With the growth of ambulatory surgery, there are increased efforts to meet demand. One approach has been changing requirements on physician-anesthesiologists in the OR, including two bills up for consideration in Illinois, both removing the requirements for direct anesthesiologist supervision of CRNAs or other providers when delivering anesthesia (1 and 2). While CRNAs are an integral part of anesthesia in ambulatory settings and incredibly valued members of teams across Scope partner practices, the role and presence of board certified anesthesiologists cannot be overlooked. It’s important to recognize that this site of service transition is driven, in part, by patient preferences and financial incentives for both physicians and insurance payers, and it is enabled by advances in technology and medicine, but doing so with a mindful appreciation of what’s best for patient safety is also critical. In short, anesthesiologists are essential.
Today, we’re going to quickly discuss three ways physician-anesthesiologist and anesthesiologist-led care teams are a necessary part of office-based surgical care to maintain the highest patient safety standards:
1. As with any surgical procedure, there is always a certain level of risk. Should an emergency arise, all personnel must be present, prepared, and equipped. That’s why Scope partner practices that make use of care-team with skilled CRNAs, there’s still an additional level of support from a physician anesthesiologist, alongside critical care trained nurses.
2. The value of an outsourced anesthesia platform in ambulatory spaces means an absolute focus on considering every possible contingency, even with healthy patients undergoing routine procedures. That means teams provide their own anesthesia-related supplies, equipment, and medications. It extends to monitoring equipment, too. State-of-the-art devices should be used to closely monitor patients’ breathing, heart rhythm, blood pressure and oxygen concentration in their blood to ensure the safety of each patient.
3. As office-based surgical care grows, surgeons can feel pressured to increase throughput by avoiding bringing in an anesthesiologist in states where regulations permit it. A partner organization fully focused on office-based surgery, providing anesthesiologists (or anesthesiologist-supervised care teams) should also work to minimize staff rotation, going as far as making sure dedicated teams of anesthesiologists and nurses can integrate as part of the office team. By integrating themselves as part of the “family,” they learn how a facility and its staff work together, which greatly reduces the chance for error.
Whether in the ASC, office, or dental practice, patient safety has to remain a top priority, and that includes the full freight of a physician-anesthesiologist operating at the top of their license to ensure safety in every procedure, even when supervising (similarly integral) CRNAs. Scope partner practices are dedicated to delivering the highest level of clinical care and patient experience while enhancing the operational and financial goals of any surgeon-client.
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