4 Components of an OR Optimized for Value-Based Purchasing

Jeff Peters, president and CEO of Surgical Directions, and Joseph Bosco, MD, vice chairman for clinical affairs at the Hospital for Joint Diseases' department of orthopedic surgery in New York City, discussed transforming perioperative services for accountable care organizations in a recent webinar presented by Becker's Hospital Review. The webinar, titled "Ensuring That Your Surgical Service Line is Successful in an ACO, Value-Based Purchasing and Bundled Payment Environment," included perioperative best practices and ways the Hospital for Joint Diseases is making its operating rooms more efficient.

In an environment with accountable care organizations and value-based purchasing, hospitals need to be focused on quality and cost. Mr. Peters shared several factors that help a hospital's perioperative department achieve high quality and low cost:

1. New organizational models. ORs need to use new organizational models to align physician incentives with the hospital's goals, according to Mr. Peters. For example, Downers Grove, Ill.-based Advocate Health Care established incentives for surgeons and anesthesiologists to meet quality measures, including those in the Surgical Care Improvement Project, Mr. Peters said.

2. Collaborative governance. Successful ORs are run by a multidisciplinary surgical services executive committee that includes representation from surgeons, anesthesia, nursing and hospital administration, according to Mr. Peters.
 
3. Education and information. OR leaders need to track and share data with physicians and staff. For example, Dr. Bosco, who is also a clinical assistant professor of orthopedic surgery at New York University Langone Medical Center, provides orthopedic surgeons with scorecards that show their performance compared with that of their peers. "Just by measuring and making it transparent, people improve," he said.

4. Efforts to drive efficiency. OR leaders need to look at case time, labor and non-labor costs to drive efficiency, according to Mr. Peters. Dr. Bosco said measuring case time and counseling physicians with excessive case lengths can improve efficiency, patient volume and revenue. Other strategies, such as including physician assistants on the OR team for complex cases, reducing the number of items on preference cards and creating turnover teams, also helped shave time off cases at the Hospital for Joint Diseases, which is part of NYU Langone Medical Center.

Download a copy of the presentation here.

More Articles on Surgical Services:

What Hospital CEOs Need to Know About Surgical Services: 4 Strategies for Protecting OR Revenue
5 Reasons Hospital ORs Score Low on Key Quality Measures
6 Practices of Top-Performing ORs

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