C19: Patients at Home Hours After Total Joint Surgery

Size: px
Start display at page:

Download "C19: Patients at Home Hours After Total Joint Surgery"

Transcription

1 C19: Patients at Home Hours After Total Joint Surgery Kaiser Permanente Santa Clara Chris Boyd, Area Manager, Senior Vice President Ashima Garg, MD, PhD, Orthopedic Surgeon Session Objectives Implement workflows that will work at your hospital for same-day discharges after total joint replacement Develop strategies to help change behavior and culture around sameday discharges Identify opportunities for other surgeries that can be appropriate for same-day discharge These presenters have nothing to disclose. 1

2 Kaiser Permanente s History and Mission To provide high quality affordable healthcare and improve the health of our members and the communities we serve. 3 December 4, 2017 Kaiser Permanente All Rights Reserved. Kaiser Permanente s History and Mission To provide high quality affordable healthcare and improve the health of our members and the communities we serve. 4 December 4, 2017 Kaiser Permanente All Rights Reserved. 2

3 Kaiser Permanente s Integrated Model Permanente Medical Groups Kaiser Foundation Hospitals 5 December 4, 2017 Health Plan Members Kaiser Foundation Health plan Kaiser Permanente All Rights Reserved. Kaiser Permanente Santa Clara Members 360,000 Infrastructure Licensed Beds Operating Rooms (IP/OP) Activity Average Daily Census ED Visits per year ,000 Deliveries per year 4,500 Surgeries per year 20,500 Prescriptions filled per year 2.1M 6 December 4, 2017 Kaiser Permanente All Rights Reserved. 3

4 Expanding Continuum of Care TELEMEDICINE MICRO CLINIC HOME AS THE HUB MOBILE SERVICES EMPLOYER CLINIC PRIMARY CARE / ANCILLARIES WEB SPECIALTY HUB W/ PRIMARY CARE MOBILE MEDICAL CENTER National Recognition 8 December 4, 2017 Kaiser Permanente All Rights Reserved. 4

5 IHI Triple Aim Population Health Experience of Care Per Capita Cost 9 December 4, 2017 Kaiser Permanente All Rights Reserved. The Problem Surgery Hospital Recovery Care Experience: relative discomfort of hospital vs. home, wasted time Time in Care: > 5 days Adverse Events: more likely Home Recovery 10 December 4, 2017 Kaiser Permanente All Rights Reserved. 5

6 The Solution Surgery PACU Recovery Care Experience: recover in comfort of home, eliminate wasted time Time in Care: < 1 day Home Recovery 11 December 4, 2017 Kaiser Permanente All Rights Reserved. Solution Implementation Roadmap Team Engagement and Alignment Standardization of Workflows Communication 12 December 4, 2017 Kaiser Permanente All Rights Reserved. 6

7 Team Engagement and Alignment Patient & Family Goals & Expectations Team 13 December 4, 2017 Kaiser Permanente All Rights Reserved. Standardization of Workflows Pre-op TJA Class Hospital Team Initial Surgeon / Patient Visit Preoperative Clinic Home Health 14 December 4, 2017 Kaiser Permanente All Rights Reserved. 7

8 Communication Outpatient Clinics Home Health Health Plan Members Hospital 15 December 4, 2017 Kaiser Permanente All Rights Reserved. The Solution: Key Tenats Pre-Op Intra-Op Post-Op 16 December 4, 2017 Kaiser Permanente All Rights Reserved. 8

9 Pre-Op Key Tenets Pre-Op Intra-Op Post-Op Patient Optimization Smoking cessation, DMI/Hb1AC, BMI, Anemia Set expectation for same day discharge Shorter spinal anesthesia No Foley catheter Tranexamic acid (TXA) Peri-capsular injection IV Tylenol Decrease IVF No PCA Adductor block for TKR No CPM/braces IV Acetaminophen Out of bed to chair before PT HH PT day after discharge 17 December 4, 2017 Kaiser Permanente All Rights Reserved. Intra-Op Key Tenets Pre-Op Intra-Op Post-Op Patient Optimization Smoking cessation, DMI/Hb1AC, BMI, Anemia Set expectation for same day discharge Shorter spinal anesthesia No Foley catheter Tranexamic acid (TXA) Peri-capsular injection IV Tylenol Decrease IVF No PCA Adductor block for TKR No CPM/braces IV Acetaminophen Out of bed to chair before PT HH PT day after discharge 18 December 4, 2017 Kaiser Permanente All Rights Reserved. 9

10 Post-Op Key Tenets Pre-Op Intra-Op Post-Op Patient Optimization Smoking cessation, DMI/Hb1AC, BMI, Anemia Set expectation for same day discharge Shorter spinal anesthesia No Foley catheter Tranexamic acid (TXA) Peri-capsular injection IV Tylenol Decrease IVF No PCA Adductor block for TKR No CPM/braces IV Acetaminophen Out of bed to chair before PT HH PT day after discharge 19 December 4, 2017 Kaiser Permanente All Rights Reserved. Enhanced Recovery After Surgery (ERAS) 20 December 4, 2017 Kaiser Permanente All Rights Reserved. 10

11 Results: Less Harm 34% 45% Harm = SSI, PNA, DVT/PE, UTI, ARF, MI, CVA, transfusion, sepsis, or cardiac arrest 21 December 4, 2017 Kaiser Permanente All Rights Reserved. Results: Length of Stay & Case Volume 22 December 4, 2017 Kaiser Permanente All Rights Reserved. 11

