The Race for Efficiency and Value: Part 1
4 Strategies to Increase Throughput and Promote Quality in the Perioperative Process
Surgery is one of the most complex undertakings in all of healthcare. It requires the surgeon, anesthesiologist and nurses to pay uncompromising attention to every detail as a care team. Just as every detail matters during surgery itself, a top-performing perioperative environment must expand this same mindset to all operations. Every workflow associated with patient throughput, from pre-op to discharge, must be optimized for quality and patient outcomes while balancing operational efficiency. Although finding the right balance can be challenging, careful preparation and collaboration with aligned anesthesia teams can enable providers to succeed in the race toward achieving maximum results for their patients and operations. Fortunately, several initiatives that optimize efficiency and throughput can also help improve quality and clinical outcomes too. These four strategies can drive improved quality and performance:
Mitigate risk with predictive stratification
You can take several steps to ensure expediency and efficiency before the patient ever enters your facility. Patient selection, for instance, is especially important. Spending extra time up front to verify if patients are ideal candidates for an ASC environment rather than an inpatient setting can promote throughput, conserve resources and mitigate risk. For example, patients who have certain cardiac or respiratory conditions can be prone to delayed discharge or complications better addressed in an inpatient environment. Appropriate screening of high-risk patients can ensure they are in the optimal environment for their procedure, increasing both patient satisfaction and outcomes, while also reducing cost and risk.
Leverage anesthesia leadership to drive evidence-based best practices
Because anesthesiologists are experts in perioperative care, they’re able to observe the entire care continuum with an eye toward improving quality and reducing costs. For example, periodic review and updating of preoperative testing guidelines can reduce unnecessary laboratory testing, increasing patient satisfaction and throughput while decreasing costs.
A recent study conducted by PhyMed Healthcare Group revealed a significant improvement in clinical outcomes after the implementation of a pulmonary protocol adherence program. Through a multi-channel educational initiative, which included podcasts, live conferences and written materials, protocol adherence jumped from between 30 – 40% to more than 75%. This achievement has not been reported in any medical literature to date.
Utilize multimodal analgesia for improved perioperative pain management
Anesthesiologists can employ regional anesthesia options such as nerve blocks for surgery and/or postoperative pain control, thereby reducing the use of general anesthesia and narcotics, which can lead to oversedation and delayed discharge. An anesthesiologist can also review current drug usage and make recommendations regarding lower-cost alternatives or generic options that are just as effective.
Employ data analytics
Data analytics is particularly useful in the ASC environment, where margins can be thin and turnover measured in minutes. This is an area where even the smallest detail can help improve performance. Capturing and analyzing these details gives leadership greater insight for making decisions. In addition, data analytics can reveal inconsistencies by facility, operating room (OR) or even clinician. If certain physicians or teams consistently experience low throughput, discussing their individual or collective data can help drive improvements such as proactive anesthesia techniques to minimize discharge delays. On the other hand, if an OR has exemplary throughput, one may be able to glean why the team’s performance is better and then replicate successful processes across the entire organization.
It’s time to rethink your approach
There are more than 2.5 million Americans addicted to prescription opioids or heroin. When someone with an addiction disorder presents for urgent care, it can cause serious complications—even death—if the anesthesiologist is unaware of the addiction. For example, if a patient is on medication-assisted treatment or in an abstinence program, it is essential to take a different approach to perioperative pain management. In this case, a lack of data leaves the patient susceptible to relapse. And patients who relapse are more likely to overdose. Looking at treatment in a new way can mitigate this risk. For example, the new ON-Q pain relief system developed by PhyMed uses local anesthesia to deliver non-narcotic pain relief. Not only does this type of innovation improve outcomes, it can help the patient recover faster and with fewer complications.
Trends such as value-based reimbursement have placed an even greater focus on quality and cost-effectiveness; however, health reform and healthcare consumerism have also increased the expectation of a better patient experience. While these four strategies can enable significant improvements in value and efficiency, they can also promote patient satisfaction. Even if you have already implemented some of them, it can be helpful to take a step back and determine how your organization can make further improvements in the race to improve quality. Any initiative, large or small, can make a difference in patient care, patient satisfaction, value and efficiency.
About the author:
Dr. Patrick Forrest is president and CMO of PhyMed Healthcare Group. This article is the first part of a three-part series focused on best practices for providers as they look to improve operational efficiencies across several areas of their practice.