At the 10th Annual Orthopedic, Spine and Pain Management-Driven ASC Conference in Chicago on June 14, Michael R. Redler, MD, founding partner of the Orthopaedic & Sports Medicine Center in Trumbull, Conn., and head team physician at Sacred Heart University in Fairfield, Conn., discussed how to reduce costs and improve quality in orthopedic ASCs. Some of the challenges in an ASC include maximizing operative time efficiency, increasing the range of cases performed in an ASC setting, decreasing total patient time spent in the ASC and managing implant and disposable equipment cost, according to Dr. Redler. He presented five areas in orthopedics ASCs should focus on to overcome these challenges.
1. Extremity surgery. "The challenge in today's ASC is to make certain surgery is performed on the same side every time," Dr. Redler said. ASCs need to follow best practices to avoid wrong-site surgery, such as using time-out protocols and marking the appropriate site where it will be visible during surgery.
2. Regional anesthesia. Regional anesthesia is "the key to broaden your horizons in terms of what you can do at [ASCs]," Dr. Redler said. Regional anesthesia decreases patient time in the post-anesthesia care unit and overall time in the ASC and increases patient comfort.
3. Arthroscopic documentation. One way to decrease costs in ASCs is to eliminate arthroscopic picture printing. Dr. Redler said in OSM, arthroscopic images are transmitted directly from arthroscopy towers to the office picture archiving and communication system. Although arthroscopic image printing may not seem like a big cost driver, the cost of printing over time adds up, so eliminating printing costs can create significant savings, according to Dr. Redler.
4. Minimally invasive surgery. Minimally invasive surgery is an ideal service for ASCs, as it requires less recovery time and creates less postoperative pain. Some minimally invasive orthopedic procedures ASCs can offer include labral repairs, superior labral tear from anterior to posterior repairs and rotator cuff repairs.
5. Anchors. ASCs can reduce costs by decreasing the number of anchors used. For example, ASCs can use anchors loaded with extra strands of suture; in some cases, these cost the same as anchors with only one strand, according to Dr. Redler.
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1. Extremity surgery. "The challenge in today's ASC is to make certain surgery is performed on the same side every time," Dr. Redler said. ASCs need to follow best practices to avoid wrong-site surgery, such as using time-out protocols and marking the appropriate site where it will be visible during surgery.
2. Regional anesthesia. Regional anesthesia is "the key to broaden your horizons in terms of what you can do at [ASCs]," Dr. Redler said. Regional anesthesia decreases patient time in the post-anesthesia care unit and overall time in the ASC and increases patient comfort.
3. Arthroscopic documentation. One way to decrease costs in ASCs is to eliminate arthroscopic picture printing. Dr. Redler said in OSM, arthroscopic images are transmitted directly from arthroscopy towers to the office picture archiving and communication system. Although arthroscopic image printing may not seem like a big cost driver, the cost of printing over time adds up, so eliminating printing costs can create significant savings, according to Dr. Redler.
4. Minimally invasive surgery. Minimally invasive surgery is an ideal service for ASCs, as it requires less recovery time and creates less postoperative pain. Some minimally invasive orthopedic procedures ASCs can offer include labral repairs, superior labral tear from anterior to posterior repairs and rotator cuff repairs.
5. Anchors. ASCs can reduce costs by decreasing the number of anchors used. For example, ASCs can use anchors loaded with extra strands of suture; in some cases, these cost the same as anchors with only one strand, according to Dr. Redler.
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