The right anesthesia group can keep your surgeons happy and your ASC running efficiently, while the wrong group can derail your schedule and endanger patient safety. Beverly Kirchner, owner and CEO of Genesee Associates, discusses five traits an ASC should look for when selecting a new anesthesia group.
1. Willingness to work with an EMR. If your ASC is planning to invest in EMR over the next several years, Ms. Kirchner recommends finding an anesthesia group willing to work with an EMR. She says her previous anesthesia group refused to use the center's EMR, insisting that the technology impeded their practice because the software was designed without their input. "Even though we brought our software people to the table and gave [the anesthesiologists] the opportunity to design the software exactly like their current paperwork, they still held out on using the EMR," she says. "So we looked for a group that had already transitioned to an EMR."
She says if the anesthesiologists and CRNAs in your anesthesia group have already made the switch to using EMR technology, it will be a lot easier to get them to use your center's system. You will save a lot of time on negotiation and compromise by finding a group that accepts EMR is a useful and inevitable part of ASC operations going forward.
2. Willingness to cooperate with your pre-admission process. In southern Louisiana, where Ms. Kirchner's center is located, many patients suffer from co-morbidities such as morbid obesity, cardiac disease and hypertension. The prevalence of health problems means the pre-admission process for Ms. Kirchner's center is necessarily extensive. "We re-pre-screened every patient, and we were on the phone doing nursing assessments on every patient before they came to the center to make sure they met our criteria," she says. "When we identified a patient that needed additional workup, the anesthesia group agreed to get on the phone and [deal with the patient] the morning of surgery."
Willingness to participate in the pre-admission process is an essential quality for anesthesia groups, especially as the focus on pre-admission testing increases, Ms. Kirchner says. Identifying inappropriate patients is critical to keep patients safe, as well as to ensure cases aren't cancelled at the last minute.
3. Interest in participating in ASC operations outside anesthesia provision. Ms. Kirchner says ideally, an anesthesia group will be interested in sitting on ASC committees and participating in quality control programs. "[Our anesthesia group] helps us with infection control based on anesthesia input and works with us on the medical committee," she says. "Their participation helps make sure the center flows and functions based on what CMS [and accreditors] are requiring."
4. Punctuality and appropriate discharge practices. Prior to working with her current anesthesia group, Ms. Kirchner says her ASC had problems convincing anesthesiologists to comply with the center's schedule. Her previous anesthesia group frequently showed up late and then refused to stay and discharge the patient appropriately after surgery. During the interview process, she made sure that the new anesthesia group she picked would be willing to put in extra time to discharge every patient. The same standard applied to punctuality. Groups that didn't demonstrate personal responsibility for showing up on time were not considered.
5. Good professional references and contract history. Most employers find that personal references go a long way in demonstrating a potential employee's true work ethic — a trait that can be hard to gauge during a job interview. "We very carefully checked [the group's] references on how they'd worked with other surgery centers and hospitals," Ms. Kirchner says.
She advises not limiting your reference check to those provided by the anesthesia group. Instead, ask for an exhaustive list and talk to everyone to make sure you get an accurate representation of the group's behavior. "We asked them for a list of all current contracts and references for contracts that had been cancelled in the last 24 months," she says. "We want to hear the good and the bad. Nobody's perfect, and you're not going to get along with everybody, but we want to know who you are and what you do."
Read more about sound anesthesia practices:
-5 Thoughts From Industry Experts on the Future of Anesthesia
-4 Ways Anesthesia Provision Will Change in the Next Five Years
1. Willingness to work with an EMR. If your ASC is planning to invest in EMR over the next several years, Ms. Kirchner recommends finding an anesthesia group willing to work with an EMR. She says her previous anesthesia group refused to use the center's EMR, insisting that the technology impeded their practice because the software was designed without their input. "Even though we brought our software people to the table and gave [the anesthesiologists] the opportunity to design the software exactly like their current paperwork, they still held out on using the EMR," she says. "So we looked for a group that had already transitioned to an EMR."
She says if the anesthesiologists and CRNAs in your anesthesia group have already made the switch to using EMR technology, it will be a lot easier to get them to use your center's system. You will save a lot of time on negotiation and compromise by finding a group that accepts EMR is a useful and inevitable part of ASC operations going forward.
2. Willingness to cooperate with your pre-admission process. In southern Louisiana, where Ms. Kirchner's center is located, many patients suffer from co-morbidities such as morbid obesity, cardiac disease and hypertension. The prevalence of health problems means the pre-admission process for Ms. Kirchner's center is necessarily extensive. "We re-pre-screened every patient, and we were on the phone doing nursing assessments on every patient before they came to the center to make sure they met our criteria," she says. "When we identified a patient that needed additional workup, the anesthesia group agreed to get on the phone and [deal with the patient] the morning of surgery."
Willingness to participate in the pre-admission process is an essential quality for anesthesia groups, especially as the focus on pre-admission testing increases, Ms. Kirchner says. Identifying inappropriate patients is critical to keep patients safe, as well as to ensure cases aren't cancelled at the last minute.
3. Interest in participating in ASC operations outside anesthesia provision. Ms. Kirchner says ideally, an anesthesia group will be interested in sitting on ASC committees and participating in quality control programs. "[Our anesthesia group] helps us with infection control based on anesthesia input and works with us on the medical committee," she says. "Their participation helps make sure the center flows and functions based on what CMS [and accreditors] are requiring."
4. Punctuality and appropriate discharge practices. Prior to working with her current anesthesia group, Ms. Kirchner says her ASC had problems convincing anesthesiologists to comply with the center's schedule. Her previous anesthesia group frequently showed up late and then refused to stay and discharge the patient appropriately after surgery. During the interview process, she made sure that the new anesthesia group she picked would be willing to put in extra time to discharge every patient. The same standard applied to punctuality. Groups that didn't demonstrate personal responsibility for showing up on time were not considered.
5. Good professional references and contract history. Most employers find that personal references go a long way in demonstrating a potential employee's true work ethic — a trait that can be hard to gauge during a job interview. "We very carefully checked [the group's] references on how they'd worked with other surgery centers and hospitals," Ms. Kirchner says.
She advises not limiting your reference check to those provided by the anesthesia group. Instead, ask for an exhaustive list and talk to everyone to make sure you get an accurate representation of the group's behavior. "We asked them for a list of all current contracts and references for contracts that had been cancelled in the last 24 months," she says. "We want to hear the good and the bad. Nobody's perfect, and you're not going to get along with everybody, but we want to know who you are and what you do."
Read more about sound anesthesia practices:
-5 Thoughts From Industry Experts on the Future of Anesthesia
-4 Ways Anesthesia Provision Will Change in the Next Five Years