What ASCs get wrong about anesthesia coverage, and 1 executive's fix

ASCs have been under pressure as the anesthesia shortage persists and anesthesia providers become spread increasingly thin, sometimes resulting in tensions between providers and ASC leaders.

Jennifer Danner, RN, the senior director of Orlando (Fla.) Health Jewett Orthopedic Institute, has experience working closely with surgeons and anesthesia providers in ASCs. She told Becker's that in order to combat the shortage, ASCs and anesthesia providers must foster a  more collaborative relationship with one another. 

"I've worked in a setting where you have an anesthesia group that has one plan or vision and the surgery center has a plan and vision, and there are two parallel roads that never cross," she said. "And when you have that kind of a situation, it's really hard to get all sides together and to be able to meet the needs of both the surgery center and the anesthesia team." 

The strategies that Ms. Danner implemented at Orlando Health emphasizes a more collaborative relationship between the ASC and anesthesia providers. 

Centralize surgical and anesthesia needs

By identifying and addressing the needs of surgeons and anesthesia in an open dialogue, ASC leaders can relieve surgical team stress and allow them to focus on completing procedures in a safe and efficient manner.

"[For example], the doctor wants a flip room. Anesthesia has one provider. What can we do for anesthesia providers to make sure both of their rooms are set up, and it's not extra work for them when they're flipping back and forth to rooms?" Ms. Danner said. "And then, what can we do from a center perspective, that allows those two rooms to be ready, so that the surgeon does not really feel the delay in room times?" 

The onus of this approach is on ASC leadership, which, while still challenging, presents a centralized strategy to managing operating rooms and can relieve stress in the long run. 

"We have our own shortages, but if you can look at it from that perspective, how do I meet both people where they need to be?" Ms. Danner said. 

Prioritize communication

Ms. Danner also said that one key to managing the anesthesia shortage is ensuring that both surgeons and anesthesia teams are clear on what plans look like and what expectations are to eliminate any potential confusion or miscommunication. 

"That is key, clear communications with your surgeons," she said. "This is what you're looking at tomorrow, and never [allow] them to walk in the door and be surprised. Those are the things that really make the difference in getting your surgeons to change the way you need them to change and to get anesthesia aligned with you."

By eliminating as much unpredictability as possible, surgeons and anesthesia teams can be more flexible and focus more on the procedure and patient. 

A structured and inclusive approach to scheduling

Ms. Danner and her ASC team have monthly "forecasting meetings" with their anesthesia providers, which allows all members of the surgical team to be involved in scheduling and preparing for procedures weeks in advance. 

"Forecasting is really crucial for us in the size of the center we have and making our anesthesia and surgeon collaboration work," she said. "As an ASC leader, you have to be able to appropriately and accurately forecast what is going to happen in your center. It doesn't mean that it's not going to change, or that there aren't going to be surprises with that scheduling."

But having this structure in place ahead of time goes a long way to ensure that any deviation from plans can be managed by ASC leadership. 

Ms. Danner also hosts daily safety huddles with surgeons and anesthesia providers to ensure the day-to-day flow of operations is as smooth and leave little room for unexpected changes. 

"In those huddles, we talk about … what are our needs for tomorrow? … Where do we need to pivot? Where do we need to change? … [T]hat daily huddle is really important," she said. 

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