Q: How do you determine length of stay, and how do you break down the benchmark to figure out where the problems lie?
Jim Stilley: We start at the front end. We look at:
• How long the patient is in admission
• How long the patient is in pre-op
• Time from when the patient enters the OR until the incision is made
• Time from incision to close
• Time from close to when the patient leaves the OR
• Turnover time (from when the patient leaves the Or to when the next patient enters that OR)
• Recovery time
Then we look at entire length of stay, from admission to discharge, for the patient. We like to track and trend those times, because as time pressure builds on the physicians, we like to show to our physicians that we are staying within our norm. It’s helped to minimize the bad days — if they’re behind and they feel the surgery center isn’t operating in a way it normally does, it allows us to see that the day is an outlier. The outliers are generally caused by pre-op, when the patient is getting ready to go to the OR. Turnover time is also really impacted by the amount of staffing we have that day.
Related Articles on ASC Turnarounds:
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