Premier Uses Change to Drive Development


The world may be moving at warp speed everywhere else, but in one little corner of it, all the gadgets and innovations may be passing outside the window as status quo is tenaciously clutched inside.

In a medium-sized Southeastern city, a hospital system that has three medical centers, including a Level 1 trauma center, was experiencing some major shifts in how it was being compensated. With economic downturn and aging population, commercial payers were declining while Medicare and Medicaid were becoming bigger players. The system's patient volume was decreasing as well. The comfortable old ways had to change.

Premier Anesthesia came in and looked at everything, from staffing levels and assignments to malpractice insurance costs and technological systems. One big need emerged: Evidence Based Staffing (EBS). The staffing levels for the anesthesia group simply didn't' match OR use.

Premier Anesthesia worked with the Chief of Anesthesiology, Practice Manager and Chief CRNA to improve the department's agility. A plan was devised for greater efficiency and productivity, meaning significant cost savings. It required staff to sometimes move from one facility to another, as required by OR usage. This was something they'd never done. Some staff that favored their current assignments didn't necessarily like the boat being rocked, but attitudes began changing.

The plan guaranteed CRNAs a specific, generous salary for 30 hours worked. If additional work was available, staffers could sign up. This was agreeable to many employees; others decided to work part time. The outcome was increased flexibility in assigning staff when and where OR needs were greatest.

The changes in the department put the staff on the move, and that left open the possibility that something could fall through the cracks. Would a patient be ready for surgery but the anesthesia team be in the wrong location? How could staffing be coordinated? The answer was simplified communication. Each staff member was provided a radio headset. Staff could confirm assignments, verify OR needs and other essential logistics with their hands free to continue their important work.

The Results

Premier Anesthesia's Medical Director came up with a remarkable plan and implemented it. "You just push a button at your waist and you're able to communicate anywhere," he said. One fantastic aspect of the radios: once the system is bought and installed, that's it. No monthly data plans or lingering costs.

Since 2007, these staffing and other transformations have helped reduce costs at the facilities by $2,650,952.

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