Outpatient Surgery Magazine, providing current information on Surgical Services, Surgical Facility Administration, Outpatient Surgery News and Trends, OR Excellence and more.
Issue link: http://outpatientsurgery.uberflip.com/i/1283756
2 6 • S U P P L E M E N T T O O U T P A 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 2 0 rehab and a private recovery suite. Patients know going in exactly what to expect, and they receive one simplified bill. The goal obviously is to reduce the cost of health care and, in our experience, you usually save about 30% versus a traditional hospi- tal stay by going through our program. The feed- back has been tremendous from patients who have qualified for and elected to do it. • Care suites. Our shoulder total joint proce- dures are done outpatient, but they're not same-day. To ensure a safe recovery, we keep total shoulder patients for less than 24 hours — but not in a PACU bay. As part of the $24,500 bundled price, patients and their companions stay the night in one of our private care suites, complete with kitchenettes, which we own and operate. Patients love it because they stay out of the hospital and enjoy a much qui- eter environment in which to recover — more like a hotel room or apartment than a hospital room. They have 24-hour access to nurses on site, and their vitals are monitored, so we're able to give them safe medical care at a moment's notice. • New tools and technologies. When you talk about total shoulders, you can't forget the tools and technologies currently available — like navigation- or pre-operative-planning templates that use CT — as well as the compelling products in the pipeline. But you don't want to invest in new technology sim- ply because it's new; there must be some tangible, data-backed benefit. Because we're so focused on our bottom line as an outpatient facility, we're high- Dr. Lervick (greglervick@tcomn.com), a fellow- ship-trained orthopedic surgeon with Twin Cities Orthopedics in Minneapolis, specializes in the treat- ment of shoulder and elbow conditions. ly strategic and informed about new additions to our toolbox, because we just can't afford them to be money-losers. When we're evaluat- ing something new that has incremental cost, we're motivated to look at it from an evidence- based point of view and ask, "Does this added cost make a difference?" The majority of the action in shoulders is on the biologic augmentation front — growth fac- tors, tissue augments, scaffolds, for example. I've been using some of those in selected situa- tions, but most require more study to determine whether or not they will become widely used. For example, there's interesting potential in augmenting a shoulder repair with a bone mar- row aspirate stem cell injection that, in addition to the patient's own biologic tissue, could be laid onto a repair to enhance healing. But that's a largely theo- retical benefit right now; we still need more data. No going back The migration of total shoulders from an inpatient procedure to outpatient surgery is gaining momen- tum. I don't see most shoulder replacements going back to inpatient ORs. There's too much good data and experience on the part of insurers, who realize the cost benefit; patients, who prefer the outpatient setting; and surgeons, who enjoy specialized infra- structure and staff. For us, everything at our centers is about orthopedics, which results in cost efficien- cies in terms of having consistent equipment as well as consistent staff from admission to pre-op to the surgical suite to post-op. My surgical techs and cir- culating nurses are very comfortable and familiar simply because of the repetition of what we do. There's so much efficiency in this model. Bottom line: The government and insurers are saving money by shifting shoulder replacements from inpatient to outpatient. It's a significant cost differential, and when you multiply it by an exponential factor, it can be a potentially huge benefit to the healthcare system overall. OSM NICE JOINT Twin Cities Orthopedics' total shoulder patients stay the night in its care suites, which combine a comfortable home-like environment with 24/7 nurse access and vital signs monitoring. Ryan Shaver