At the Becker's ASC 21st Annual Meeting — The Business and Operations of ASCs, Oct. 23 to 25, in Chicago, Robert S. Bray, MD, founding director and CEO, and Karen Reiter, RN, CNOR, RNFA, CASC, COO of Marina del Rey, Calif.-based DISC Sports & Spine Center, discussed bringing high-acuity procedures into ambulatory surgery centers from the surgeon's perspective as well as the COO’s perspective.
According to Dr. Bray, there have been interesting growth curves in spine surgery. The average length of stay for spine surgery has come down from five or six days to six hours. "We have moved that curve down and we are bringing high-acuity cases into the outpatient environment," said Dr. Bray. To encourage surgeons to perform high-acuity procedures at a surgery center, the ASC staff needs to inspire confidence in the surgeon. The surgeon needs to know that the team is equipped to handle the cases smoothly and efficiently, he said.
ASC administrators need to build efficient processes around high-acuity cases, such as pain management and preoperative process. "Have repeatable processes all over the facility," she said. "You need to dictate processes and build appropriate teams." The entire team needs to be educated and have extensive competencies. The ASC should invest in staff training and cross-train staff members, she added.
Also, having a surgeon champion to encourage other surgeons to perform high-acuity cases at your ASC is very helpful. "Having a surgeon advocate in your facility helps bridge the gap between you and the new high-acuity procedure surgeon you are trying to bring on board. You need to have a very strict peer-review process to find the right physician," said Ms. Reiter.
According to Dr. Bray, it is important that the surgeon and ASC educate patients and their family about high-acuity care in the outpatient setting. By providing patients with the correct information and informing them of every step in the process, surgeons can tout the benefits of performing these procedures in the ASC.