Key-Whitman Eye Center in Dallas is a combined clinic and surgery center, with the ASC located directly adjacent to the clinic. Over the past few years, the center has implemented several new technologies to improve efficiency.
"To a large extent, surgery is an assembly line process from start to finish," says Dan Chambers, Chief Administrative Officer with Key-Whitman Eye Center. "You can identify the time it takes to complete the process and the reliability of each step in order to be compliant and minimize errors. That's how ASCs are able to provide patients with high quality outcomes."
Mr. Chambers and Nikki Hurley, BSRN, MBA, COE, Director of Surgical Services at Key-Whitman Eye Center, discuss the technologies that have propelled their center to success.
1. Patient tracking systems. Last month, Key-Whitman Eye Center began using the Versus Advantages™ Real-time Locating System (RTLS), a patient tracking technology, and already sees improved efficiency. The technology records when patients are in each area of the ASC and how long they spend there, so Hurley, can extract information about patient wait times and identify bottlenecks in the process.
"This helps track patients throughout the process so you know where the breakdowns of communication can be within your own staff," she says. "If there is something holding them back in pre-op, the nursing staff can view that more readily and figure out how to make the process smoother. They can also deploy additional staff to help in real time, if necessary."
The data can be pulled for various reports to help refine processes. "We place the software on a hosting computer remote to our location and I can view the information from my satellite office," says Mr. Chambers. "I know from 20 miles away how many patients are waiting and where the physicians and staff are in real time."
ASCs can also display a screen with the tracking system in their waiting rooms so families can see where their loved ones are. The program is HIPAA compliant and uses numbers or initials instead of full names on the screen.
2. Nurse tracking. In addition to the patient tracking capabilities, the Versus RTLS can also track where the nurses are. This is a huge benefit for appropriately staffing the ASC.
"You can determine whether you can moderate the staffing requirement and make sure nurses are where you need them most," says Mr. Chambers. "When you look at the whole facility in one snap shot, you can track the imbalance of staffing needs and potentially reduce a few nurses. If you have 40 personnel and are able to adjust a few people, that's saving $100,000 per year."
Moving staff around to shorten wait times improves patient satisfaction, which will be important going forward. "Looking at the future of reimbursement, and staffing squeezes, the more you can automate to improve costs and decrease wait times, the patient's experience will be better," says Mr. Chambers. "Patient satisfaction is a component of meaningful use and in hospitals that can increase or decrease payment. I expect the same will happen for ASCs in the future."
3. Computer simulation. Computer simulation technology can help administrators model the workflow at their ASCs and develop a pathway for different processes. Key-Whitman uses Simcad® Process Simulator integrated with Versus location data. The program allows you to make slight changes in the process and simulate what would likely happen based on individual ASC data.
"When you establish the flow chart and individual processes are taken into account, you can assign a time to each task," says Mr. Chambers. "A few years ago, you would have to hire an engineer with a stop watch to time the processes. Now with the Versus [RTLS] technology, we can get exact cycle times and apply changes to the simulation to determine the level of utilization or resources that model can attain."
The program takes into account the utilization of surgeons, operative techs, operating rooms and front desk staff, among several other factors, to see how a modification would affect them.
"If we can reduce wait time and room turnover, then our surgeons' expectations are higher," says Mr. Chambers. "As we bring new laser technologies for procedures like evolving cataract surgery, we can determine what impact that will have."
Simulation takes out the trial-and-error time otherwise spent making sure a new process works well. "We would typically have to spend time planning and implementing a new system and getting a feel for how well the system works, then make adjustments," says Mr. Chambers. "That can take weeks or months. This technology allows you to test the system before it starts by showing the ripple effects we didn't think about. We can minimize the mistakes and errors in how we would redesign the system to meet the ongoing needs in cost-reduction and work flow improvement."
4. Scheduling system. An automated scheduling system can help office staff populate the surgical schedule and make simple changes as necessary. The system can help expedite patients who arrive at the office late or squeeze in last-minute cases.
"The scheduling system determines what the best 'flight patterns' are for the patients," says Mr. Chambers. "We can move the patients through more quickly and indicate which patients need to go first."
Coupled with the Versus and CAD technology, administrators can simulate how moving patients through differently could impact the ASC. "This tool allows us to examine more efficient models for everything, including scheduling," says Mr. Chambers. "This is very cost effective and continuous. We can update our model as we change equipment or personnel."
5. Electronic medical records. Even though EMRs are a huge capital expense and take time and energy to implement, they can improve data collection and patient flow at the surgery center. After they are running properly, an EMR designed for the outpatient setting can have a huge impact on efficiency and profitability.
"Our EMR program does a lot to help efficiency in the ASC," says Ms. Hurley. "There are reports we can extract from them to begin process improvement. We can gather data and look at the patient's medical information more easily."
Data collection can help surgery centers prove their quality and cost-effectiveness during payor contract negotiations. They can also allow patients to enter medical histories online and easily transfer from other providers with compatible programs.
"The key to adding ASC volume when we are talking about drastically reducing payments to ASCs is becoming more productive and efficient," says Ms. Hurley.
