Launching a successful perioperative surgical home program: 4 things to know

The need for patient-centered, value-based care has never been clearer. Amid a pandemic that has upended healthcare delivery, organizations must double down on efforts to ensure patient safety, improve outcomes and enhance efficiency. Launching a perioperative surgical home program can help healthcare organizations achieve their goals and overcome challenges wrought by COVID-19.

During a Sept. 23 webinar, Surgical Directions' Thomas Blasco, MD, senior physician medical director, and Lisa Branding, director of strategy and value-based care, discussed the financial challenges facing the U.S. healthcare system and how a perioperative surgical home program can help hospitals drive meaningful change. The webinar was sponsored by Surgical Directions and hosted by Becker's Healthcare.

Even before the COVID-19 pandemic hit the U.S., health systems were facing rising costs and narrow profit margins, said Dr. Blasco. The typical hospital generates about two-thirds of its revenue from procedural services, including surgical services in the operating room, interventional radiology and endoscopy services. The untenable cost of these services as well as patient preference for lower cost sites of care — driven by the increase in out-of-pocket costs for patients — has led to the migration of these services to the outpatient setting.

Then the pandemic hit, exacerbating these financial issues. Many of the procedural services that hospitals depended on for revenue were halted in the early months of the pandemic, and now, though they are permitted to return, patients are still reluctant to enter the hospital setting. Even after federal bailouts, the American Hospital Association estimates that revenue lost as a result of the pandemic will be hundreds of billions of dollars, Dr. Blasco said.

"Never before have hospitals had to face this kind of economic challenge," he said. "Hospitals and surgeons are looking for methods and ways for returning as [many patients] as possible to a much [safer] system following the emergence from COVID."

Moving toward value-based, patient-centric care can help hospitals recover, and one tool hospitals can use to ensure success is launching a perioperative surgical home program, a team-based model of care that coordinates the patient's entire surgical experience, Ms. Branding said.

Here are four things to know about implementing the perioperative surgical home model:

1. Team buy-in is crucial. All team members involved with the perioperative surgical home must be equally committed to the model, including surgeons, anesthesiologists, hospital leadership and nurses. Ms. Branding suggests hospitals set up a perioperative surgical home steering committee to help guide the implementation.

2. Establish key elements for success. Though there is no standard perioperative surgical home program, there are certain elements that can set a program up for success, Ms. Branding said. These include a nurse navigator, enhanced recovery after surgery protocols and clear communication pathways.

3. Conduct an initial assessment and then plan for implementation. It is important for hospitals to assess their surgical service line and establish baseline data before implementing the program, said Ms. Branding. For implementation, Ms. Branding suggests starting small and building from there.

"I call it the principle of one," she said. "You start with one service line, identify one surgeon within that service line and then one patient for that surgeon. You put that first patient through the surgical home, and then you can quickly and easily evaluate other things that need to change, what worked well, what didn't. Then you bring on more patients for that surgeon. Then you bring on other surgeons. And then other service lines."

4. Data helps drive success. Collect data on certain metrics, including patient outcomes and financial measures, and display it for surgeons. Create a dashboard to show how quality metrics change over time with the perioperative surgical home model, Ms. Branding said. This will help drive cultural change and solidify support for the program.

Learn more about Surgical Directions here, and view the webinar here.




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