Q: How have responsibilities evolved for anesthesia providers?
Jay Horowitz — Back in the day, it didn’t much matter how long it took to turn over an OR, or provide peripheral nerve blocks for anesthetics and post-op pain management. Anesthesia providers didn’t even worry much about how long a patient was in the recovery room — possibly nauseated or vomiting — and uncomfortable. Patients were delivered without any effort on the part of the anesthesia group; all they had to do was give an anesthetic and wake the patient up. Today, giving a safe anesthetic is the bare minimum expected from the anesthesia team, and the bare minimum they should provide.
Q: What else should anesthesia providers be expected to contribute?
Jay Horowitz — The anesthesia team should be an active part in the overall effort to increase patient satisfaction, enable efficiency and increase your competitive edge. If your providers aren't doing all those things, you should be looking for ways to engage them, to take advantage of all the contributions they can make.
Q: What responsibility do facilities have for making sure their anesthesia providers are fully engaged?
Jay Horowitz — The relationship between facilities and providers is a two-way street, of course. Does your facility treat anesthesia providers as hired help, or do your see them and treat them as an integral part of the facility? Are you making sure your team is incentivized to give you their best efforts? Do you have a process for continuous quality improvement in your anesthesia department?
Q: How can you make sure anesthesia providers know they're considered part of the team, and not just "hired help"?
Jay Horowitz — Who are the people you have on your committees? Are you inviting your anesthesia providers to participate? What about facility reimbursements? Are anesthesia providers involved in your regular assessments? Are they on the front lines when it comes to formulating policies for patient and employee safety? Do they help assess and revise the facility formulary? These are all ways to help ensure that they’re part of the team.
Q: What other expectations go along with making sure providers are fully engaged?
Jay Horowitz — For starters, facilities should insist that a real human anesthesia provider is readily accessible to patients who have either clinical or billing questions. They should also expect anesthesia peer reviews to be realistic, appropriate and meaningful. Ultimately, the goal should be to align goals, integrate services, incentivize buy-in, and thereby create a smooth, efficient and positive working environment. There are ways to do that, even if it takes a "reboot" to get things going in the right direction.