Premier Anesthesia’s Accomplishments for Baptist Health
Just Short of ‘Unbelievable’
As told by Dr. Robert Harris, Vice Chairman of Surgery
Symptoms
Dissatisfied surgeons
Reduced service in OR
Recruiting crisis
Inconsistent personnel
High staff turnover
Lack of profitability
Outcomes
Profitable OR
Reputation for excellent service
Attracts top talent
Departmental stability
Administrative Control
Within 60 days, surgery cases had increased by 100 per month.
Problem
A leading provider for central Alabama, Baptist Health of Montgomery's ongoing problems with the anesthesia department threatened to impede its excellent reputation. The anesthesia group's repeated conflicts with both administration and surgeons had caused a breakdown in effective communication. Dissatisfied surgeons were diverting admissions to other facilities.
High turnover of anesthesiologists and CRNA added to the disjointed, inconsistent environment. Complaints of unfair scheduling and overtime were escalating. The hospital's attempts to recruit a new team had not been successful; an excellent compensation package couldn't offset the department's widespread reputation for a poor work environment. In the past 10 years, Baptist had hired five Chiefs of Anesthesia. Each had only brief success.
Solution
Premier's consultative process
included an anesthesia staffing analysis
-- interviewing all permanent and locums
anesthesiologists, CRNAs, surgeons, and
administration. We identified four
problems contributing to a dysfunctional
environment.
Disorganization of anesthesia services, including:
Lack of governance
Lack of leadership
Inability to recruit
The current group's overall disorganization was the root of its problems, hindering communication and teamwork. Administration did not have a clear picture of coverage and revenue, and therefore could not maximize profitability. The group's lack of governance led to internal conflict and scheduling problems; it needed proven leadership.
Our solution included several components:
System of governance that worked with hospital administration
Leadership by proven management
Recruiting program with national power
Result
Within 60 days, surgery cases had increased by 100 per month. Within 5 months, Premier had recruited 8 permanent anesthesiologists and 29 permanent CRNAs, including Dr. James Harper, former Chair of Anesthesiology at the Mayo Clinic. Today's team of 10 permanent anesthesiologists and 30 permanent CRNAs have "mutual respect" and are "able to concentrate on patient care rather than politics," according to Chief CRNA Stewart Hoven, who has been at Baptist for nearly 15 years.
Premier's financial model provided a plan for increasing OR profits through anesthesia management services. Premier manages all recruiting, billing and collections while maintaining frequent reporting and site meetings. As a result, the anesthesia team provides better care to a larger number of patients — and Baptist Health has become increasingly profitable and well-renowned for high-quality anesthesia services.
