Change in the healthcare industry is forcing hospital executives to sharpen their focus simultaneously on providing high-quality care, boosting patient and physician satisfaction and enhancing their bottom lines. With these imperatives, many hospital leaders are turning their attention to their operating rooms (ORs),which are responsible for as much as 70 percent of a facility’s revenue and 40 to 50 percent of its profits, and discovering that converting their anesthesia service from an all-physician delivery model to an anesthesia care team (ACT) model can help them reach all three goals. This white paper will explore the benefits of medically directed ACTs and discuss the process through which hospitals can transition from an all-physician delivery model to an ACT service model.
A medically directed ACT combines one anesthesiologist with up to four certified registered nurse anesthetists (CRNAs) as a team. Together, the team can manage a complex array of cases with the physician’s attention involved at critical junctures of each patient’s anesthesia experience. The physician is available to the CRNA throughout the entire case, during which the CRNA handles much of the pre-op preparation, remains at the patient’s bedside throughout the surgery, and is with the patient when they are transferred to the post-anesthesia care unit (PACU). Meanwhile, the anesthesiologist is involved with each patient at important points in their care, including the patient’s pre-op interview, working with the CRNA to develop the anesthesia care plan, attendance during intubation, emergence from anesthesia and at regular monitoring points throughout the case.
Why a Care Team Model?
- Improved efficiency
- Increased revenue and profits
- Improved teamwork and communication
- Higher surgeon and patient satisfaction scores
- Standardization of care
- Service line specialization
- Alignment with hospital mission and goals
Advantages of a Care Team Model
The advantages of the care team model are several, including:
Improved efficiency. A care team model allows the providers to simultaneously prep one patient while others are in surgery and recovery, instead of having one physician managing a single case at a time from start to finish. Together, the care team providers keep each patient moving efficiently through the continuum of care, thereby eliminating or dramatically reducing anesthesia-related case delays or cancellations.
Flexibility. There are times when the hospital needs anesthesia skills outside of the OR, such as for providing airway support during a code or sedation services for the endoscopic lab, CT service, catheterization lab, co-located ambulatory surgical center or other department.
Increased revenue and profits. By streamlining the perioperative functions to eliminate backlogs and reduce turnover times, the ACT allows a hospital to complete its usual number of daily surgeries in less time.
Improved teamwork and communication. In an ACT, teamwork and communication are built into the model. The structure allows anesthesiologists to be available to answer questions, help with scheduling changes or troubleshoot. The anesthesiologist and CRNA develop each patient’s anesthesia care plan collaboratively so there is no confusion and they can accommodate variations in anesthetic approach based on surgeon preferences.
Higher surgeon and patient satisfaction scores. An ACT model can increase job satisfaction for the entire perioperative team and patient satisfaction with the hospital experience.
Standardization of care. The ACT model promotes collaboration and sharing of best practices among providers and creates a standardization of processes and protocols that are designed to ensure efficiency across the continuum of care and consistent outcomes.
Service line specialization. Unlike an all-physician model, an ACT model allows the hospital to limit the number of physicians and CRNAs on a particular service line to a select few, letting those teams develop specific skill sets. This specialization can lead to better outcomes without compromising provider availability.
Alignment with hospital mission and goals. The structure of an ACT allows providers to more easily implement processes and practices that address core hospital goals, such as improvements on specific core measures.
Making the Decision to Change
Converting to a new anesthesia management company and a new delivery model takes time and preparation. However, if the hospital picks the right partner and the process is managed properly, the transition should result in minimal headaches for hospital leaders and staff and immediately begin to provide benefit to the hospital.