12 Results: Patient Days 23 December 4, 2017 Kaiser Permanente All Rights Reserved. One Patient s Story 24 December 4, 2017 Kaiser Permanente All Rights Reserved. 12

Transforming Payment and Care Models for Total Joint Replacement. Stephen J. Zabinski, MD

Transforming Payment and Care Models for Total Joint Replacement. Stephen J. Zabinski, MD Transforming Payment and Care Models for Total Joint Replacement Stephen J. Zabinski, MD Stephen John Zabinski, M.D. Director of the Division of Orthopaedic Surgery and Total Joint Replacement Services

More information

Euclid Hospital CMS BPCI Episode

Euclid Hospital CMS BPCI Episode Euclid Hospital CMS BPCI Episode Two Paradigms in Health Care Reform Managing population 1 health, 2 PCMH Managing episodes of care, Bundled payments Health Status Baseline Episode Total Spend: Commercial

More information

Emerging Trends in Outpatient Orthopedic Strategy

Emerging Trends in Outpatient Orthopedic Strategy Service Line Strategy Advisor Emerging Trends in Outpatient Orthopedic Strategy April 2015 Cynthia Tassopoulos Analyst Service Line Strategy Advisor TassopoC@advisory.com Road Map 2 1 2 Impetus for Outpatient

More information

Perioperative Essentials for Early Discharge and Outpatient Total Joint Arthroplasty

Perioperative Essentials for Early Discharge and Outpatient Total Joint Arthroplasty Perioperative Essentials for Early Discharge and Outpatient Total Joint Arthroplasty R. Michael Meneghini MD Associate Professor of Orthopaedic Surgery Indiana University School of Medicine Indianapolis,

More information

Enhanced Recovery After Surgery in OB/GYN

Enhanced Recovery After Surgery in OB/GYN Enhanced Recovery After Surgery in OB/GYN Audra Williams, MD Ashley Wright, MD University of Alabama at Birmingham Department of OB/GYN Women s Reproductive Healthcare Division Outline Brief background

More information

What is Orthopedic Certification?

What is Orthopedic Certification? ORTHOPEDIC CERTIFICATION Pathways to excellence in patient care 1 2 What is Orthopedic Certification? Joint Commission orthopedic certifications provide structure for programs to improve their patient

More information

Your Anesthesiologist, Anesthesia and Pain Control

Your Anesthesiologist, Anesthesia and Pain Control You can reduce your pain level after surgery by planning ahead. For example, if you know that you are going to be getting up to do your exercises with the therapist, ask for pain control medication in

More information

IHI Expedition. Expedition: Preparing Care Teams for Bundled Payments Session 5: Care Team Redesign

IHI Expedition. Expedition: Preparing Care Teams for Bundled Payments Session 5: Care Team Redesign May 19, 2015 Begins at 1:00 PM IHI Expedition Expedition: Preparing Care Teams for Bundled Payments Session 5: Care Team Redesign Trisha Frick, MS, RN Nick Bassett, MBA Lucy Savitz, PhD, MBA Molly Bogan,

More information

Enhanced Recovery in NSQIP (ERIN): an update on the collaborative. Julie Thacker, LianeFeldman, and Julia Berian ACS NSQIP National Conference 2015

Enhanced Recovery in NSQIP (ERIN): an update on the collaborative. Julie Thacker, LianeFeldman, and Julia Berian ACS NSQIP National Conference 2015 Enhanced Recovery in NSQIP (ERIN): an update on the collaborative Julie Thacker, LianeFeldman, and Julia Berian ACS NSQIP National Conference 2015 No disclosures ERIN, ERAS, and ERP ERIN-Enhanced Recovery

More information

Improving Hospital Performance Through Clinical Integration

Improving Hospital Performance Through Clinical Integration white paper Improving Hospital Performance Through Clinical Integration Rohit Uppal, MD President of Acute Hospital Medicine, TeamHealth In the typical hospital, most clinical service lines operate as

More information

Your Anesthesiologist, Anesthesia and Pain Control

Your Anesthesiologist, Anesthesia and Pain Control You should avoid having pain after surgery by planning ahead. For example, if you know that you are going to be getting up to do your exercises with the therapist, ask for pain control medication in advance.

More information

ASC TOTAL JOINT REPLACEMET

ASC TOTAL JOINT REPLACEMET ASC TOTAL JOINT REPLACEMET Mark A. Hartzband, MD Hartzband Center for Hip & Knee Replacement Holy Name Medical Center Hackensack University Medical Center DISCLOSURES Zimmer - Design, Consulting BACKGROUND

More information

ORTHOPEDIC CERTIFICATION. Pathways to excellence in patient care

ORTHOPEDIC CERTIFICATION. Pathways to excellence in patient care ORTHOPEDIC CERTIFICATION Pathways to excellence in patient care 1 JOINT COMMISSION CERTIFICATION PATHWAYS TO EXCELLENCE IN PATIENT CARE Accreditation is Just the Beginning For health care accreditation,

More information

Webinar: Practical Approaches to Improving Patient Pre-Op Preparation

Webinar: Practical Approaches to Improving Patient Pre-Op Preparation Webinar: Practical Approaches to Improving Patient Pre-Op Preparation Your Presenters Michael Hicks, MD, MBA, FACHE Chief Executive Officer EmCare Anesthesia Services Lisa Kerich, PA-C Vice President Clinical

