OR White Paper

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OR White Paper

THE PROBLEM

Today’s surgical department has to deal with three competing elements, all pulling in different directions; patients, physicians and managed care. Patients want effective treatment with all options covered, the most positive outcomes and comfort. Physicians want to provide first rate medical treatment, state-of-the-art, almost miraculous in some cases, while remaining above issues such as costs. Managed care providers and insurance companies look at patient and procedure expected outcomes, requiring economic feasibility and justifications for each procedure. Their concern is bottom line viability.

Surgery remains a key revenue generator for acute care facilities, and is the economic leader in this area. Today’s perioperative department requires the highest level of productivity and streamlined operations in order to survive. Meeting the needs of patients, physicians and managed care providers is the challenge facing the department manager. How can all of these competing interests be served?

A simple alternative is to focus inward by providing a structured, team oriented, environment that will allow for the best possible outcome, regardless of the competing element(s) being served. This requires the establishment of priorities based upon the realities of today’s healthcare, recognizing that each organization is different; teaching institutions, for profit facilities, urban social/charity organizations, etc. Therefore, each institution’s surgery area will have somewhat different priorities.

THE ANALYSIS

Three simple, but effective, management priorities are suggested for survival in the present healthcare environment.

Priority #1 – Know your real costs.

Priority #2 – Micro-manage your resources.

Priority #3 – Create effective documentation

Knowing Your Real Costs

If you really know your costs, you can manage and contain them. Your supplies will be provided on the most cost-effective basis. No charges will be overlooked, and your reimbursements will become reasonable. Ongoing coordination with departments such as accounting, materials management and admitting is crucial. Understanding the basis of your expenses and the sources of your revenues will allow you to present ongoing return on investment (ROI) to administration.

Micro-manage Your Resources

Timing is everything, especially for complex events. In OR, the room, the staff, the equipment, the supplies, the drugs, the physicians, the patients, etc., all must meet at their appointed place and time. Detailed planning is required. Anticipation of issues is critical, including the need to change directions quickly because of unanticipated events. Delays are costly and reduce productivity, which ultimately impact quality. Automation, communication and management reporting are “must have” items

Effective Documentation

Documentation of resources utilized is critical to improving the outcome. If the collection of utilization data is a cumbersome, inefficient process, the data will be inaccurate. Therefore, in order for the documentation to be effective for future analysis, cost tracking, etc., the collection process needs to be highly convenient and efficient. It will tie together priorities one and two above, and allow you to revise as needed to become more effective overall. Convenient documentation should not add workload to already stretched staff.

THE SOLUTION - perioOperative Resource Management System (ORMS)

USA’s ORMS solution is both a structure and a discipline which allows the surgical department to make significant improvements in efficiencies and productivities. These improvements increase the quantity and quality of care available to both physicians and patients, at a lower cost per case or procedure. ORMS meets the competing demands of patients, physicians and managed care. ORMS accomplishes this through planning, scheduling, documenting and analyzing the use of your surgery resources, conveniently and effectively.

ORMS PLANS

With your policies, procedures and available resources, establish rules and profiles to follow automatically and consistently.

Rules and profiles may be changed dynamically, as needed, when your environment changes.

Physician preferences remain current, and updates may be automatic, throughout the enterprise.

ORMS SCHEDULES

Based upon your rules, policies and available resources, schedules are quickly and conveniently arranged.

Conflicts are resolved automatically.

When outcomes and events are different than planned, schedules for all events are changed dynamically, as needed.

Key parties are notified automatically.

When the procedure is scheduled, you are assured the resources needed are there.

ORMS DOCUMENTS

Data is permanently stored as a byproduct of routine procedures

Forecasts events and required resources

Utilization is based upon actual events

Required clinical reports automatically prepared to your specifications

Audit trail of transactional events, including care plans

ORMS ANALYZES

Resource utilization, relevant to:

procedures
patient classes
providers
periodic and elapsed times
supplies and equipment
staff
revenue and expense
facilities
managed care plan(s)
DRB, ICD-10, CPT codes

or any combinations of elements through a query reporting capability.