. They directly influence the business by providing sound clinical care that improves patient outcomes and enables patients to be discharged in a timely manner. Ensuring operational efficiencies reduces room turnover time, so ASCs can perform as many procedures as possible.
Anesthesiologists also have an indirect effect on the success of ASCs by contributing to patient and surgeon loyalty.
“When an ASC operates well and has good anesthesiology leadership, that reputation gets around,” Dr. Mesrobian said. “Other surgeons hear about it and patients share their experiences with their friends. That’s very important because ASCs are very dependent on referrals from the community. It’s essential that anesthesia groups contribute to generating goodwill and a sound reputation for ASCs.”
Good anesthesiologists or anesthetists view surgeons as their partners in care. This partnership is based on communicating effectively, developing standard protocols and contributing to value added steps that promote efficiency in the clinic.
“Anesthesia teams must participate in the management of the ASC and build surgeon partnerships,” Dr. Mesrobian said. “It’s the little things like setting protocols and policies, meeting regulatory requirements and contributing beyond simply giving patients anesthesia care.”
Conclusion
ASCs continue to grow, not only in terms of the volume of cases they handle but also the types of procedures they perform. Open-minded and innovative partners in anesthesiology will contribute to the ongoing success of ASCs.
“The cases handled now in the ASC setting, like joint replacements, spine surgeries and even cardiac catheterizations wouldn’t have even been considered 10 years ago,” Dr. Mesrobian said. “Today, many procedures can be performed in an ASC with the right patient selection and best practice protocols around anesthesia care. The key is for anesthesiologists to be collaborative, openminded and willing to consider new approaches and procedures.”