More information

Enhanced recovery after surgery: the role of the PACU & Pre-op

Enhanced recovery after surgery: the role of the PACU & Pre-op Enhanced recovery after surgery: the role of the PACU & Pre-op Magnus K. Teig BSc (Hons.) MBChB MRCP FRCA EDIC FFICM Assistant Professor Anesthesia & Neurosurgery Director UH PACU University of Michigan

More information

Physician Executive Council. Using the Perioperative Surgical Home to Improve Joint Replacement

Physician Executive Council. Using the Perioperative Surgical Home to Improve Joint Replacement Physician Executive Council Using the Perioperative Surgical Home to Improve Joint Replacement 9 Today s Presenters Julie Riley Physician Executive Council Senior Consultant 202-266-5628 RileyJu@advisory.com

More information

BUNDLE PAYMENT CARE INITIATIVE: Improved Care with Less Expense Joseph L. Verzal, MPAS, PA-C DISCLOSURES

BUNDLE PAYMENT CARE INITIATIVE: Improved Care with Less Expense Joseph L. Verzal, MPAS, PA-C DISCLOSURES BUNDLE PAYMENT CARE INITIATIVE: Improved Care with Less Expense Joseph L. Verzal, MPAS, PA-C DISCLOSURES I have no financial disclosures pertinent to this presentation. 1 GOALS Define the Bundle Payment

More information

TORRANCE MEMORIAL MEDICAL STAFF

TORRANCE MEMORIAL MEDICAL STAFF BYLAWS COMMITTEE: APPROVED WITH NO CHANGES 10/3/2017 Dates Approved: Medical Executive Committee 09/14/2010; 12/9/2014 PATIENT ATTRIBUTION PLAN: This Attribution Plan assures that all staff are able to

More information

Fast Track Hip and Knee Replacement Marginal Gains

Fast Track Hip and Knee Replacement Marginal Gains Fast Track Hip and Knee Replacement Marginal Gains Paul Partington Arthroplasty Lead Northumbria Trust Fast Track Hip and Knee Replacement Marginal Gains Paul Partington Arthroplasty Lead Northumbria Trust

More information

Hospital Based Same Day

Hospital Based Same Day Title bullets Hospital Based Same Day Presentation Joint Program August 15, 2014 Donna Howell, AVP Surgical Services Gregory Bernardo, MD Perioperative Medicine Kim Allen, Clinical Director Title AtlantiCare

More information

TOTAL HIP REPLACEMENT FLOW SHEET

TOTAL HIP REPLACEMENT FLOW SHEET TOTAL HIP REPLACEMENT FLOW SHEET Before Surgery: Nothing to eat or drink after midnight the night before surgery. Make sure you have a bowel movement the day before surgery. Be sure to attend your pre-op

More information

Partnerships: Developing an Elective Joint Replacement Program

Partnerships: Developing an Elective Joint Replacement Program Partnerships: Developing an Elective Joint Replacement Program Amy R. Ehrlich, MD Angela Schonberg, MPT Wojciech Rymarowicz, MPT Overview Session Overview: Montefiore network Program Development Data and

More information

Working together to improve health care quality, outcomes, and affordability in Washington State. Coronary Artery Bypass Graft Surgical Bundle

Working together to improve health care quality, outcomes, and affordability in Washington State. Coronary Artery Bypass Graft Surgical Bundle Working together to improve health care quality, outcomes, and affordability in Washington State. Coronary Artery Bypass Graft Surgical Bundle TBD 2015 The intent of the Coronary Artery Bypass Graft Surgical

More information

4/10/2013. Learning Objective. Quality-Based Payment Models

4/10/2013. Learning Objective. Quality-Based Payment Models Creating Best in Class Perioperative Services under Accountable Care and Value- Based Purchasing Becker s Healthcare Jeffry Peters Learning Objective How ACA/VBP changes how we measure surgical services

More information

AmSECT Quality and Outcomes Conference

AmSECT Quality and Outcomes Conference AmSECT Quality and Outcomes Conference Patient Blood Management: A Wise Investment for the Patient and the Health System Miriam A. Markowitz, CEO October 2, 2014, 1:45pm 2:10pm AABB Introduction 2 Emerging

More information

1. Introduction. 1 CMS section

1. Introduction. 1 CMS section 1. Introduction Anesthesiology is the practice of medicine including, but not limited to, preoperative patient evaluation, anesthetic planning, intraoperative and postoperative care and the management

More information

OUTPATIENT TOTAL JOINT

OUTPATIENT TOTAL JOINT OUTPATIENT TOTAL JOINT REPLACEMENTS How to Prepare, Transition and Deliver High Quality of Care Becker s ASC 22 nd Annual Meeting October 22-24, 2015 Chicago, IL Marcia A. Friesen, RN, BS, FAIHQ, FACHE

More information

9/29/2017. Enhanced Recovery After Surgery at the University of Virginia Medical Center. Disclosures. Objectives. None

9/29/2017. Enhanced Recovery After Surgery at the University of Virginia Medical Center. Disclosures. Objectives. None Enhanced Recovery After Surgery at the University of Virginia Medical Center Bethany Sarosiek, RN, MSN, MPH, CNL University of Virginia Health System Charlottesville, VA ErasRN@virginia.edu Disclosures

More information

Impact of Regional Anesthesia on Quality, Cost and Patient Satisfaction: Minor Changes, Immediate Impact. April 26, :15 p.m.

