Outsourcing Anesthesiologists

Personnel outsourcing has become a vital component to the workflow in many healthcare facilities, and it can be a viable solution for ambulatory surgery centers (ASCs) looking to add a dedicated team of anesthesiologists. A successful partnership with an outsourcing company can help recruit a qualified workforce, reduce procedure turn-around time and save money on everyday tasks. Anesthesia Healthcare Partners (AHP) offers a turn-key approach to providing a quality anesthesiologist or anesthesia team by handling credential-related issues and other human resources tasks, leaving more time for patient-care activities.

View the financial savings that could be derived from outsourcing from a clinical perspective. The faster and more efficient your team operates, the more surgeries you will be able to schedule, which in turn means increased profits. All factors, including patient throughput, pre-op and post-op protocol and time management skills for administrative tasks should be examined to have a clear picture of how your ASC functions. Examine all areas in which time savings can be executed while maintaining a high degree of patient safety, and you will most likely identify areas in which your ASC can improve — ultimately keeping more money in your pocket.

As Andre Dobson, MD, corporate medical director of AHP, states, “Minimizing the turnaround time at our partners’ facilities helps to both eliminate overtime costs for their staff along with decreasing moment-to-moment expenses for materials and drugs.”

AHP’s extensive background in outpatient surgery allows the company to create a business model specific to ASCs’ unique needs.

“Over the past 10 years and with more than 50 ASC partnerships, we have found that the anesthesia services requested by an ASC are vastly different from the anesthesiology services typically found in a hospital setting,” says Timothy Beisner, vice president of marketing for AHP. “These demands, including efficiency, cost-effectiveness and teamwork, are the basis of our ‘invited guest’ approach. Many times the physicians who perform the procedures in an ASC are also owners of the center, which is why the term ‘invited guest’ is used since we are exactly just that — invited guests in their ‘home’ (the center). We want our team’s goals to duplicate the center’s goals and allow patients to have the safest and most efficient and pleasurable experience at the ASC.”

AHP’s style of outsourcing allows an ASC to carry out the core basics of facility operations. “Our primary method to accomplish this ‘invited guest’ approach is to dedicate an anesthesia care team to the center,” Beisner adds. “This means that the anesthesiologists and certified registered nurse anesthetists (CRNAs) who provide the anesthesia services will not be rotating through other centers or hospitals, thus allowing for a collaborative partnership that shares a common goal. For example, if a center has a goal to increase patient satisfaction; our anesthesia care teams can implement sedation techniques that minimize the patient’s recovery period thus improving the center’s ability to discharge patients safely; while overall improving the patient’s satisfaction.”

Collaboration between the outsourcing company and potential partners will ensure a clear understanding of how important a dedicated team of anesthesiologists is to positive patient outcomes.

“Our anesthesia care teams are recruited specifically for our partner’s facility,” Beisner emphasizes. “That means that the facility’s procedure and operating rooms are the only priority of the anesthesia care team, not a secondary location for an anesthesia group that may be subsidizing other local facilities being served by the same group. This also helps create a team spirit within the center, since it will be the same team in the center every day and team members learn how each of the physician’s procedures move, therefore supporting a better experience for the patient, the physician and center’s staff.”

Patient throughput is one of the most important factors in keeping an ASC efficient. Pre-operative logistics, if not handled properly, can impact your ASC’s financials. It is important to consider the turn-around timing and to know where your facility’s strengths and weaknesses lie in all aspects of a surgery.

“In some of our centers that experience a bottleneck in the patient flow in the pre-op portion of the process of evaluating the patient’s history and other information gathered prior to our team sedating the patient, we have implemented advance phone calls to patients at home prior to the day of their procedure to review the pre-op anesthesia evaluation,” Beisner explains. “This not only strengthens the relationship between the patient and the center, it helps reduce cancellations by reminding the patients of their procedure and most importantly it allows our anesthesia team to review the patient’s history in less time prior to the procedure since they have already spoken the day before.”

Along with other pre-operative practices, ensuring a first-rate action plan for post-operative throughput is essential. As Beisner notes, “We often partner with surgery centers that experience congestion in their patient flow in the recovery area due to patients being groggy or nauseated from the anesthetics used for sedation. To help our surgery center partners alleviate this bottleneck, we can implement anesthesia techniques proven to lessen a patient’s recovery period, thus freeing up the recovery area for other recovering patients.”

Beisner says that a quality anesthesia team can drive significantly improved patient satisfaction scores.

“Patients sometimes say that they had the best eight hours of sleep, even though it was only a 15-minute procedure. Our anesthesia care teams are trained to help move their patients through the center in the most efficient and safe manner via the best practices learned through each of our 60-plus facility partners; however we do realize each center is different and modify the process to each center’s flow.”

Outsourcing a trained anesthesia team also will enable an ASC to use up-to-date sedation techniques. “As the country’s leader in propofol sedation administered by both anesthesiologists and CRNAs in a surgery center setting, AHP has experienced an increased interest from both single-specialty endoscopy centers and multi-specialty surgery centers that are looking to provide complete anesthesia services or simply a dedicated propofol sedation service for their patients,” says Beisner. Using propofol can help save valuable time in the OR setting, a boon to ASCs. “Propofol sedation compared to traditional conscious sedation acts much faster and superior to alternative sedation agents. It acts much faster and wears off considerable faster with most patients experiencing very few side effects, compared to a traditional patient sedation. With propofol, it takes 10 second to get the patient asleep so that saves 8 to10 minutes per procedure. Along with quicker recovery, where the patient’s traditional recovery is much groggier and can last for hours after the procedure, propofol will only take 2 minutes of a recovery period. This is the biggest time savings for ASC.” Beisner adds.

Many ASCs lack a dedicated human resources department, so administrators and nurse managers may be handling various administrative responsibilities simultaneously. Some tasks, especially securing a clinician’s credentials and other paperwork can be tedious and time-consuming. Most importantly, physician owners of the ASC and AHP share the understanding of the importance of verifying the anesthesiologist’s or CRNA’s credentials. Members of the anesthesiology team provided by AHP are accompanied by a comprehensive packet of paperwork documenting everything from board certification, education, state license(s), work history, DEA/CSD registration, malpractice claim history, proof of malpractice insurance, facility privileges and professional references. Any sanctions or queries from the Federation of State Medical Boards, the Healthcare Integrity and Protection Databank, and the National Practitioner Databank are provided as well.

“AHP dedicates a CRNA and/or an anesthesiologist team to the surgery center. Many facilities, even though they might have three rooms that need coverage, are running a group of 15 or so individuals through the center on any given day,” Beisner says. “With AHP, we might only have four people dedicated to that center so when we hand over the credentialing packet for those four folks, the credentials are already onsite, making the administrator’s job easier. They don’t have to give privileges to 15 individuals and keep their credentials up to date; they only have to do it for the four dedicated folks, which makes it much easier than researching so many people. In addition, we check annually for ACLS and CPR skills.”

“We adhere to the strictest standards of credentialing, as outlined by the industry, in order to ensure that the best care is provided to all of our patients,” Dobson says. Sean Lynch, co-founder and chief executive officer at AHP adds, “With the redundant process of having AHP validate the provider’s credentials and in turn the facility doing their own due diligence, we are assured of the best clinicians serving the center to prevent any oversights.”

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