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Metrics: Legacy Good Samaritan Medical Center, Portland, OR

Case Studies


Legacy Good Samaritan Medical Center is recognized as one of the top hospitals in the area, but their anesthesia program suffered from break-downs in customer service, communication, and management of the surgical suite. After repeated efforts to address these issues, the hospital decided to transition the anesthesia program from an all-physician model to a medically directed anesthesia care team (ACT) model to help them reach their goals.


With minimal disruption to the program, TeamHealth Anesthesia began the transition process and quickly implemented the following process improvements:

  • Recruitment of an anesthesia medical director who possessed a strong customer service mindset, understood the hospital’s vision and goals, and had the interpersonal skills to create a positive group culture
  • Recruitment and retention of a core group of physicians and 16 new certified registered nurse anesthetists (CRNAs) to round out the anesthesia team
  • Team building workshops with the anesthesia providers, surgical leadership, and the hospital executive team
  • Appointment of an internal Chief CRNA to be the “go to” resource for the medical director on all CRNA issues, which wove the providers and CRNAs into a tight functional team
  • Implementation of a multi-modal pain management program that immediately reduced the orthopedic length of stays
  • Innovative leverage of TeamHealth’s resources to improve satisfaction scores by implementing customer service training such as “AIDET”
  • Shared leadership meetings that encouraged consistent collaboration (anesthesia leadership now attends nursing department meetings, and nursing leadership now attends anesthesia department meetings)
  • Daily anesthesia “team huddles” to ensure all processes are properly in place for the following day’s patients


By allowing faster room turnover and “flipping” rooms, the ACT model reduced the inefficiency common to many operating rooms and in turn makes surgeons far more efficient. In less than six months, turnover times for orthopedic surgical joint procedures fell from an average of 60 minutes to 30 minutes and continue to improve. Additionally, within one month of implementation, the multi-modal pain block program helped reduce orthopedic length of stay by one full day.


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