Impact of Regional Anesthesia on Quality, Cost and Patient Satisfaction: Minor Changes, Immediate Impact. April 26, :15 p.m. Impact of Regional Anesthesia on Quality, Cost and Patient Satisfaction: Minor Changes, Immediate Impact April 26, 2011 2:15 p.m. EST Hugh Morgan Director, Quality Assurance John LaFratta Corporate Training

More information

San Jose Kaiser Permanente OPHTHALMOLOGY PREOPERATIVE INSTRUCTIONS

San Jose Kaiser Permanente OPHTHALMOLOGY PREOPERATIVE INSTRUCTIONS San Jose Kaiser Permanente OPHTHALMOLOGY PREOPERATIVE INSTRUCTIONS Preparing for Surgery Please pre-admit up to 30-days before your date of surgery, and best if no later than 7 days before surgery. The

More information

JOINT REPLACEMENT & OUTPATIENT BUNDLED PAYMENTS. Chris Bishop, CEO Regent Surgical Health

JOINT REPLACEMENT & OUTPATIENT BUNDLED PAYMENTS. Chris Bishop, CEO Regent Surgical Health JOINT REPLACEMENT & OUTPATIENT BUNDLED PAYMENTS Chris Bishop, CEO Regent Surgical Health HISTORY OF JOINTS IN THE OUTPATIENT SETTING Initial Headwinds to Change Payors Surgeons Clinical Staff Strong leadership

More information

Patient Selection, Optimization and Disposition: Tools for Success in Orthopedic Bundles

Patient Selection, Optimization and Disposition: Tools for Success in Orthopedic Bundles Patient Selection, Optimization and Disposition: Tools for Success in Orthopedic Bundles Luann Tammany Tribus, PT, MBA SVP, Clinical Strategy & Innovation Remedy Partners John Kilgore, MD Orthopedic Surgeon

More information

Rapid-Learning Healthcare Systems

Rapid-Learning Healthcare Systems Rapid-Learning Healthcare Systems in silico Research and Best Practice Adoption in Promoting Rapid Learning Sharon Levine MD July 11, 2012 NIH Training Institute for Dissemination and Implementation Rapid-Learning

More information

The MITRE Corporation Plan

The MITRE Corporation Plan Benefit Type Plan Year Type Calendar Year Annual Medical Out of (for certain services) Employee Employee + 1 Family Annual Prescription Drug Out of Employee Employee + 1 Family Copayments: One copay per

More information

HOW TO GET STARTED

HOW TO GET STARTED 0.01 BUNDLING AND VALUE BASED CARE: Tony DiGioia, MD and Gigi Crowley HOW TO GET STARTED TONY@PFCUSA.ORG DEC 12 2017 40 Minutes 0.02 The existing deficiencies in health care cannot be corrected simply

More information

Ensuring Your Surgical Service Line is Successful in an ACO Value-Based Purchasing and Bundled Payment Environment

Ensuring Your Surgical Service Line is Successful in an ACO Value-Based Purchasing and Bundled Payment Environment Ensuring Your Surgical Service Line is Successful in an ACO Value-Based Purchasing and Bundled Payment Environment Jeffry Peters, President Surgical Directions, LLC Joseph Bosco, MD Associate Professor;

More information

EHR Enablement for Data Capture

EHR Enablement for Data Capture EHR Enablement for Data Capture Baylor Scott & White (15 min) Bonnie Hodges, RN University of Chicago Medicine(15 min) Susan M. Sullivan, RHIA, CPHQ Kaiser Permanente (15 min) Molly P. Clopp, RN Tammy

More information

? Prehab, immunonutrition. Safe surgical principles. Optimizing Preoperative Evaluation

? Prehab, immunonutrition. Safe surgical principles. Optimizing Preoperative Evaluation Optimizing Preoperative Evaluation Timothy Geiger, MD, MMHC Associate Professor of Surgery Executive Medical Director, Surgery Patient Care Center Chief, Division of General Surgery Director, Colon and

More information

OUTPATIENT JOINT REPLACEMENT & BUNDLED PAYMENTS. Chris Bishop, CEO Regent Surgical Health

OUTPATIENT JOINT REPLACEMENT & BUNDLED PAYMENTS. Chris Bishop, CEO Regent Surgical Health OUTPATIENT JOINT REPLACEMENT & BUNDLED PAYMENTS Chris Bishop, CEO Regent Surgical Health HISTORY OF JOINTS IN THE OUTPATIENT SETTING Initial Headwinds to Change Payors Surgeons Clinical Staff Strong leadership

More information

Transforming Care for Older Adults AGE DIFFERENT. Jann Dorman, Alen Vartan, Faye Sahai, and Estee Neuwirth, Phd

Transforming Care for Older Adults AGE DIFFERENT. Jann Dorman, Alen Vartan, Faye Sahai, and Estee Neuwirth, Phd Transforming Care for Older Adults AGE DIFFERENT Jann Dorman, Alen Vartan, Faye Sahai, and Estee Neuwirth, Phd Minicourse 16 Annual IHI National Forum on Quality Improvement in Health Care Dec. 8, 2014