More Articles on Surgery Centers:
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"To a large extent, surgery is an assembly line process from start to finish," says Dan Chambers, Chief Administrative Officer with Key-Whitman Eye Center. "You can identify the time it takes to complete the process and the reliability of each step in order to be compliant and minimize errors. That's how ASCs are able to provide patients with high quality outcomes."Mr. Chambers and Nikki Hurley, BSRN, MBA, COE, Director of Surgical Services at Key-Whitman Eye Center, discuss the technologies that have propelled their center to success.
1. Patient tracking systems. Last month, Key-Whitman Eye Center began using the Versus Advantages™ Real-time Locating System (RTLS), a patient tracking technology, and already sees improved efficiency. The technology records when patients are in each area of the ASC and how long they spend there, so Hurley, can extract information about patient wait times and identify bottlenecks in the process.
"This helps track patients throughout the process so you know where the breakdowns of communication can be within your own staff," she says. "If there is something holding them back in pre-op, the nursing staff can view that more readily and figure out how to make the process smoother. They can also deploy additional staff to help in real time, if necessary."
The data can be pulled for various reports to help refine processes. "We place the software on a hosting computer remote to our location and I can view the information from my satellite office," says Mr. Chambers. "I know from 20 miles away how many patients are waiting and where the physicians and staff are in real time."
ASCs can also display a screen with the tracking system in their waiting rooms so families can see where their loved ones are. The program is HIPAA compliant and uses numbers or initials instead of full names on the screen.
2. Nurse tracking. In addition to the patient tracking capabilities, the Versus RTLS can also track where the nurses are. This is a huge benefit for appropriately staffing the ASC.
"You can determine whether you can moderate the staffing requirement and make sure nurses are where you need them most," says Mr. Chambers. "When you look at the whole facility in one snap shot, you can track the imbalance of staffing needs and potentially reduce a few nurses. If you have 40 personnel and are able to adjust a few people, that's saving $100,000 per year."
Moving staff around to shorten wait times improves patient satisfaction, which will be important going forward. "Looking at the future of reimbursement, and staffing squeezes, the more you can automate to improve costs and decrease wait times, the patient's experience will be better," says Mr. Chambers. "Patient satisfaction is a component of meaningful use and in hospitals that can increase or decrease payment. I expect the same will happen for ASCs in the future."
3. Computer simulation. Computer simulation technology can help administrators model the workflow at their ASCs and develop a pathway for different processes. Key-Whitman uses Simcad® Process Simulator integrated with Versus location data. The program allows you to make slight changes in the process and simulate what would likely happen based on individual ASC data.
"When you establish the flow chart and individual processes are taken into account, you can assign a time to each task," says Mr. Chambers. "A few years ago, you would have to hire an engineer with a stop watch to time the processes. Now with the Versus [RTLS] technology, we can get exact cycle times and apply changes to the simulation to determine the level of utilization or resources that model can attain."
The program takes into account the utilization of surgeons, operative techs, operating rooms and front desk staff, among several other factors, to see how a modification would affect them.
"If we can reduce wait time and room turnover, then our surgeons' expectations are higher," says Mr. Chambers. "As we bring new laser technologies for procedures like evolving cataract surgery, we can determine what impact that will have."
Simulation takes out the trial-and-error time otherwise spent making sure a new process works well. "We would typically have to spend time planning and implementing a new system and getting a feel for how well the system works, then make adjustments," says Mr. Chambers. "That can take weeks or months. This technology allows you to test the system before it starts by showing the ripple effects we didn't think about. We can minimize the mistakes and errors in how we would redesign the system to meet the ongoing needs in cost-reduction and work flow improvement."
4. Scheduling system. An automated scheduling system can help office staff populate the surgical schedule and make simple changes as necessary. The system can help expedite patients who arrive at the office late or squeeze in last-minute cases.
"The scheduling system determines what the best 'flight patterns' are for the patients," says Mr. Chambers. "We can move the patients through more quickly and indicate which patients need to go first."
Coupled with the Versus and CAD technology, administrators can simulate how moving patients through differently could impact the ASC. "This tool allows us to examine more efficient models for everything, including scheduling," says Mr. Chambers. "This is very cost effective and continuous. We can update our model as we change equipment or personnel."
5. Electronic medical records. Even though EMRs are a huge capital expense and take time and energy to implement, they can improve data collection and patient flow at the surgery center. After they are running properly, an EMR designed for the outpatient setting can have a huge impact on efficiency and profitability.
"Our EMR program does a lot to help efficiency in the ASC," says Ms. Hurley. "There are reports we can extract from them to begin process improvement. We can gather data and look at the patient's medical information more easily."
Data collection can help surgery centers prove their quality and cost-effectiveness during payor contract negotiations. They can also allow patients to enter medical histories online and easily transfer from other providers with compatible programs.
"The key to adding ASC volume when we are talking about drastically reducing payments to ASCs is becoming more productive and efficient," says Ms. Hurley.
More Articles on Surgery Centers:
6 Industry Experts Discuss Surgery Center Transactions Outlook for 2013
10 Common Reasons Top ASC Procedures are Unexpectedly Denied
5 Ways to Boost Profits at Cash-Strapped ASCs