FIVE TAKE AWAYS

A VALUE-BASED AP­PROACH TO PERIOPERATIVE CARE: IM­PROV­ING OUT­COMES AND RE­DUC­ING COSTS THROUGH A SHARED-SAV­INGS MODEL

Modern Healthcare - - THE WEEK AHEAD -

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Or­ga­ni­za­tions that want to suc­cess­fully mi­grate to value-based care must un­der­stand how to align in­ter­nal pro­cesses with new pay­ment mod­els.

These five takeaways were pre­sented in a we­bi­nar on Dec. 6. The en­tire we­bi­nar can be ac­cessed at ModernHealth­care.com/perioperative.

De­velop col­lab­o­ra­tive part­ner­ship

Health sys­tems with con­strained re­sources are chal­lenged to suc­ceed in a value based world. Team­ing with in­no­va­tive in­dus­try part­ners who share your com­mit­ment to value can help pro­vide in­creased band­width and achieve mean­ing­ful re­sults more quickly. For ex­am­ple, Medtronic pro­vided a South Florida hospi­tal with guided train­ing in hys­terec­tomy pro­ce­dures by of­fer­ing their ex­per­tise and re­sources to help hospi­tal staff stan­dard­ize sur­gi­cal tech­niques more ef­fec­tively.

2 Op­ti­mize pref­er­ence cards

Physi­cian pref­er­ence can lead to sig­nif­i­cant staff con­fu­sion and fur­ther in­crease vari­abil­ity. Ac­cord­ing to Medtronic, costs for man­ag­ing up to thou­sands of physi­cian pref­er­ences can ac­count for vari­abil­ity and im­pact the fa­cil­ity’s spend on equip­ment, along with hours of time. En­sure that clin­i­cians keep their pref­er­ence cards up to date, or even al­lo­cate out­side re­sources to help man­age. This can help re­duce com­plex­ity, line-item counts, in­ven­tory space re­quire­ments, staff time, and sup­ply er­rors.

3 Re­duce vari­a­tions within your sys­tem

One way to help your fa­cil­ity suc­cess­fully tran­si­tion to value in perioperative care is through stan­dard­iza­tion and a re­duc­tion in vari­abil­ity. Putting in path­ways that are agreed upon by providers can re­duce pro­ce­dure com­pli­ca­tions and over­all length of stay for pa­tients. But, this is a huge chal­lenge for most providers. “Only about 50% of clin­i­cians fol­low es­tab­lished guide­lines,” said Dr. Stu­art Hart, Di­rec­tor of Global Med­i­cal Af­fairs for Medtronic. “This leads to im­proper pre­ven­tion, di­ag­no­sis and treat­ment, which can con­trib­ute to an es­ti­mated $650 bil­lion in wasted health­care ex­penses an­nu­ally.” Start­ing points in­clude de­vel­op­ing new pro­to­cols for post-op ar­eas, such as pain con­trol or fluid man­age­ment, and stan­dard­iz­ing less con­se­quen­tial items like spec­i­men bags.

4 Pro­vide in­di­vid­ual score­cards to physi­cians

Score­cards are a great way to help physi­cians track their own progress. Score­cards can mea­sure ar­eas like av­er­age cost, read­mis­sion rates, OR times, av­er­age length of stay, and more. And from a sys­tem per­spec­tive, hav­ing this in­for­ma­tion for all clin­i­cians gives executives a com­plete pic­ture and trans­parency to eval­u­ate or­ga­ni­za­tion wide perioperative per­for­mance.

5 Cre­ate a sup­port­ive ad­min­is­tra­tive team

Strong col­lab­o­ra­tion be­tween ad­min­is­tra­tion and physi­cians is an im­por­tant area of suc­cess in value-based care. “You must be amenable to a mul­ti­dis­ci­plinary and col­lab­o­ra­tive team ap­proach to­ward solving prob­lems,” Dr. Hart said. “In or­der to lower costs and im­prove clin­i­cal out­comes, it’s es­sen­tial to im­prove the skill sets of your physi­cians, and uti­lize the ex­per­tise and tal­ent of ev­ery­one in­side the or­ga­ni­za­tion.”

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