More information

Total Hip Replacement

Total Hip Replacement Total Hip Replacement Pre-operative Joint Class Updated: November 2017 Where to Begin Thank you for attending the UNC REX Joint Replacement Class today This presentation is designed to prepare you for

More information

Hip Today Home Tomorrow:

Hip Today Home Tomorrow: Hip Today Home Tomorrow: A Collaborative Effort between an Orthopedic Practice and a Hospital to Create an Innovative Outpatient Total Hip Replacement Program Kimberley Murray RN MS CNS-CNOR Kelly Keenan

More information

PSI 12 - Perioperative Pulmonary Embolism or Deep Vein Thrombosis Rate Opportunity

PSI 12 - Perioperative Pulmonary Embolism or Deep Vein Thrombosis Rate Opportunity MAY 2018 A MESSAGE FROM THE SAINT LUKE S CARE CMO Table of Contents PSI 12 - Perioperative Pulmonary Embolism or Deep Vein Thrombosis Rate Opportunity 1,2 NEW Order Sets & Documents 3 Saint Luke s Care

More information

SCIP. Surgical Care Improvement Project. Making Surgeries Safer. By: Roshini Mathew, RN

SCIP. Surgical Care Improvement Project. Making Surgeries Safer. By: Roshini Mathew, RN SCIP Surgical Care Improvement Project Making Surgeries Safer By: Roshini Mathew, RN Importance Hospitals could prevent 13,000 patient deaths and 271,000 surgical complications each year 4 measures are

More information

Surgical Directions

Surgical Directions Surgical Directions 2015 1 Sample Clients (540+) and Growing! Surgical Directions has been the trusted partner in helping over 540 hospitals transform perioperative and anesthesia services. Surgical Directions

More information

PREVENTION OF POSTOPERATIVE PULMONARY COMPLICATIONS: Reducing Postoperative Mechanical Ventilation

PREVENTION OF POSTOPERATIVE PULMONARY COMPLICATIONS: Reducing Postoperative Mechanical Ventilation PREVENTION OF POSTOPERATIVE PULMONARY COMPLICATIONS: Reducing Postoperative Mechanical Ventilation Rowena Chona O. Sano, MSN, RN, CNL, CPHQ Memorial Hermann Greater Heights Hospital Houston, TX Nothing

More information

THE BEST OF TIMES: PHARMACY IN AN ERA OF

THE BEST OF TIMES: PHARMACY IN AN ERA OF OBJECTIVES THE BEST OF TIMES: PHARMACY IN AN ERA OF ACCOUNTABLE CARE Toni Fera, BS, PharmD October 17, 2014 1. Describe the role of pharmacists in accountable care organizations (ACO). 2. List four key

More information

Outpatient Joint Replacement in the ASC; Service Line Approach

Outpatient Joint Replacement in the ASC; Service Line Approach Outpatient Joint Replacement in the ASC; Service Line Approach Richard Conn, MD, Associate Medical Director, SPS Marita Parks, RN, BS, MHA, Project Manager, SPS TODAY S AGENDA Outpatient Joint Replacement

More information

Managing Populations to Achieve Triple Aim Outcomes

Managing Populations to Achieve Triple Aim Outcomes Managing Populations to Achieve Triple Aim Outcomes Pete Knox, Executive Vice-President and Chief Learning & Innovation Officer March 2014 Agenda 2 1. Overview of Bellin 2. Strategically Aligning the Work

More information

Aldijana Avdić, BSN, RN, PBMS, CPHQ Assistant Director, Patient Safety and Privacy 1

Aldijana Avdić, BSN, RN, PBMS, CPHQ Assistant Director, Patient Safety and Privacy 1 Aldijana Avdić, BSN, RN, PBMS, CPHQ Assistant Director, Patient Safety and Privacy 1 Program Definition The timely application of evidence-based medical and surgical concepts designed to maintain hemoglobin

More information

SARASOTA MEMORIAL HOSPITAL PERIOPERATIVE DEPARTMENT POLICY

SARASOTA MEMORIAL HOSPITAL PERIOPERATIVE DEPARTMENT POLICY PS1070 SARASOTA MEMORIAL HOSPITAL PERIOPERATIVE DEPARTMENT POLICY TITLE: ADMISSION/DISCHARGE CRITERIA: POST ANESTHESIA CARE UNITS (PACU) EFFECTIVE DATE: REVIEWED/REVISED DATE: POLICY TYPE: Job Title of

More information

F 5 STANDING COMMITTEES. Finance and Asset Management Committee. UW Medicine Clinical Transformation Project INFORMATION

F 5 STANDING COMMITTEES. Finance and Asset Management Committee. UW Medicine Clinical Transformation Project INFORMATION STANDING COMMITTEES F 5 Finance and Asset Management Committee UW Medicine Clinical Transformation Project INFORMATION This item is being presented for information only. Attachment Clinical Transformation

More information

Total Knee Replacement

Total Knee Replacement Total Knee Replacement Pre-operative Joint Class Updated: November 2017 Where to Begin Thank you for attending the UNC REX Joint Replacement Class today This presentation is designed to prepare you for

More information

Bundled Payments to Align Providers and Increase Value to Patients

Bundled Payments to Align Providers and Increase Value to Patients Bundled Payments to Align Providers and Increase Value to Patients Stephanie Calcasola, MSN, RN-BC Director of Quality and Medical Management Baystate Health Baystate Medical Center Baystate Health Is

