Improving OR performance with a partner

Clinical outsourcing: It's not just for hospitalists and the ED. See how one hospital reduced LOS by 0.61 days and blood and blood component costs by $3,500 per case through outsourcing OR clinical services

The following content is sponsored by SpecialtyCare

In a time when hospital and health system funds are tight — yet inextricably linked to quality — organizations have to start thinking creatively to provide the best possible care at the lowest possible price.

To do so, many hospitals and health systems have turned to outsourcing partners for many nonclinical services, such as housekeeping, food service and patient satisfaction surveys, as well as, increasingly, clinical services, such as hospitalist and emergency department staffing, and dialysis services.

"Hospitals, like all businesses, are looking for a way to maximize value and at the same time ensure world class quality outcomes.," says Melvin Hall, PhD, CEO of SpecialtyCare, on why hospitals look to outsourcing.

The business case for outsourcing is compelling: It allows hospitals to save on labor costs, and often improve performance and efficiency. "Outsourcing is not only the right thing to do [for patients], but a business-prudent initiative as well," Dr. Hall asserts.

One area of clinical outsourcing currently growing in popularity is specialized positions and services in the OR, such as perfusion and intraoperative neuromonitoring. A trusted clinical partner provides highly trained specialists in these areas to hospitals and health systems and assists them in meeting their quality and costs goals

Benefits of Outsourcing in the OR

Outsourcing these areas to a trusted partner can both improve the quality of care provided to surgical patients as well as save hospitals and health systems money.

For one, outsourcing perfusionists or surgical neurophysiologists can reduce labor costs. "Hospitals do better financially when their ORs are fully utilized," says Dr. Hall. When perfusion services are outsourced, the partner puts professionals in place only when there is a procedure happening. If a hospital employs the perfusionists itself, those professionals are "sitting on the sidelines when procedures are not being executed" with the hospital paying for that time, Dr. Hall explains.

Outsourcing to a national partner for these services can also help the hospital benchmark its OR's performance against itself and other ORs across the country. On their own, hospitals have no way of knowing how their perfusionists perform against their peers in areas such as glucose, fluid management and other important clinical metrics.

The lack of comparable data is often why many hospitals turn to outsourcing for other services as well, such as patient satisfaction surveys. "Hospitals collect the data but they don't have a way to compare how they do with other hospitals or groups of hospitals, like ones of similar size," says Dr. Hall. By partnering with a national organization, hospitals gain that capability.

Once that data is available for comparison, it can be used to drive quality improvement efforts both within the partner organization and the OR itself. "Physicians, particularly heart surgeons, are very competitive," Dr. Hall says. If they are presented with high-quality data, such as a national benchmark on glucose management, and data on where their OR stands, they are more likely to take action to improve their own performance and that of their team. "They are going to do something about it," he says.

And national outsourcing partners can step in and help with those quality improvement efforts. SpecialtyCare clinicians are focused on quality and ready to partner with the OR team to drive improvement. “We're not just content providing data, we want to play a role in the quality improvement process,” says SpecialtyCare CMO Chris Wells, MD, MBA. "We want to help solve problems rather than just provide service for a case."

And the company has numerous examples of successful programs under its belt. For example, at Abington Memorial Hospital, a program supported by SpecialtyCare associates decreased the average amount of red blood cells transfused per case by 0.98 units and reduced the average post-operative length of stay by 0.61 days. Cost for blood and blood component use per case also decreased by $3,500.

Considerations When Choosing a Partner

If a hospital executive is interested in gaining those benefits by having a partner for some OR services, there are some considerations to take into account before diving into a new relationship. Executives must consider the following:

Clinical metrics. Hospital executives should ask potential partners about how they measure clinical excellence and benchmark, Dr. Hall says. This will allow a hospital to both demonstrate and improve upon its commitment to clinical excellence..

Compliance. Given the severe penalties for non-compliance, choosing a clinical partner that understands the law and follows it is of upmost importance in this new age. The costs both financial and to a hospital's reputation can be enormous. Being compliant with Stark and anti-kick back laws is a must for hospitals and healthcare systems.. "We believe that being compliant is not only the right thing to do; we owe it to our customers and to ourselves to be diligent in that regard," says Dr. Hall.

Surgeon satisfaction. Teams from the outsourcing partner will work directly and hand-in-hand with surgeons from the hospital or health system. "Surgeons see them as part of the OR team," says Dr. Hall.

SpecialtyCare has a client retention rate of 98 percent, which speaks to its teams' ability to integrate with an organization's physicians and provide value. "As the physician, you don't even think about it," Benjamin Sun, MD, of the Minneapolis Heart Institute, says. "They're an extremely well-run organization that takes the worry out of perfusion and clinical technician services. It's cost effective, and it's professional."

Training opportunities. A quality outsourcing partner will provide its clinicians with opportunities to advance their careers and training to make sure they are up-to-date with the latest technologies and techniques. SpecialtyCare, for instance, founded SpecialtyCare University in 2010 so that its associates can stay on top of new care techniques. "SpecialtyCare does provide us with training throughout the year and they also encourage us as perfusionists to participate in…continuing education," says Chris Langford, a team leader and chief perfusionist with SpecialtyCare.

At the end of the day, a trusted clinical partner will have "highly trained, motivated clinicians who wake up trying to think about how to improve the delivery of healthcare," Dr. Hall says.

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