Anesthesiologists are sometimes called the "lone wolves" of surgery. Often, these physicians work solo in the operating room and exist on the periphery of the ordinarily close-knit professional circles of surgeons and nurses. However, that doesn't have to be the scenario. Hospitals should instead work to make their anesthesia team the "face" of the surgical program — when it comes to both patient interaction and coordination of care — because it can increase the efficiency of ORs and boost physician and patient satisfaction. Here are four key tenets of that strategy.
1. Know the patient. Typically a patient arrives at the hospital two hours before the scheduled surgery. He or she interacts with a nurse, a surgeon and an anesthesiologist — who usually pops in to say hello and check the patient's chart to make sure he or she is ready to undergo anesthesia. But few patients realize that this person, who they met for three minutes, is the person responsible for their comfort and safety during surgery.
Anesthesiologists should take a few minutes to talk to their patients, tell them they're glad to see them and know their patients' names without consulting charts. Patients will visibly relax when somebody is telling them they've paid attention to their care. That can go a long way toward improving or maintaining patient satisfaction.
2. Take ownership of preoperative testing. Instead of becoming familiar with a patient only a couple hours before surgery, anesthesiologists should review the patient's records and test results at least 72 hours prior to the day of surgery and interview those with high acuity or major co-morbidities. This gives the anesthesiologist an opportunity to evaluate the patient's medical history and order any needed lab tests, consultations or medications. Completing such tasks before the day of surgery helps ensure the patient receives the highest quality care and eliminates the need for last-minute tests or examinations that could delay or force cancellation of surgery.
Proper management of preoperative testing is most important for the first cases of the day because early morning delays cause backups that can affect other physicians, patients, equipment scheduling, OR time and a number of other issues throughout the day. By taking ownership of preoperative testing, anesthesiologists keep surgeries on schedule — a key component of keeping patients and physicians happy and maximizing the efficiency of a hospital's OR. In most hospitals, surgery accounts for 55 percent or more of net revenues and 20 to 35 percent of the costs. Efficiency in the OR can help hospitals maximize profits.
3. Manage the continuum of care. In many hospitals that struggle with managing the continuum of care, nurse managers — who typically have tenure of only two and a half years — are the ones handling the process, which includes everything from patient transport to interacting and coordinating with surgeons. Many anesthesia practices lack seasoned managers and ultimately don't have the expertise or gravitas to interact directly with the surgeons or collaboratively restructure a troubled department, and those departments frequently have angry surgeons. In those cases, the anesthesia team is on the sideline, and their day has been disrupted, too.
The anesthesia service should take the lead for managing the continuum of care for their patients. Given that anesthesiologists follow and track their patients' health and comfort during their surgical stays, they are in a unique position to help solve problems, set processes and smooth protocols related to arrival, registration, admission, patient transport and the like. Effective management of patient throughput enhances patient and physician satisfaction, and this helps eliminate inefficiencies that can increase costs (for example, overtime pay) and reduce revenue (such as patients who tell their friends they had a lousy experience or surgeons who take their business elsewhere).
4. Make it a team effort. Using a "care team model" in anesthesia is one of the best ways to increase efficiency in the operating suite. In this model, rather than just using physicians, the anesthesia service also utilizes mid-level providers, such as certified registered nurse anesthetists or anesthesia assistants who can help the physician care for more than one patient at a time. With a care team model, hospitals are giving their anesthesiologists additional hands. For example, a patient can be in surgery while another is being prepped.
An anesthesia medical director should lead the entire anesthesia operation, providing oversight to the day's events and handling the integration of emergency cases or other unexpected issues. Surgery is one of the most traumatic things people will experience throughout their lives. Anesthesiologists are the perfect people to bring comfort and security to a patient while playing a crucial role in OR efficiencies. They should view themselves as the face of surgery.
10 Experts Share the One Behavior They Believe Cripples an OR
The One Change ORs Should Make to Improve Efficiency: 9 Responses
1. Know the patient. Typically a patient arrives at the hospital two hours before the scheduled surgery. He or she interacts with a nurse, a surgeon and an anesthesiologist — who usually pops in to say hello and check the patient's chart to make sure he or she is ready to undergo anesthesia. But few patients realize that this person, who they met for three minutes, is the person responsible for their comfort and safety during surgery.
Anesthesiologists should take a few minutes to talk to their patients, tell them they're glad to see them and know their patients' names without consulting charts. Patients will visibly relax when somebody is telling them they've paid attention to their care. That can go a long way toward improving or maintaining patient satisfaction.
2. Take ownership of preoperative testing. Instead of becoming familiar with a patient only a couple hours before surgery, anesthesiologists should review the patient's records and test results at least 72 hours prior to the day of surgery and interview those with high acuity or major co-morbidities. This gives the anesthesiologist an opportunity to evaluate the patient's medical history and order any needed lab tests, consultations or medications. Completing such tasks before the day of surgery helps ensure the patient receives the highest quality care and eliminates the need for last-minute tests or examinations that could delay or force cancellation of surgery.
Proper management of preoperative testing is most important for the first cases of the day because early morning delays cause backups that can affect other physicians, patients, equipment scheduling, OR time and a number of other issues throughout the day. By taking ownership of preoperative testing, anesthesiologists keep surgeries on schedule — a key component of keeping patients and physicians happy and maximizing the efficiency of a hospital's OR. In most hospitals, surgery accounts for 55 percent or more of net revenues and 20 to 35 percent of the costs. Efficiency in the OR can help hospitals maximize profits.
3. Manage the continuum of care. In many hospitals that struggle with managing the continuum of care, nurse managers — who typically have tenure of only two and a half years — are the ones handling the process, which includes everything from patient transport to interacting and coordinating with surgeons. Many anesthesia practices lack seasoned managers and ultimately don't have the expertise or gravitas to interact directly with the surgeons or collaboratively restructure a troubled department, and those departments frequently have angry surgeons. In those cases, the anesthesia team is on the sideline, and their day has been disrupted, too.
The anesthesia service should take the lead for managing the continuum of care for their patients. Given that anesthesiologists follow and track their patients' health and comfort during their surgical stays, they are in a unique position to help solve problems, set processes and smooth protocols related to arrival, registration, admission, patient transport and the like. Effective management of patient throughput enhances patient and physician satisfaction, and this helps eliminate inefficiencies that can increase costs (for example, overtime pay) and reduce revenue (such as patients who tell their friends they had a lousy experience or surgeons who take their business elsewhere).
4. Make it a team effort. Using a "care team model" in anesthesia is one of the best ways to increase efficiency in the operating suite. In this model, rather than just using physicians, the anesthesia service also utilizes mid-level providers, such as certified registered nurse anesthetists or anesthesia assistants who can help the physician care for more than one patient at a time. With a care team model, hospitals are giving their anesthesiologists additional hands. For example, a patient can be in surgery while another is being prepped.
An anesthesia medical director should lead the entire anesthesia operation, providing oversight to the day's events and handling the integration of emergency cases or other unexpected issues. Surgery is one of the most traumatic things people will experience throughout their lives. Anesthesiologists are the perfect people to bring comfort and security to a patient while playing a crucial role in OR efficiencies. They should view themselves as the face of surgery.
Related Articles on OR Efficiency:
Connecticut's St. Francis Hospital Improves Safety Through Checklist Training10 Experts Share the One Behavior They Believe Cripples an OR
The One Change ORs Should Make to Improve Efficiency: 9 Responses