More information

From Private Practice to an Integrated Health System: Playing to Your Strengths

From Private Practice to an Integrated Health System: Playing to Your Strengths From Private Practice to an Integrated Health System: Playing to Your Strengths Mark Schickendantz, MD Director, Cleveland Clinic Center for Sports Health Associate Professor of Surgery, Cleveland Clinic

More information

Understanding The Rapid Recovery Program

Understanding The Rapid Recovery Program Understanding The Rapid Recovery Program Rapid Recovery Understanding The Rapid Recovery Program Efficiency and Quality of Care in Joint Replacement Objectives and Principles Health care systems increasingly

More information

Hospital Perioperative Assessment Statement of Work. Prepared by Amblitel Date

Hospital Perioperative Assessment Statement of Work. Prepared by Amblitel Date Hospital Perioperative Assessment Statement of Work Prepared by Amblitel Date 1 Table of Contents Background... 3 Objective... 3 Scope of Work... 3 Phase 1 - Establish Overall Project Structure and Process...

More information

Kaiser Permanente: Integration, Innovation, and Capitation in Health Care

Kaiser Permanente: Integration, Innovation, and Capitation in Health Care Kaiser Permanente: Integration, Innovation, and Capitation in Health Care November 9, 2017 Molly Porter, MS, Director, Kaiser Permanente International Molly.porter@kp.org kp.org/international Copyright

More information

Management of the Surgical Patient Preoperative, Intraoperative and Postoperative

Management of the Surgical Patient Preoperative, Intraoperative and Postoperative NURS 143 Nursing in Health Alterations II Management of the Surgical Patient Preoperative, Intraoperative and Postoperative Upon completion of the O.R., PACU, or SDS experience, the student will be able

More information

Total Joint Partnership Program Identifies Areas to Improve Care and Decrease Costs Joseph Tomaro, PhD

Total Joint Partnership Program Identifies Areas to Improve Care and Decrease Costs Joseph Tomaro, PhD WHITE PAPER Accelero Health Partners, 2013 Total Joint Partnership Program Identifies Areas to Improve Care and Decrease Costs Joseph Tomaro, PhD ABSTRACT The volume of total hip and knee replacements

More information

2016 Community Health Needs Assessment Implementation Plan

2016 Community Health Needs Assessment Implementation Plan 2016 Community Health Needs Assessment Following the 2016 Community Health Needs Assessment, Saint Mary s Hospital developed an Implementation Strategy to illustrate the hospital s specific programs and

More information

Preparing for Thoracic Surgery and Recovery

Preparing for Thoracic Surgery and Recovery Division of Thoracic Surgery Preparing for Thoracic Surgery and Recovery A Guide for Patients and Families Brigham And Women s/faulkner Hospitals Important Phone Numbers Important Phone Numbers BWH NUMBERS

More information

Considerations for an Outpatient Total Joint Arthroplasty Program

Considerations for an Outpatient Total Joint Arthroplasty Program Considerations for an Outpatient Total Joint Arthroplasty Program Presenters Frank Gilbert Executive Director Rustin Becker President & COO Jen Edmonds Research Analyst 1 Proliance Orthopaedics and Sports

More information

Getting Operational Leaders on Board to Deliver the Triple Aim

Getting Operational Leaders on Board to Deliver the Triple Aim Session #37 Getting Operational Leaders on Board to Deliver the Triple Aim Lauren Anthony, MD System Medical Director Allina Health Clinical Laboratories Learning Objectives Recognize the three most important

More information

Clinical Standardization

Clinical Standardization Clinical Standardization Joe Sharma, MD, FACS, FACE Associate Professor of Surgery Director, of Endocrine Surgery Chief Quality Officer Emory University School of Medicine Disclosures Engineer US Navy

More information

Causes and Consequences of Regional Variations in Health Care Resources in Ontario

Causes and Consequences of Regional Variations in Health Care Resources in Ontario Causes and Consequences of Regional Variations in Health Care Resources in Thérèse A. Stukel, Ph.D. DA Alter, R Saskin, DM Rothwell Institute for Clinical Evaluative Sciences, Health Services Restructuring

More information

Hendrick Medical Center significantly lowers turnover times with the help of OR Benchmarks Collaborative

Hendrick Medical Center significantly lowers turnover times with the help of OR Benchmarks Collaborative Care Providers Hospitals and Healthcare Organizations Healthcare Analytics Hendrick Medical Center significantly lowers turnover times with the help of OR Benchmarks Collaborative As a not-for-profit institution

More information

2/13/2018. Enhanced Recovery after Surgery (ERAS) in Gynecology

2/13/2018. Enhanced Recovery after Surgery (ERAS) in Gynecology Enhanced Recovery after Surgery (ERAS) in Gynecology J. Michael Straughn, Jr., MD Professor, Gynecologic Oncology University of Alabama at Birmingham Outline What is Enhanced Recovery after Surgery (ERAS)?

