Inside Ambulatory Surgery Centers (ASCs), smooth and efficient procedures and positive patient experiences are necessary for success. 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, MBA, 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.
The importance of efficiency in the OR
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.
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, patient safety and patient experience.
"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."
Anesthesiology as a driver of patient satisfaction
In dozens of ASC sites across the country, TeamHealth’s anesthesiologists’ first point of emphasis is to implement 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."
TeamHealth anesthesiologists also understand how to implement appropriate 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.
TeamHealth anesthesiologists are also committed to helping drive positive patient experiences. "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."
The final 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.
Partners in care — The power of innovative collaboration in the ASC
Anesthesiology teams impact ASC growth in multiple ways—these teams can play a central role in driving greater 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."
Good anesthesia teams view surgeons as 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."
As 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 be essential for success.
"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. "In this environment, the key is for anesthesiologists to be collaborative, open-minded and willing to consider new approaches and procedures."