The Mobile Way: Part 3 – Making Sure Your Anesthesia Provider is Implementing Preventative Risk Management
Benjamin Franklin is credited with saying: “An ounce of prevention is worth a pound of cure.” Yet when you ask most anesthesia providers about their risk management programs, much of the response is actually related to their crisis management program after an adverse event has occurred. Certainly there are situations beyond our control, so having a crisis management program is vital, but investing in systems and processes to avoid as many adverse events as possible is a cornerstone of a high-quality anesthesia practice.
Here are some questions to ask your outsourced anesthesia provider:
What is your patient screening process?
It can be costly for an anesthesia practice to spend time pre-op’ing patients, but it should be an investment that pays off. Ensuring that any necessary work-ups or additional lab work are done in advance of the procedure helps to avoid last-minute cancellations. And pre-op’ing patients in advance ensures that procedures will be performed in the appropriate setting; not everyone is a good candidate for office-based surgery, so the sooner we can get them scheduled at the hospital or ASC if necessary, the better.
Do you follow any accreditation standards? Which one(s)?
Three main accrediting bodies provide varying levels of requirements for office-based surgery: AAAHC (the Accreditation Association for Ambulatory Health Care), AAAASF (the American Association for Accreditation of Ambulatory Surgery Facilities), and JCAHO (the Joint Commission for Accreditation of Healthcare Organizations). Accreditation ensures that your anesthesia provider complies with a base level of guidelines that demonstrate an organization’s commitment to patient safety and quality. Also ensure that your anesthesia provider keeps up with new and changing requirements, as the guidelines are constantly being updated to reflect best practices.
Do you have a peer review process?
Not only does a structured peer review process ensure that an organization’s clinical leadership is committed to high-quality care, it can also prevent repeated issues, facilitate communication among the clinical staff, and ensure complete and accurate documentation. A good peer review process is randomized and anonymized to minimize bias, should never be treated as a “blame game”, and has its general findings shared throughout the organization.
We asked a risk management expert from a leading medical malpractice carrier about red flags that are often indicative of poor risk management programs. She identified the following:
• Lack of communication among the staff. When staff members refuse to share information—good or bad—that is a sign that issues will repeat themselves.
• One-and-done training. Ongoing training is essential to ensure staff stay current on their skills and compliant with the latest policies.
• No corrective action plan for clinicians. When problems arise, do they ignore them and hope they go away (spoiler: they won’t!)? Or do they professionally address issues for everyone’s long-term benefit?
• Policies collecting dust. Things change, including state laws, accreditation requirements, and best practices. When was the last time policies were reviewed? (Hint: Policies should be reviewed at least annually.)
Investing in preventative risk management strategies benefits everyone. Doctors have reduced liability, the business staff see financial gains, and most importantly, patients are safer and happier. Don’t be afraid to ask your anesthesia providers about their risk management strategy!