More information

How and Why We Implemented a Preop Anemia Service as Part of our Patient Blood Management Program

How and Why We Implemented a Preop Anemia Service as Part of our Patient Blood Management Program How and Why We Implemented a Preop Anemia Service as Part of our Patient Blood Management Program Katie Dettenwanger, MLS (ASCP) CM Transfusion Safety Officer University of Missouri Health Care Emily Coberly,

More information

Description Goals Objectives

Description Goals Objectives Stanford University General Surgery Residency Program Kaiser Permanente Medical Center, Santa Clara Goals and Objectives - PGY 2 (Night Service) Rotation Director:Maureen Tedesco, MD Description The surgery

More information

Creating Clinical Pathways

Creating Clinical Pathways Creating Clinical Pathways Michael Stifelman, MD Professor and Chairman of Urology Director, Urologic Oncology & Courtney DiBona, MSN, RN-BC Nurse Manager: Urology Why create clinical pathways? Institute

More information

Redesigning Health Care in an Accountable Care World

Redesigning Health Care in an Accountable Care World Redesigning Health Care in an Accountable Care World Jack Cox, MD: Chief Quality Officer Hoag Memorial Hospital Presbyterian, Newport Beach CA Diane Laird, MPH: Chief Executive Officer Greater Newport

More information

JULY 2012 RE-IMAGINING CARE DELIVERY: PUSHING THE BOUNDARIES OF THE HOSPITALIST MODEL IN THE INPATIENT SETTING

JULY 2012 RE-IMAGINING CARE DELIVERY: PUSHING THE BOUNDARIES OF THE HOSPITALIST MODEL IN THE INPATIENT SETTING JULY 2012 RE-IMAGINING CARE DELIVERY: PUSHING THE BOUNDARIES OF THE HOSPITALIST MODEL IN THE INPATIENT SETTING About The Chartis Group The Chartis Group is an advisory services firm that provides management

More information

Ovarian Tumor Reduction Surgery

Ovarian Tumor Reduction Surgery PATIENT EDUCATION patienteducation.osumc.edu Information About Your Your doctor found a mass in your pelvic area. Surgery is used to remove the pelvic mass and to find out if the tissue is benign (not

More information

Health Care Institutions

Health Care Institutions Chapter 10 Health Care Institutions Slide Show developed by: Richard C. Krejci, Ph.D. Professor of Public Health Columbia College 4.9.15 Key Questions What institutions make up the Healthcare System? Observation

More information

U.R. & Surgery Scheduling Addressing Inpatient- Only Best Practices & U.R. w/surgery Daily Activity

U.R. & Surgery Scheduling Addressing Inpatient- Only Best Practices & U.R. w/surgery Daily Activity U.R. & Surgery Scheduling Addressing Inpatient- Only Best Practices & U.R. w/surgery Daily Activity July 23, 2015 3 rd National Physician Advisor & U.R. Boot Camp Pamela Foster Mayo Clinic Health System,

More information

You will be having surgery to remove a the distal or tail part of your pancreas.

You will be having surgery to remove a the distal or tail part of your pancreas. Distal pancreatectomy You will be having surgery to remove a the distal or tail part of your pancreas. This handout will help you learn about the surgery, how to prepare for surgery and your care after

More information

Alaina Tellson, PhD, RN-BC, NE-BC

Alaina Tellson, PhD, RN-BC, NE-BC Alaina Tellson, PhD, RN-BC, NE-BC Localized injury to the skin and/or underlying tissue, usually over a bony prominence, as a result of pressure or pressure in combination with shear and/or friction tional

More information

Office-Based Surgery Frequently Asked Questions

Office-Based Surgery Frequently Asked Questions Clinical Office-Based Surgery Frequently Asked Questions 1. What are the best types of surgical procedures to be performed in the office setting? Patients undergoing the following types of procedures may

More information

Expedition: Improving Safety and Reliability for Surgical Procedures

Expedition: Improving Safety and Reliability for Surgical Procedures These presenters have nothing to disclose Expedition: Improving Safety and Reliability for Surgical Procedures Session 5 William Berry, MD, MPA, MPH, FACS Kathy Duncan, RN January 23, 2014 Expedition Coordinator

More information

Your guide to surgery at Edward Hospital

Your guide to surgery at Edward Hospital Your guide to surgery at Edward Hospital Please use this guide to help you know how to prepare for your surgery and what to expect on the day of surgery. Your Guide to Surgery Important information Your

More information

Effect of Colon Bundle Implementation in a Community Hospital. Michael Barringer, MD, FACS CHS Cleveland

Effect of Colon Bundle Implementation in a Community Hospital. Michael Barringer, MD, FACS CHS Cleveland Effect of Colon Bundle Implementation in a Community Hospital Michael Barringer, MD, FACS CHS Cleveland Doug Hobson, MD, Surgeon Champion Mike Barringer, MD, Surgeon Champion No Disclosures Except for

More information

The Nexus of Quality and Finance

The Nexus of Quality and Finance The Nexus of Quality and Finance Kristen Geissler Pat Ercolano March 4, 2014 Transition from Volume to Value: IHI Triple Aim IHI Triple Aim Improve patient experience of care (quality & satisfaction) Improve

More information

The ASA defines anesthesiology as the practice of medicine dealing with but not limited to:

The ASA defines anesthesiology as the practice of medicine dealing with but not limited to: 1570 Midway Pl. Menasha, WI 54952 920-720-1300 Procedure 1205- Anesthesia Lines of Business: All Purpose: This guideline describes Network Health s reimbursement of anesthesia services. Procedure: Anesthesia

More information

Charge Integrity of Surgical Services

Charge Integrity of Surgical Services Charge Integrity of Surgical Services Crowe Healthcare Webinar Series Audit Tax Advisory Risk Performance 2015 Crowe Horwath LLP Agenda 1. Objectives 2. Surgical Services Charge Structures 3. Accounting

More information

Enhanced Recovery Implementing Meaningful Change

Enhanced Recovery Implementing Meaningful Change Enhanced Recovery Implementing Meaningful Change Jeff Simmons MD Associate Professor UAB Department of Anesthesiology and Perioperative Medicine I have no relevant financial relationships to disclose.

