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Because ophthalmic ambulatory surgery centers keep popping up and reimbursement for cataracts keeps going down, many hospitals are basically abandoning cataract surgery, reasoning that it's not worth the trouble. But is that really the right move? I wonder.
Not long ago, some local surgery centers started inviting our cataract surgeons out for dinner and giving them facility tours. This got our attention. Cataracts comprise about 150 of the 450 cases we do each month in our suburban hospital. And although cataract is not our most profitable procedure, it is important to our financial well-being. More importantly, it is our mission to serve our community. If the residents think they have to go elsewhere for cataracts, they may come to believe that they need to go elsewhere for other procedures.
Once I learned that our surgeons were considering other opportunities, I gathered our OR and short-procedure staff together and explained the challenge before us. I expressed the thought that although we were doing a good job with cataracts, we were going to have to do even better. Mincing no words, I looked my staff in the eye and said: "You and I cannot afford to lose this business." I let them know that I wanted their support and ideas, and that they could expect some changes, not all of them popular.
Next, we selected a team that would specialize in cataract procedures. I felt our surgeons would be happiest if they could rely on the same helpers for every single case. Also, as cataract typically is a bilateral procedure, I felt patients would also appreciate dealing with the same group of professionals not only throughout their first visit, but on their return visit as well.
Following several visits to local surgery centers, we made more changes. In our short procedure area, we used to put our cataract patients right alongside all the other patients, including those facing or recovering from a total hip or a colon resection. To resolve this, we converted two of the eight bays in our holding area to a living-room type setting. We bought some reclining chairs, a television, a nice picture for the wall, and some silk flowers. Patients sit here pre- and post-operatively; they only lie on the gurneys during the procedure and while they're being wheeled to and from the OR.
We used to ask these patients to completely disrobe for their surgery, a big deal for elderly patients. Now they remove their tops only.
The cost of these changes was nominal, and the results have exceeded my expectations. The feedback from patients has been very positive, and our cataract volume has actually grown. Patients who get surgery here tell their friends about their surgeons and our facility, a testament to the efforts of our cataract team.
Flush with our success, we are now looking into converting one of our small procedure rooms into a fast-track orthopedic room and dealing with those patients in the same manner.
A lot of people in hospitals work long hours for relatively little thanks, and do a good job in spite of it. But competition is getting tougher. We need to remember that even though we do a great job, we always need to continue to strive to improve.
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