Outpatient Surgery Magazine

OR Excellence Awards - September 2018 - Subscribe to Outpatient Surgery Magazine

Outpatient Surgery Magazine, providing current information on Surgical Services, Surgical Facility Administration, Outpatient Surgery News and Trends, OR Excellence and more.

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ambulation and the ability to navigate stairs. To achieve "meticulous" hemostasis, Excelsior suggests intravenous and topical tranexamic acid, careful dissection in hips and tying off small vessels and tourni- quets in knees. Excelsior's "multidimensional" pain management includes steroids, regional blocks and anti-inflammatories. A water- resistant dressing remains on for 7 days. • Rehabilitation. Returning patients to the normal activities of daily liv- ing is critical to achieving positive outcomes. Your post-op focus should be on early ambulation, strengthening, minimizing swelling and obtaining full range of motion. It begins the day of surgery and continues on-site at Excelsior. • Reimbursement. Let's not forget how to get paid. The team at Excelsior developed bundled payment agreements with its payers. It's critical to define every element in the bundle, including its duration, which is typically the episode of care from the surgical discussion through 90 days post-op. Define what services are included in the bun- dle, such as surgical and surgical-assist fees, anesthesia, facility fees, supply costs (including implants), therapy visits, recovery suite facili- ty, meals and nursing, home care, DME, and post-op follow-up and X- rays. Just as important as what's included in the bundle, specify what's excluded, including pre-op testing and medical clearance, MRIs, hospital re-admissions due to complication, post-op pharmacy costs and revision procedures. One size doesn't fit all Because every hospital, health system and surgery center is different, there is no one-size-fits-all solution to developing a successful total joint replacement program. But whatever your approach, you'll have a greater chance of success if it's built on these pillars. OSM 1 1 2 • O U T PA T I E N T S U R G E R Y M A G A Z I N E • S E P T E M B E R 2 0 1 8

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