13 December 2016

Five Key Strategies for Driving Change in the OR

Now more than ever, hospitals and ambulatory surgery centers are seeking anesthesia partners capable of driving positive change in their operating rooms. However, for many anesthesia providers, there are hurdles that must be overcome before such change can be realized.

Anesthesia groups of any size, regardless of their financial strength, can employ proven strategies to ensure the success of facility-wide patient care improvement initiatives. Here are five such strategies that Dr. Adam Blomberg, Sheridan’s national education director, has found to be effective.

Collaborate with nursing and surgeons on incremental steps toward larger improvements

Securing the buy-in of nursing and surgical staff is crucial for ensuring that improvements are universally adopted. Regular status meetings and Kaizen lean process improvement events are examples of methods used for promoting collaboration among all stakeholders in the OR.

Break down the silos

Collaboration is only possible when individuals involved in improvement activities are able to communicate freely across departmental boundaries. Traditionally, the hierarchical structure of the operating room inhibits the flow of information upward. By establishing relationships early on, it is possible to avoid the political turmoil that hampers most improvement efforts.

Work with the C-suite to form a collaborative governance structure

Once key stakeholders have been brought into the fold, the structure and operations of the core improvement team need to be formalized. Often, this will require a significant investment in resources and time; however, the return on such investments usually outweigh upfront costs. Clearly communicating the proposed benefits of the program will help to ease any uncertainty on the part of administrators.

Practice evidence-based medicine

No amount of investment in time and resources can make up for variability in the provision of anesthesia. This is why it is imperative to standardize processes early on and in accordance with evidence-based best practices. Collaboration with other local anesthesia groups can facilitate this process through the sharing of best practices; however, it is ultimately up to anesthesiologists, CRNAs and AAs to determine which practices fit the unique cultural and financial requirements of their facility.

Develop sound preadmission testing guidelines

One of the most significant challenges anesthesiologists, CRNAs and AAs face today is addressing the inconsistencies associated with a variable preadmission testing process. Overcoming this obstacle is no easy feat, given that surgeons’ ordering patterns often reflect years of deeply engrained practices. However, by slowly introducing standards in collaboration with local surgeons, anesthesia staff can realize significant returns almost immediately through fewer canceled cases and greater OR efficiency.

As clinical outcomes begin to take center stage under MACRA, anesthesia providers will be increasingly called upon to address the myriad of challenges facing surgical service lines at facilities across the United States. Confronting the root cause of these problems will require close collaboration among surgical, nursing and anesthesia staff, as well as the buy-in of administration. Learn how our anesthesia leaders have used collaboration and expertise to support higher quality patient care and improved stakeholder satisfaction.