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How ASCs can increase patient throughput by 25% — The value of process management automation

Every industry is tasked with the overall goal of improving efficiency, and healthcare is no exception. However, many healthcare organizations, including surgery centers, struggle with ensuring their operations are running at their peak efficiency, which may compromise their ability to stay competitive in 2018 and beyond. Despite the obstacles at play, ASCs can readily identify areas for improvement within their operations and accrue savings to stay viable through process management automation.

During an executive roundtable discussion sponsored by IBSS, an information technology and consulting services firm, and hosted by Becker's ASC Review on Oct. 27 at Becker's ASC Review 24th Annual Meeting: The Business and Operations of ASCs, held in Chicago, industry leaders discussed how process management automation is driving efficiency within organizations. Ruth Vaiden, RN, former administrator of a Richmond, Va.-based Surgical Suite, detailed how IBSS' Watershed Process Management Automation, a system that automates processes within an ASC, improved patient throughput and bolstered patient/family and staff satisfaction at the surgery center without uprooting any of its existing systems.  

The ins and outs of process management automation
ASC staff members are often pressed for time, and providing them with the right solutions to fine-tune processes allows them to allocate their time and skill sets to focus on patient care. Equipped with training as an engineer, Stuart Massey, president and COO of IBSS, set out to create such a system that improved the lives of healthcare personnel.

"I thought, 'How do we make a difference in people's lives?' And the way we have done that successfully in other industries is making sure they can focus on their primary objective," Mr. Massey said. "The lessons we learned in other industries [on improving efficiency] are possible in healthcare if you have the right systems in place."

Process management automation works by providing the right information to people when they need data to drive decision-making. Mr. Massey said Watershed "anticipates your next move and makes sure the data for that is available."

"If you look at other industries, there is about 25 percent of latent capacity you don't get access to. When you apply automation, you gain that additional 25 percent capacity," Mr. Massey said. "We are applying that idea to healthcare to make everything smoother for everybody involved and achieve the capacity through the right automation."

Effectively using data to drive decision-making
Data drives healthcare business decisions; a dearth of data can result in ineffective processes, hindering an ASC's ability to improve operations and processes. The Richmond-based surgical suite opted to eliminate inefficiencies in its processes and integrated Watershed into its existing systems to provide data on cost per case.

"We had a lot of frustration from our staff who had to vet each case to ensure it would be profitable," Ms. Vaiden said. "By using automation, I could see the outcomes of what each case was costing the center and I looked at that monthly."

ASCs do not have to eliminate or adjust any of their current systems to implement Watershed. Mr. Massey explained, "A good execution does not recreate redundant functionality within existing systems. [Process management automation] is about reducing the effort to access the data you need from your systems."

Prior to implementing the automation system, Ms. Vaiden did all the case costing for the ASC's three operating rooms in her head or manually. However, relying on mental math to record case costing often leaves room for human error, which can ultimately translate to dollars lost.

"Before, we carried all the math around in our head," she noted. "Within the first month of implementation, we increased our patient throughput by 25 percent, which allowed us to do more cases each day." Improving OR efficiencies enabled the ASC to schedule more cases per day, putting the ASC in an optimal financial situation and driving patient/family and staff satisfaction. Ms. Vaiden said this also helped garner buy-in from physicians.

When analyzing monthly reports, Ms. Vaiden could assess how surgeons compared in terms of cost per case for the same CPT code. Using data to show the cost of each case gave Ms. Vaiden the ability to communicate with physicians on the best course of action to maximize reimbursement, whether that was ascertaining the CPT code was correct or possibly taking the case to another location.

"When doctors came to me asking how much a case would cost, they do not want data I gathered in my head," Ms. Vaiden said. "They want to see what the definitive cost was, and that is why automation was so important in these interactions."

Elevating the patient-physician experience: The benefits of automation
As healthcare moves into a consumer-driven model, providing patients and caregivers an excellent experience from check-in to follow-up care is of paramount importance. Simply put, patients do not want to answer the same series of questions they were asked by another staff member. Before integrating Watershed, the surgical suite's systems did not communicate with each other; the front desk often asked patients, redundant questions to update their systems. After using Watershed, information was readily transferred from one system to the other, which streamlined the registration process and gave staff additional time to focus on clinical care.

"With the interface, we didn't have to reinvent the wheel," Ms. Vaiden noted. Watershed features a dashboard detailing a patient's progress to their families, who often are waiting anxiously for status updates. After implementing Watershed, the ASC's patient satisfaction scores reached 99 percent, and nurses saved time as they did not have to stop what they were doing to call into the waiting room to update a patient's family on where they were in a procedure. Instead, the actual status of the patient is automatically obtained and transferred from the ongoing anesthesia record. Such an automated process management is emblematic of the advantage derived from the IBSS Watershed system when all process improvements are compiled. The additional time developed allowed the surgery center to take on additional cases per day.

Process management automation also improves satisfaction among physicians, according to IBSS Medical Advisor Mark Rosenblum, MD. When conducting an independent survey, Dr. Rosenblum found physicians and nurses alike felt they were appreciated, as the automation allowed them to receive what they required throughout surgical procedures.

"Surgeons feel their time is respected, and they were able to use their newly discovered time most efficiently, in their clinical role and in the ASC. Overall they found that Watershed exceeded their unexpressed wishes and needs in a variety of ways"  Dr. Rosenblum said, "Surgeons are the ones who are responsible for deciding which cases to an ASC. If you satisfy them, you will most likely retain them and be able to recruit more surgeons.  As well, they will most often bring cases from a hospital setting into your ASC."

Moving forward into the next phase of healthcare, surgery centers must resolve inefficiencies that detract from their bottom lines. Bill Bysinger, PhD, principal of WGB Advisory Group, said process management automation is the future of healthcare, as it requires looking at the entirety of an organization and working out the kinks to maximize efficiency.

"Process management automation is really about getting a handle on all that happens throughout an entire ASC," he noted. "It is not just an application; process management automation is an environment."

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