Efficiencies, specialty teams equip hospital outpatient departments for same-day spine surgery
CHICAGO — Although payments are sometimes lower for spine surgery performed at an ASC vs. a hospital outpatient department, a presenter here said the efficiencies and lower risk related to spine surgery performed outpatient in a hospital may make it the preferred treatment setting for many types of spine surgery cases.
“Risk is something that has to be taken into great consideration here,” Michael P. Steinmetz, MD, said during a symposium at the North American Spine Society Annual Meeting about ASCs as the next possible frontier in spine surgery.
He said it can be uncertain, should a complication occur during spine surgery at an ASC, who is available and able to care for the patient. However, according to Steinmetz, should the same unexpected complication occur in a patient undergoing outpatient surgery at a hospital, “I have all the care I need to provide immediate support and care.”
In addition, with the greater amount of risk that is now associated with spine surgery, such as with lumbar fusion and anterior cervical discectomy and fusion that involves multiple levels, surgeons and their teams need to be more careful than ever, Steinmetz said. Therefore, he recommended that all ASC staff be trained and up to date on lifesaving procedures and how to use any equipment needed should an emergency arise either intraoperatively or when the patient is in recovery.
Efficiency can always be improved on in any operative setting, Steinmetz said.
“It’s hard to argue that you can have an equally efficient hospital setting and an ASC setting. I think that would be a ridiculous argument, but it sort of also sets the stage that you can become more efficient in a hospital. [You] can you work on efficiencies to lower cost in your hospital [and] do more outpatient procedures there,” he said.
“Continuous improvement is something we at the Cleveland Clinic have dove headfirst into” through maximized block time, predictive scheduling and other efforts, Steinmetz said. – by Susan M. Rapp
Steinmetz MP. Hospital-based practice: My take on it. Presented at: North American Spine Society Annual Meeting; Sept. 25-28, 2019; Chicago.
Disclosure: Steinmetz reports he is an employed physician of a health care system.