PowerPoint: Practical Approaches to Improving Patient Pre-Op Preparation
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The webinar focuses on improving patient preoperative preparation to enhance surgical efficiency, safety, and satisfaction. Key challenges include variability in patient preparation, communication gaps, and traditional practices that hinder effective care delivery. Strategies discussed aim to standardize processes, optimize resource use, and improve outcomes for patients and healthcare providers.
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Overview of the problem
Current pre-admission processes typically
• Driven by patient registration and “required” lab testing needs
[not assessment and intervention]
• Reactive instead of anticipatory
• Constrained by traditional roles and responsibilities
• View the surgical experience as a series of siloed, sequential
steps - with the patient treated like inventory moving down an
assembly line with minimal communication
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PowerPoint: Practical Approaches to Improving Patient Pre-Op Preparation
- 1. Webinar: Practical Approaches to Improving Patient Pre-Op Preparation
- 2. 2 Your Presenters Michael Hicks, MD, MBA, FACHE Chief Executive Officer EmCare Anesthesia Services Lisa Kerich, PA-C Vice President Clinical Services Pre-Op Anesthesia
- 3. 3 Overview An efficient surgical department requires management of a complex ecosystem of multiple processes, people and communication pathways. How your institution handles the preoperative preparation of the surgical patient is an important part of this ecosystem and one that increasingly drives your operational and financial success. Failures to adequately collect, communicate, coordinate and act on pertinent patient and surgical procedure information can lead to suboptimal care including: decreases in patient safety, operating efficiencies, and ultimately in the satisfaction of patients, staff and surgeons. We will review basic strategies that boost O.R. efficiency and case throughput, reduce cancellations and delays in the surgery schedule, and ultimately enhance patient safety, metrics and surgeon satisfaction. MH
- 4. 4 Key themes of this presentation There is tremendous variation in how patients are prepared for surgery, even within a given hospital or surgery center Even facilities with an existing planned process have variation in patient preparation based on surgical specialty, surgeon, anesthesia clinician, nursing and even primary care preferences Lack of a coordinated approach to patient preparation leads to case cancellations and delays, decreased satisfaction of patients, medical and nursing staffs, increased costs and even potential decreases in patient safety Using tools and skills that you likely already possess can make significant improvements in your preparing your patients for their surgical procedure MH
- 5. 5 Overview of the problem Current pre-admission processes typically • Driven by patient registration and “required” lab testing needs [not assessment and intervention] • Reactive instead of anticipatory • Constrained by traditional roles and responsibilities • View the surgical experience as a series of siloed, sequential steps - with the patient treated like inventory moving down an assembly line with minimal communication MH
- 6. 6 Overview of the problem This leads to • Variability in patient preparation and surgical experience • Mismatch in resources requested and needed (e.g., labs ordered and needed) • Mismatch in personnel • Communication and information gaps • And ultimately an inefficient, costly and suboptimal surgical experience MH
- 7. 7 Goals of Preoperative Preparation Optimize patient’s surgical outcomes through standardization Optimize value creation through better resource utilization Provide all participants what they need (information, intervention, etc.) where they need it and when they need it to do their jobs Drive higher satisfaction of patients, families and clinicians MH
- 8. 8 The Perioperative Continuum: an exercise in clinical care delivery as supply chain management Perioperative medicine: The discipline dedicated to creating value as the surgical patient flows through an integrative surgical experience. MH
- 9. 9 Perioperative Medicine Clinical Care Service Operations Cost Quality and value in perioperative medicine Throughput • Case cancellations • 1st case delays • Room Turnover • % Pts seen in clinic Satisfaction • Patients • Surgeons • Staff • Anesthesia Personnel Care Delivered • SCIP • Clinical indicators • Airway • Block adequacy Total Fixed & Variable • Facility • Professional • Ancillary • “Rework” or complications MH
- 10. Strategic Review and Implementation LK
- 11. 11 What seems to be the problem? Hospitals may or may not have a designated pre- admission procedure and/or screening process Of those hospitals that do have a pre-admission process in place, only 50% of patients are pre- admitting Very few patients are getting pre- anesthesia optimization Patients who are not pre-admitting and pre-screened make up the majority of cancelled cases LK Only 50% Pre-Admit √
- 12. 12 Barriers to improvement LK Resistance to change (primary care, surgeon, anesthesiology, nursing, etc.) Medical community environment Fear of penalization/ retribution; punitive use of data Work flow constraints Poor design of measurement instruments Manual processes
- 13. 13 Barriers to improvement LK Technology (EMR) Educational deficiencies including lack of ongoing training Lack of use of common definitions and guidelines Nursing staff turnover Employees and policies from multiple institutions involved in the process Lack of administrative support
- 14. 14 Evaluate your current pre-op process LK How do the patients currently get scheduled for surgery? Who does the scheduling? What information is collected? What information is the surgeon’s office giving the patient? Preregistration process? When are benefits verified? Is there a nurse interview for clinical information? How far out are you in your throughput?
- 15. 15 Evaluate your current pre-op process Surgical cases # of cases annually? Block time? # cancelled within 24 hours of start time / same day? Cost per case cancelled? # delayed or rescheduled ? Overtime cost? Post surgical complications, length of stay and readmissions within 30 days of discharge LK Post surgical
- 16. 16 PCP Patient Surgeon Pre-Admit Screening Software Patient Scheduled for PAT Patient Screened in Hospital's PAT Clinic Patient Goes to Surgery Model 2020 LK ASA 1 and 2: patients go to pre-admit ASA 3 and 4: patient goes to pre-anesthesia clinic
- 17. 17 Keys to success Patients who are well prepared for surgery have better outcomes. Implementing a PAT clinic model significantly improves efficiency and the perioperative experience for all stakeholders. The perioperative surgical home concept is not new. Bringing all the necessary players to the table is the key to success. LK
- 18. 18 When the PAT Clinic is done right! Model allows for improved performance and revenue Surgeon/ anesthesia/ hospitalist/ PCP/patient satisfaction Reduction of cancellations and delays Reduction in overall expenses to hospital Better patient care and satisfaction Quality analysis and best practices reporting measures LK
- 19. 19 When the PAT Clinic is done right! Revenue for not cancelling surgeries Expense savings for patient, insurance company and hospital Revenue generated through the PAT clinic Increased O.R. utilization LK
- 20. 20 “The best way to predict the future is to create it.” MH Thank you!
- 21. 21 Q&A Q&A Contact Us: Call 877.416.8079 or visit www.emcare.com.