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“They are really one of the only members of the staff who have inter- action with all of the functions of the surgery center and all of the people that provide these functions; there’s usually nobody in the ASC that does not interact with the anesthesiolo- gist,” Shapiro adds. “They need to be involved in all aspects of every patient’s care. This extends from the initial booking of the case—to make sure they can staff the case and have the resources for the procedure—and continues through the discharge plan- ning phase—to make sure patients understand the side effects of anesthe- sia and any new medications.”

Team Up for Top Quality Care

How to get the best from your anesthesia provider. BY ROBERT KURTZ


he top two priorities for an ASC administrator are usually ensur-

ing surgeon satisfaction and appropri- ate insurance contracts, says Thomas M. Wherry, MD, principal of Total Anesthesia Solutions in Ellicott City, Maryland. Rounding out the top three, he says, should be keeping anesthesia providers “on their best game.” “When anesthesiologists are ef-

fectively engaged by an ASC, their contributions are significant and go beyond just providing anesthesia ser- vices,” Wherry says. “When anesthe- siologists are engaged, I think you see better outcomes. That does not neces- sarily mean patients will do better, but I think patients notice when relation- ships are positive and when the anes- thesiologist is truly part of the ASC team.

22 ASC FOCUS JUNE 2013 “If you have a positive relationship

with your anesthesia providers, they’ll be more involved in helping with day- to-day operations, and I think you will find them to be more flexible in providing coverage,” he continues. “They’ll be more accepting of when you’re trying to grow and may have empty operating rooms and will work to help fill those rooms.” “It is important to recognize that

your anesthesia providers are in- volved in all elements of patient care and likely interact with most, if not all, members of your clinical staff,” advises David Shapiro, MD, CASC, an

anesthesiologist and immediate past president of ASCA. “This makes it even more important for ASCs to treat anesthesiologists like a member of the team.

Establish Expectations Early To effectively engage anesthesia pro- viders, the ASC’s expectations of the group need to be established clearly up front, Wherry says. “When you en- ter into the contract with anesthesia, that’s the time to start laying expec- tations. You need to be very clear on when you expect them to arrive for the first case; room coverage needs; their participation in the preop screen- ing and postop processing; and their availability, even when they’re not in the ASC, for urgent phone calls and to address any issues that may arise. “You will also want to discuss and address their general participation in the growth of the ASC and promot- ing the center,” Wherry adds. “All of these are top issues when it comes to anesthesia, and they should all be clearly spelled out in the contract.” Another contractual issue might be the notion of staffing with at least a single anesthesiologist assigned to the facility every day. “The reason you want one individual there every day, regardless of whether there are other anesthesia professionals that come in and out of the facility, is for consis- tency,” Shapiro says. “Consistency is important for patient care, primar- ily because if this anesthesiologist is

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