More information

CLINICAL PATHWAY. Surgical Services. Recurring Ventral Hernia

CLINICAL PATHWAY. Surgical Services. Recurring Ventral Hernia CLINICAL PATHWAY Surgical Services Recurring Ventral Hernia Recurring Ventral Hernia Table of Contents (tap to jump to page) INTRODUCTION 1 Scope of this Pathway 1 Pathway Contacts 1 CLINICAL PATHWAY 3

More information

Surgical Technology Patient Care Skills Preop Routine Objectives:

Surgical Technology Patient Care Skills Preop Routine Objectives: Surgical Technology 8-Jul-09 Patient Care Skills Preop Routine Objectives: 1) Discuss why preop preparation of the patient is important a) Preparing the patient decreases impact and potential risks of

More information

General OR-Stanford-CA-1 revised: Tuesday, February 02, 2016

General OR-Stanford-CA-1 revised: Tuesday, February 02, 2016 Stanford University Anesthesiology Residency Program Rotation specific goals and objectives for residents Core Curriculum for PGY 1 Surgery Residents on the Anesthesia Rotation Description: The General

More information

PREPARING FOR SURGERY

PREPARING FOR SURGERY PREPARING FOR SURGERY SURGICAL SERVICES DEPARTMENT 970-641-7240 WWW.GUNNISONVALLEYHEALTH.ORG/SURGERY HOSPITAL SENIOR CARE CENTER HOME MEDICAL SERVICES ASSISTED LIVING FAMILY MEDICINE CLINIC MOUNTAIN CLINIC

More information

Centralizing Multi-Hospital Mortality Reviews

Centralizing Multi-Hospital Mortality Reviews December 7, 2016 Session Codes: D4 (9:30am-10:45am) & E4 (11:15am - 12:30pm) Centralizing Multi-Hospital Mortality Reviews IHI 28 th National Forum Mark P Jarrett, MD, MBA, MS SVP, Chief Quality Officer,

More information

Preparing your Patient for Surgery at The Valley Hospital

Preparing your Patient for Surgery at The Valley Hospital Preparing your Patient for Surgery at The Valley Hospital Ensuring a smooth preoperative course to provide safe and efficient care Cristina Smith, RN, BSN, CPAN HOUSEKEEPING Bathroom location Cell Phone

More information

What s Wrong with Healthcare?

What s Wrong with Healthcare? What s Wrong with Healthcare? Dan Murrey, MD, MPP Chief Executive Officer Agenda What s wrong with healthcare in the US? What would make it better? How can you help? What s wrong with US healthcare? What

More information

Hip Replacement Modern Total Hip Replacement in an Ambulatory Surgery Center. A Brief History of Total Hip Replacement

Hip Replacement Modern Total Hip Replacement in an Ambulatory Surgery Center. A Brief History of Total Hip Replacement Modern Total Hip Replacement in an Ambulatory Surgery Center James T. Caillouette, M.D. Chairman Newport Orthopedic Institute 1 A Brief History of Total Hip Replacement Hip replacement 1990: LOS 7 Days

More information

Roadmap to accountable care: The chicken or the egg technology investment or clinical process improvement?

Roadmap to accountable care: The chicken or the egg technology investment or clinical process improvement? Roadmap to accountable care: The chicken or the egg technology investment or clinical process improvement? August 29, 2012 Meet the Presenters Michael Griffis CIO Innovative Practices Tucson, AZ Beth Hartquist,

More information

Quality improvement for caesarean section - a multifactorial approach. Ian Wrench Consultant Anaesthetist Jessop Wing Obstetric Unit

Quality improvement for caesarean section - a multifactorial approach. Ian Wrench Consultant Anaesthetist Jessop Wing Obstetric Unit Quality improvement for caesarean section - a multifactorial approach. Ian Wrench Consultant Anaesthetist Jessop Wing Obstetric Unit Structure of talk: Rationale for introduction of enhanced recovery for

More information

Survey of Nurse Employers in California 2014

Survey of Nurse Employers in California 2014 Survey of Nurse Employers in California 2014 Conducted by UCSF Philip R. Lee Institute for Health Policy Studies, California Institute for Nursing & Health Care, and the Hospital Association of Southern

More information

Eliminating Common PACU Delays

Eliminating Common PACU Delays Eliminating Common PACU Delays Jamie Jenkins, MBA A B S T R A C T This article discusses how one hospital identified patient flow delays in its PACU. By using lean methods focused on eliminating waste,

More information

Care Redesign: Budgeted Episodes for Total Knee Replacement

Care Redesign: Budgeted Episodes for Total Knee Replacement Care Redesign: Budgeted Episodes for Total Knee Replacement Wade Johannessen, PhD Director, Sg2 Allen Marsh Ortho/Neuro Service Line Director CaroMont Health October 13, 2011 Chicago London www.sg2.com

More information

As healthcare moves toward value-based care and risk-sharing payment models, many hospitals are taking a new look at ambulatory surgery centers (ASCs) as a transformational outpatient strategy with potential

More information