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Archive ORX Session Previews 2019

Demand More From Your Anesthesia Providers

Ashish Sinha

Ashish Sinha, MD, PhD


Jay Horowitz

Jay Horowitz, CRNA


Thomas Durick

Thomas Durick, MD


Your anesthesia providers get paid to wake patients from surgery free of pain and PONV, but you need them to go above and beyond that basic job description.

"Clinical competency should be a given," says Jay Horowitz, CRNA, owner of Quality Anesthesia Care Corporation in Sarasota, Fla. "Now, it's all about finding added value, the extra things providers can do to help you achieve excellent outcomes and deliver cost-effective care."

During a 3-hour workshop on the conference's opening morning, Mr. Horowitz will be joined by anesthesiologists Thomas Durick, MD, of Envision Physician Services in Walnut Creek, Calif., and Ashish Sinha, MD, PhD, DABA, MBA, of Temple University in Philadelphia, Pa., to let you know how to get the most out of your providers.

  • Understand the business. When is it time to look elsewhere for anesthesia services? "It's no longer enough for providers to say, "We've been with you for 25 years. We have a great reputation and patients love us,'" says Mr. Horowitz. "That might all be true, but you can — and sometimes should — draft a request for proposal to see what else is out there."

He'll also pull back the curtain on what anesthesia providers are thinking during contract negotiations and share insights that will help you establish mutually beneficial business relationships.

The panel will address large national anesthesia services buying up small local groups, a trend that has created provider conglomerates and forced facilities in some markets to deal with providers who are the only game in town.

  • Tap into their potential. Anesthesia providers are playing key roles in preparing patients for surgery and optimizing outcomes as more of an emphasis is being placed on entire episodes of care. They're also the gatekeepers of the OR and make the final call on whether your facility will perform complex procedures on acute patients.

"It's a fine line to walk," admits Dr. Durick. "There has to be open communication and trust between anesthesia providers and administrators."

He recently worked a bilateral distal radius fracture repair on a 91-year-old woman, a case he never would have considered doing in the outpatient setting just 5 years ago. But his combination of a peripheral nerve block and a non-opioid multimodal medication cocktail had the woman smiling and ready to head home soon after surgery. It's that type of pain management expertise you should expect from your providers.

  • Look beyond the bedside. Mr. Horowitz works at a busy ophthalmic surgery center and is an active member of the facility's leadership team. He helps develop policies and procedures, provides advice on equipment purchasing, ensures care is efficient and helps lower case costs.

Providers who are involved in the day-to-day operations of your facility are more willing to contribute to its success, points out Dr. Durick. "If you allow anesthesia to have a little buy-in, they have skin in the game and will be more responsive when you approach them with requests or process improvement ideas," he says.

Ask providers about their expectations and what they need to be successful. You, in turn, can touch on the role you need them to play in safe, effective and efficient patient care. "Those discussions establish lines of communication and trust," says Dr. Sinha.

  • Promote patient satisfaction. Your anesthesia providers should ensure patients have the best possible experience through effective pain management and PONV prevention. Good providers also establish a hushed calm in the OR at the time of induction, says Dr. Sinha.

"There can be an auditory overload with needless conversations taking place and instruments being prepared," he says. "The patient is lying naked on a cold bed just as her stress level is peaking. She needs to know that the entire team is focused on the procedure that's about to begin. The simple phrase We're all here for you makes a big difference." OSM

Speaker Profile

  • Dr. Sinha is professor and vice chairman of the department of anesthesiology at Temple University's Lewis Katz School of Medicine in Philadelphia, Pa.
  • Dr. Durick has served as the medical director of a busy surgery center in the San Francisco Bay area for 10 years.
  • Mr. Horowitz is an active member of the American Association of Nurse Anesthetists, and a champion of the value and skill that CRNAs bring to the OR.
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