The operating room is the engine of a facility. The personnel can be considered the fuel. If the engine, (read operating room) is not tuned properly it becomes an inefficient, unreliable, and costly engine to operate.
Quality management is paramount for any facility with a focus on efficiency. Being able to actively measure quality relative to predetermined indices, be it clinically, financially, and institutional is not only mandated by healthcare reform but maximizes revenue and mitigates costly inefficiencies. The OR requires seamless integration of the healthcare professional team. Operating room managers, surgeons/proceduralists, and the anesthesia provider group have the following shared interests:
- High quality care
- Operating room efficiency and productivity
- Maximizing Revenue
- Decreasing cost.
Inadequacy in any one service line hinders the other vested partners. OR efficiency is contingent on active involvement of the healthcare team, federal/state oversight, and an ongoing process improvement/quality improvement program. Notwithstanding is the importance of the OR management and the anesthesia partnership. The surgeon’s are a valuable commodity as they generate an ongoing revenue stream for the respective facility, however, a solid partnership between OR leadership and anesthesia leadership has to exist in order to foster a culture of productivity and efficiency. The importance of the relationship amongst all vested partners cannot be overstated, but the anesthesia provider is the one constant in the continuum of care, from the preoperative evaluation through the patient’s recovery/ discharge. A strong partnership amongst OR management and the anesthesia leadership provide a strong framework for building support, teamwork, and efficiency. This quickly translates into facility, surgeon, and patient satisfaction.
Current industry changes, most notably the Patient Protection and Affordable Care Act (PPACA) have instituted a myriad of industry regulations to maximize efficiency and maintain cost. An anesthesia group that retains experts in policy and quality care initiatives are no longer an option but a must have to remain survey ready and compliant. The National Quality Forum (NQF) contains more than 650 NQF endorsed quality measures.1 An anesthesia management group with advanced knowledge of process improvement (PI) and quality improvement (QI) is imperative for continued success. Executive Anesthesia Solutions is the premier anesthesia group for data driven clinical management optimization.
Examples of Quality Care Initiatives:
Center for Medicare and Medicaid (CMS)
- Agency for Healthcare Research and Quality (AHRQ)
- Patient Safety Indicators
- Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS)
- survey tool used in the Value Based Purchasing (VBP) program
- Inpatient Prospective Payment System (IPPS)
- started in 2013 a reduction in diagnose related group (DRG) payments offsets funding for the VBP program
- Physician Quality Reporting System (PQRS)
- Incentivized payment/reduction system for quality indices information reporting
- Value- Based Purchasing (VBP)
- Outcome measurements, patients satisfaction/experience, and process of care measurements
Joint Commission on Accreditation of Healthcare (JCAHO)
- Surgical Care Improvement Project (SCIP)
- Inpatient quality care measurements
1 NQF Endorsed standards, Washington, D.C., National Quality Forum. Available at http://www.qualityforum.org/Home.aspx. Accessed November 21, 2013.