The operating room is the nucleus of any ASC and OR efficiency can make or break a facility. Efficient ASCs aren't paid more for the amount of time used or supplies. The payment is based on CPT code, so the ability to fit more cases in on a daily basis means a center can be more profitable.
"You are getting paid the same amount for long or short procedure, for procedures with more supplies and with fewer supplies," says Stephanie Martin, RN, BSN, CNOR, CASC, administrator at Flagler Surgery Center in St. Augustine, Fla. "So efficiency improves profitability. You can fit in more procedures in a day when the OR is running at full efficiency."
Here are six best practices that are the low hanging fruit of ensuring OR efficiency:
1. Prepare well in advance. Get as much information as possible about the patient before they come in for a procedure, says Ms. Martin. Try and prepare for any health issues they may have, such as allergies, recurring health problems or medication sensitivities. ASCs can use tools such as online health assessments to determine these issues.
"The phrase 'don't put off until tomorrow what you can do today' is very pertinent in an ASC," says Ms. Martin. "Try and address as many patient issues as possible before the patient enters the facility."
Also, patients need to be reminded of the things they must do before coming in for surgery, she says, such as not eating anything after midnight the night before surgery or making sure a responsible adult is able to pick them up and stay with them post-surgery.
2. Assume responsibility for inefficiencies. One of the biggest mistakes surgery center leaders make is assuming there are aspects of ASC efficiency outside their control. Instead, look at all inefficiencies and brainstorm ways to tackle them.
For example, many ASC owners and operators think patient or physician tardiness isn't controllable; that's not true.
"Automated phone calls that remind patients about their upcoming appointments is a great way to ensure that more patients arrive on time," she says.
Physicians tend to come in late if they think the OR, patient or clinical staff will not be ready on time. Make sure the OR staff are ready before the surgeon arrives. "Hold people accountable when the patient is not ready," Ms. Martin says.
3. Remember: Communication is a cornerstone. Communication between the departments is an important and effective method for improving OR efficiency. All departments, from the front desk to preop to postop must coordinate with each other to preempt potential problems and tackle new ones, says Ms. Martin. For example, the front desk should let the preop department know if a patient isn't on-time or is not coming, and the preop department can then pass the information to other departments.
4. Work closely with the anesthesia department. Keep the anesthesia department in the loop to make the OR ultra-efficient. "If they are on board and helping with every case, it makes the cases more quickly and more smoothly," Ms. Martin says. "For example, in our facility if the nurse has trouble getting an IV started they immediately reach out to the anesthesia department who can address the issue quickly. This also leads to an improved patient experience."
5. Look to the data. Data helps administrators understand inefficiency in the OR and how to solve it. Utilize your computer software to the max. At Flagler Surgery Center, SourceMedical's AdvantX software is used to run reports which are reviewed daily, weekly and monthly. When issues come up at the ASC, Ms. Martin and her team look into the statistics. If the OR department feels as though the patient isn't being prepped properly, the administration team looks into data to determine what the issue may be.
"We identify the issues and then implement the change that will improve workflow," she says.
6. Involve staff members. The answer to OR efficiency lies largely with the ASC staff itself. Ms. Martin involves her staff in decisions regarding OR operations as often as possible. One idea staff members at Flagler Surgery Center came up with was putting up a big white board in pre-op to communicate status of pre-op patients with the OR, such as what time they were scheduled for surgery, if they have any prior health issues, etc. The white board helped all departments better prepare for each day's procedures and make sure things run smoothly.
"Talking and working through the issues helps everyone in the ASC find a happy medium," says Ms. Martin. "Everyone wants to be more efficient, so we align our goals to make that happen."
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