If anesthesia is truly committed to the success of your facility, it will do all it can to ensure business efficiencies.
“Anesthesia should critically look at the delivery of anesthesia to continually address the cost of anesthesia per case,” says David Shapiro, MD, CPHRM, LHRM, CHC, chair of the Ambulatory Surgery Foundation and chair-elect of the ASC Association. “In some cases, nothing can be changed, because you need to maintain patient safety, but in other cases, you can find unnecessary or excessive use of disposables, or that a generic drug can be used.”
Stanford Plavin, MD, an anesthesiologist, managing partner of Ambulatory Anesthesia of Atlanta and board member of Georgia Society of ASCs, agrees, and offers that saving money doesn’t have to mean hardship for anesthesia providers.
“For example, if you switch to generic anti-emetics, not only are you spending $1.50 per dose compared with $15 or $20, but you can afford to offer it to more patients and cut down on post-op nausea, which leads to more efficiency overall,” he says.
Use of propofol for sedation is another strategy for saving money and enhancing patient care and efficiency.
“Using propofol improves efficiencies; if, instead of doing 13 or 14 cases by 5 p.m., you can do 18 cases by 3 p.m., that’s big money,” says Dr. Plavin. “In a GI center, at a $450 facility fee per procedure, you’re looking at millions in revenue annually. Not to mention the ability to schedule more efficiently something that will increase surgeon satisfaction and patient satisfaction, because they don’t have to spend a month worrying before they are scheduled.”
A lot of these efforts begin in materials management, so anesthesia, not just surgeons, needs to be kept in the loop on purchasing, notes Dr. Shapiro. This also circles back to the concept of consistency among the anesthesia providers in the ASC setting.
“Surprises are bad in the ASC, and having anesthesia involved in many facets of the center can help eliminate those,” says Dr. Shapiro. “When anesthesia is involved in purchasing, it contributes to cost-containment efforts. When anesthesia is involved in scheduling and pre-op processes, you don’t end up cancelling a case on the operative day and wasting a pack or other supplies.”
