Driven in part by a CMS and payer push to move as many procedures as safely possible to the outpatient setting, ASCs (ambulatory surgery centers) have a critical need to adapt.
This shift is especially true for the anesthesiology team, which is a critical component of the perioperative care environment.
During an October webinar hosted by Becker’s Hospital Review and sponsored by Sound Physicians, experts discussed care in the ASC environment and how anesthesia teams can adapt to increase efficiency and cost-effectiveness while improving the patient experience. Speakers from Sound Physicians were:
- Phil Eichenholz, MD, CEO, Sound Physicians – Anesthesia
- Andi Damron, CRNA, chief anesthetist officer, Sound Physicians – Anesthesia
- Chris Hutson, MD, regional medical director, Sound Physicians – Anesthesia
Four key insights were:
- The use of ASCs is growing, with repercussions for anesthesia care teams. CMS made changes this year that will allow 1,700 procedures, when clinically appropriate, to be performed at ASCs rather than inpatient settings by 2024. This shift is expected to increase both the ASC caseload and the complexity of cases simultaneously, which will impact anesthesia teams.
“This is a major sea change in a rapid period of time in the surgical world,” Dr. Eichenholz said. “But concurrent with that, while the case growth is substantial, the estimates for surgery center growth doesn’t quite keep pace.”
That means providers and patients will have opportunities to choose where they go for their work and their care. As a result, ASCs will need to focus on excellence in quality and efficiency to attract them.
- To adapt, anesthesia teams must assume leadership roles at ASCs. Key imperatives should include developing cost-effective models with the right mix of physicians and CRNAs (certified registered nurse anesthetists). Teams should also be clear on patient and surgeon goals and ensure that systems and protocols are aligned to drive quality and efficiency. ASC leaders should also rely on evidence-based medicine to reduce the variability in care.
“One of the biggest problems is that not a lot of clinicians are trained in the business of anesthesia,” Dr. Hutson said. “Not all clinicians will have — or need to have — an MBA, but finding the right, high-quality staff who can partner in the overall goals of ASCs is important,” he said. - Consider a team-based, collaborative approach rather than a staffing model. This approach helps both patient and surgeon satisfaction. Patients are becoming more informed as consumers of healthcare and expect quality experiences. While they might have met the surgeon, they usually haven’t met the anesthesia team before their procedure. Pre-assessments help ensure the patient has met their team and feels more comfortable while also allowing regional blocks or other services to take place outside the operating room to enhance efficiency.
- CRNAs are key team members and drivers of the collaborative approach. “A culture of mutual respect, where CRNAs and physicians team up and complement one another’s skill sets, is beneficial for the ASC business and patient care,” according to Ms. Damron. Processes are streamlined when CRNAs can perform regional blocks or other services while working in concert with the rest of the care team.
“Such a model also helps attract talent,” Ms. Damron said. “We are able to recruit CRNAs because we are able to offer them enhanced clinical opportunities. We’re very successful in hiring,” she said.
To register for upcoming webinars, click here.