Here are five points on improving surgery center processes from the waiting room to the operating room, to improve practice efficiency and patient satisfaction.
1. Focus on specific procedures. Successful orthopedic and spine practices should consider focusing on specific types of procedures, rather than try to offer everything, to eliminate distractions and make sure the institution runs effectively, says John Grossmith, MD, a board certified neurosurgeon at The Bonati Spine Institute in Hudson, Fla. A focused facility has a specific workflow to keep the patients moving through the pre-, intra-, and postoperative process. At The Bonati Spine Institute, the spine surgeons only perform minimally invasive endoscopic laser spine surgery involving the thoracic, lumbar and cervical spine. The surgeons and medical staff have extensive experience treating patients undergoing these specific procedures, therefore the process is able to run smoothly, says Dr. Grossmith.
2. Patient navigation. Patient navigation serves two goals, says Frank Grant, founder and CEO of Grant Healthcare Group. The first is to drive home the program’s difference to the patient. The patient now has a personal resource as well as help with appointments and access to all spine center providers and services. This is the game-changing way of altering the patient’s experience because it eliminates the fragmentation within the market.
The second is to control the referral for downstream services. Participating providers must coordinate with the patient navigator for all diagnostic testing and treatment services. The patient navigation service makes this coordination of care easier for the patient and the office practice. The office practice staff no longer needs to make these appointments or obtain these authorizations. Spine center patients have all this performed by the spine center as part of the patient navigation services.
This model is virtual and does not require that all the providers be in one group, or that the hospital build a new medical office building to locate its spine center. Success with these programming elements does not require either of these. However, you may find that as the spine center providers gain experience working as a team they will feel compelled to be together in one building (while keeping their practices separate). Many find this to be a valuable consolidation initiative in year three or four of the program. Include outpatient hospital services such as outpatient surgery, MRI, pain procedure rooms and physical therapy in this plan for a consolidated one-stop spine center.
3. Exercise transparency. A key element of AAAHC's 10-step performance improvement process is to communicate the findings of performance improvement efforts to physicians, staff and the governing body. Joe Ollayos, administrator at Tri-Cities Surgery Center in Geneva, Ill., says his surgery center sends a full "Performance Improvement Program Report" from its physician executive committee to its management board on a quarterly basis.
"Every meeting, there is a report on our performance improvement program, so we'll look at the number of cases performed, the benchmarking comparisons, patient satisfaction survey results, peer review, what the incidents were and the resolutions that resulted from those incidents," he says. "Then the physician executives will take that report to the full management board so we are able to complete the cycle of communication."
Performance improvement study results are also reviewed with staff at their monthly meetings.
4. Rearrange work space. Our practice has six physicians and four mid-level practitioners, says Penny Forbes, practice administrator at Sierra Regional Spine Institute in Reno. At any given time we have four providers and six medical assistants in a very small area sharing nine patient rooms. To alleviate some of this crush we scanned all of our paper charts, pulled out the metal file system and have converted this area to a work space for our medical assistants. We rotate the MAs out of clinic on days the MAs don't support clinic patients, thus opening the clinic work space to those who do. In the end, we have effectively removed unneeded bodies from clinic, which has opened up space for providers with patients to work more effectively.
5. Standardize equipment as much as possible. Joe Skochdopole, executive director of finance for TriMedx says many healthcare facilities find it difficult to standardize equipment, as different providers have different needs and some vendors specialize in particular products but may not be able to provide everything a center needs. However, he says that your center should standardize equipment purchase as much as possible to improve your relationship with the vendor. You can accomplish this by implementing a formalized process for physicians before they introduce a new piece of equipment to the center.
1. Focus on specific procedures. Successful orthopedic and spine practices should consider focusing on specific types of procedures, rather than try to offer everything, to eliminate distractions and make sure the institution runs effectively, says John Grossmith, MD, a board certified neurosurgeon at The Bonati Spine Institute in Hudson, Fla. A focused facility has a specific workflow to keep the patients moving through the pre-, intra-, and postoperative process. At The Bonati Spine Institute, the spine surgeons only perform minimally invasive endoscopic laser spine surgery involving the thoracic, lumbar and cervical spine. The surgeons and medical staff have extensive experience treating patients undergoing these specific procedures, therefore the process is able to run smoothly, says Dr. Grossmith.
2. Patient navigation. Patient navigation serves two goals, says Frank Grant, founder and CEO of Grant Healthcare Group. The first is to drive home the program’s difference to the patient. The patient now has a personal resource as well as help with appointments and access to all spine center providers and services. This is the game-changing way of altering the patient’s experience because it eliminates the fragmentation within the market.
The second is to control the referral for downstream services. Participating providers must coordinate with the patient navigator for all diagnostic testing and treatment services. The patient navigation service makes this coordination of care easier for the patient and the office practice. The office practice staff no longer needs to make these appointments or obtain these authorizations. Spine center patients have all this performed by the spine center as part of the patient navigation services.
This model is virtual and does not require that all the providers be in one group, or that the hospital build a new medical office building to locate its spine center. Success with these programming elements does not require either of these. However, you may find that as the spine center providers gain experience working as a team they will feel compelled to be together in one building (while keeping their practices separate). Many find this to be a valuable consolidation initiative in year three or four of the program. Include outpatient hospital services such as outpatient surgery, MRI, pain procedure rooms and physical therapy in this plan for a consolidated one-stop spine center.
3. Exercise transparency. A key element of AAAHC's 10-step performance improvement process is to communicate the findings of performance improvement efforts to physicians, staff and the governing body. Joe Ollayos, administrator at Tri-Cities Surgery Center in Geneva, Ill., says his surgery center sends a full "Performance Improvement Program Report" from its physician executive committee to its management board on a quarterly basis.
"Every meeting, there is a report on our performance improvement program, so we'll look at the number of cases performed, the benchmarking comparisons, patient satisfaction survey results, peer review, what the incidents were and the resolutions that resulted from those incidents," he says. "Then the physician executives will take that report to the full management board so we are able to complete the cycle of communication."
Performance improvement study results are also reviewed with staff at their monthly meetings.
4. Rearrange work space. Our practice has six physicians and four mid-level practitioners, says Penny Forbes, practice administrator at Sierra Regional Spine Institute in Reno. At any given time we have four providers and six medical assistants in a very small area sharing nine patient rooms. To alleviate some of this crush we scanned all of our paper charts, pulled out the metal file system and have converted this area to a work space for our medical assistants. We rotate the MAs out of clinic on days the MAs don't support clinic patients, thus opening the clinic work space to those who do. In the end, we have effectively removed unneeded bodies from clinic, which has opened up space for providers with patients to work more effectively.
5. Standardize equipment as much as possible. Joe Skochdopole, executive director of finance for TriMedx says many healthcare facilities find it difficult to standardize equipment, as different providers have different needs and some vendors specialize in particular products but may not be able to provide everything a center needs. However, he says that your center should standardize equipment purchase as much as possible to improve your relationship with the vendor. You can accomplish this by implementing a formalized process for physicians before they introduce a new piece of equipment to the center.