Recently, the Richmond-based Virginia Eye Institute led by CEO Bradley Smith, considered a change in anesthesia providers, seeking better coverage, quality, processes and data metrics.
In the end, VEI decided on North American Partners in Anesthesia.
The eye institute introduced various quality programs to measure performance and satisfaction as part of the collaboration. For instance, VEI and other ASCs have implemented Peak Performance² remote video auditing, where cameras are used to audit specific operating compliance measures.
Rafael Cartagena, MD, regional director and chief of anesthesia at NAPA, and the institute’s Mr. Smith, spoke on strategies to improve ASC safety and satisfaction during the Becker’s ASC 23rd Annual Meeting: The Business and Operations of ASCs on Oct. 28 in Chicago.
Mr. Smith commented that VEI, which sees about 160,000 clinic visits a year at it’s eight full-service clinics in Central Virginia, decided to use remote video monitoring after a recommendation from NAPA. The decision to proceed with implementation was predicated on achieving improved quality and as a means by which to prepare for value-based contracting with managed care companies.
To implement remote video auditing, VEI installed high-definition cameras in every operating room, though all the images are produced in low-definition to meet HIPAA and personal health information Compliance. Dr. Cartagena said that’s also purposely done to obscure any facial features.
“The goal with that really isn’t to observe or watch surgery. It’s to make sure that the processes as dictated by the facility are followed,” he said, adding that the processes typically measured are the different steps of terminal cleaning.
Similarly, VEI uses remote video auditing during surgical “time-outs,” which occur before the planned procedure is initiated to reassure accurate patient identity, surgical site and planned procedure.
“Our perspective was, it’s not just the fact we’re doing a ‘time-out,’ it’s the quality of the ‘time-outs.’ Is everyone in the room engaged? Are we doing it at the right time? Are we touching on all of the elements?” Dr. Cartagena said.
Auditors monitor the RVA system at remote locations to scan a number of OR video feeds at two-minute intervals, according to NAPA. Dr. Cartagena said auditors look for indications of compliance with surgical checklist milestones. Aggregate feedback, he said, is delivered in real time via text alerts to the surgical team to monitor factors such as first case start time, OR minute gains and surgical safety checklist compliance. The team also receives reminders and performance evaluations aimed at faster OR throughput and turnover times. The goal is also to help surgeons maximize their schedules.
Mr. Smith noted there was some reluctance from surgeons at first because they didn’t like the thought of being videod during surgery. However, they were assured that no one sees the videos outside of the auditors. The institute also vetted the decision with its insurance carrier and legal counsel prior to implementation.
Mr. Smith indicated that the partnership between ASC and anesthesia providers can yield significant benefits to respective partners and ultimately lead to improved quality, safety and patient satisfaction.
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