Gary Guidry, RN, MBA, HCM
President, Perfusion Services
August 11, 2016
Today, the need for continuous improvement is a given. How can we do more with less, but not sacrifice quality? Ultimately, how can we deliver greater value? That is the core idea of value-based payment models now being tested across the country and lies at the heart of the mandatory cardiac bundles recently proposed by the Centers for Medicare and Medicaid Services (CMS). Getting the highest quality from all components of a bundled service is paramount.
One such component, cardiovascular perfusion, can have a significant impact on outcomes, recovery, and readmissions. But, how do you know that the perfusionists in your OR are capable of driving value and helping you achieve your quality goals?
SpecialtyCare has been in the perfusion outsourcing business longer than any other company; we support one in every nine open heart surgeries performed in the U.S. That makes us the nation’s largest and most experienced provider of outsourced perfusion services. This volume enables us to collect an enormous amount of clinical data—quality metrics for more than 100,000 perfusion procedures annually. Our Medical Department analyzes these data to identify benchmarks and standards that drive evidence-based solutions for our hospital partners and the industry as a whole. It’s wonderful, rewarding work.
I have found a number of recurring themes when talking with surgeons, hospital executives, and administrators who are assessing their current perfusion services. They are trying to determine whether a different staffing model would best meet their needs, but they lack strong data for decision making:
- “I like my perfusionists, but I’m not sure they’re using best practices.”
- “We’re having trouble covering an increased number of cases.”
- “We have to transfer ECMO or other intensive cases.”
- “One of my perfusionists is retiring, and we’re having trouble hiring a good replacement.”
- “We might have quality issues, but honestly, we don’t have enough data to tell.”
Based on these conversations, here are some considerations to make sure you have the best available perfusion team in your OR.
What are the perfusion team’s quality standards, and can the team provide benchmarking? If they can’t demonstrate their quality on paper, they might not be able to deliver it in the OR. Ask your provider for clinical quality guidelines and learn everything you can about their quality program. Quality is not a place for guesswork. Yes, the quality of the relationship between surgeon and perfusionist is vital, but sometimes you have to think critically. Am I really giving my patients the best available option or is this just familiar? When you have clinical quality data, it’s incredibly valuable to be able to benchmark the data against metrics collected throughout the hospital system, and against regional and national data as well. Is your provider capable of showing you the big perspective along with granular detail?
What credentials do your perfusionists hold? What about their training? In addition to meeting licensing requirements, your perfusionists should be able to document their education, how their certification and credentials are managed, how they meet annual training requirements, and how their clinical competencies are systematically evaluated and confirmed. Are your perfusionists backed by certification of The Joint Commission? What about mentorship or structured professional development programs? You need to see evidence of standards and expectations for the team that will serve your hospital and patients.
Who will oversee your perfusion program, and how will it be billed? Is communication effective? If you’re considering a transition from in-house to outsourced perfusion, how exactly will the outsource partner support your current team? Change can be painful, so you need to know how that pain will be managed. Are there appropriate standards in place to ensure you’ll maintain regulatory compliance? You also need to know that you will be billed fairly and clearly. Do you understand the true and total costs of perfusion services, or are you getting bundled pricing with extra invoices for add-on services?
Does your perfusion team have capabilities beyond essential perfusion? Your team must evolve with the needs of your hospital and the community you support. Can a perfusion team also provide blood management, autotransfusion, ECMO, HIPEC, or other services that will enhance your hospital’s service capabilities and your reputation as a destination treatment center?
The need to deliver greater value has never been more acute and the recent proposal from CMS, along with the overall shift from fee-for-service to value-based reimbursement, will apply even more pressure on cardiac service providers in their quest for quality over quantity. Just as SpecialtyCare is committed to using our data to help hospitals improve cardiac surgery and their overall clinical and financial outcomes, we offer the above suggestions to help assess and improve their perfusion teams as well.
LEARN MORE ABOUT PERFUSION
LEARN MORE ABOUT ECMO
LEARN MORE ABOUT AUTOTRANSFUSION