5 Tips for Increased Anesthesia Program Efficiency
“Lost time is never found again.” – Benjamin Franklin
A strong, well-functioning anesthesia program will have lasting gains to keep your OR running on-time and ensure quality metrics will be achieved—contributing to the overall operational and financial success of your hospital or ambulatory surgery center. Furthermore, following evidence-based principles within the anesthesia program will promote patient satisfaction, throughput, and safety. Read our five tips for delivering high-value, efficient care within anesthesia programs.
1. Standardize Screening Process for Maximum Anesthesia Program Efficiency
An effective Preanesthesia Screening (PAS) program ensures not only that proper testing is completed, but also eliminates unnecessary testing, which can lead to costly delays. It also facilities the assignment of appropriate staff, equipment and room preparation.
This begins with the chart preparation process. A complete chart will include all patient history, preoperative testing (labs, X-rays, etc.), and all consents for surgery and anesthesia. With so many moving parts it’s imperative that charting follows a systematic approach before the chart is handed off to the surgical team.
When preanesthesia screening personnel are made aware of incomplete charts 48 hours before the patients’ scheduled procedure times, changes can be made to the surgery schedule. This advanced management of the schedule reduces the need for crisis management on the day of surgery. When patients and staff know what is required to prepare for the day of surgery, preventable delays can be minimized or eliminated.
2. Clear Medication Guidelines for the Day of Surgery
Developing clearly defined medication guidelines allows the office and PAS nurses to instruct patients on what to take and what to delay on the day of surgery. Establishing these guidelines makes it clear who will manage the process if bridging is needed specifically for anticoagulant/antiplatelets.
Preprocedural consults and questions need to be addressed by anesthesia.
When are the medications required?
How far from the day of the procedure is acceptable?
When should the medication be repeated?
What types of consults are necessary?
3. Appropriate Staff Training & the Subtlety of a Structured Patient Handoff
Anesthesia providers must complete a clear and concise patient handoff to PACU or ICU nurses — ensuring the nurse fully understands the patient’s acute and chronic issues, resulting in increased patient outcomes and satisfaction. With standardized handoff procedures in place, including a fixed time and location for the face-to-face exchange, higher rates of handoff can be achieved.
Markers of a successful anesthesia program include both a standardized handoff procedure and plentiful staff training opportunities. Continued learning is an integral part of a high-performing anesthesia program and helps the facility best prepare for multiple scenarios. In addition, having the anesthesia team participate in staff drills fosters a collaborative team approach among key stakeholders (anesthesiologists, anesthesia medical directors, nurses, and surgeons) in the program.
4. Establish Block Scheduling Program
Achieving consistent on-time, every time case starts is a team process that not only demands systematic preparation but a strategic block scheduling program (link to blogs on block scheduling). Key elements of a successful block scheduling program include well-defined surgery scheduling policies/procedures, variable block sizes, and release times to continued block scheduling management. Implementing block scheduling can result in improved financial and operational efficiencies for the facility.
5. Redesign or Reconfigure Perioperative Department Layout
According to a white paper published by the Institute for Healthcare Improvement, “Failing to achieve hospital-wide patient flow — the right care, in the right place, at the right time — puts patients at risk for suboptimal care and potential harm.”
Improving patient flow saves both time and money, but more importantly, is paramount to providing the highest level of patient care. A redesign or reconfiguration of the perioperative department is often necessary to achieve optimal flow and ensures the following:
Safe and effective patient care
Operative case time effectiveness
Key stakeholder satisfaction
Efficient management and preparation of surgical instruments and tools
Communicating Expectations and Mapping Out the Day of Surgery
Lack of communication creates situations where medical errors can occur and have the potential to cause patient harm. From pre-surgery to discharge, communication is critical. If anesthesia providers and other key stakeholders can interact in a sequenced manner to confirm patient information, the process goes much more smoothly.
Does Your Hospital or Ambulatory Surgical Center Need an Anesthesia Assessment?
Our Sullivan anesthesia consultants offer Anesthesiology Program Assessments that focus on improving anesthesia provider efficiency, reducing costs in the operating room, and other delivery areas.
Contact us to learn how we can help you review the rationale for an exclusive anesthesia contract and identify other key non-clinical issues within your program.
Randy Heiser is the President of Sullivan Healthcare Consulting. Randy has been a hospital consultant since 1983 and has specialized in perioperative consulting since 1992. He has directed more than 500 surgery department operational improvement studies (and participated in an additional 350) in programs ranging from small community hospitals and freestanding surgery centers to some of the largest university hospitals in the U.S. He was instrumental in the design, development and implementation of the Surgery Benchmark Program that has been used by more than 280 hospitals. He has also participated in the design of several proprietary surgery scheduling information systems currently available in North America.