NEWS March 08

Overbooking Appointments Can Increase Efficiency

University of Colorado at Boulder Leeds School of Business instructor Linda LaGanga and fellow researcher Stephen Lawrence, an associate professor of operations management, found that overbooking could increase patient access and improve clinic productivity, resulting in reduced costs and greater patient satisfaction.

According to the study, overbooking would address patient no-shows and enable clinics to see more patients. However, clinic administrators must be willing to endure increased patient waiting and increased clinic overtime.

“Many clinics overbook, but they don’t do it well,” she states. “Anecdotally, they will admit they do it, but it’s not done systematically.

It’s done in the sense of ‘squeezing in’ another patient.”

For their study, LaGanga and Lawrence developed a computer simulation tool that enables healthcare administrators to weigh benefits such as seeing more patients and making healthcare workers’ time more efficient against potential costs such as increased patient waiting and staff overtime.

The tool gives administrators an option to decide whether their clinics would benefit from overbooking and how they might structure the procedure for greater efficiency.

Administrators can then assign a value to the benefit of seeing additional patients against the costs of extra patient waiting and staff overtime.

Different administrators might assign different values for their clinics, according to the study.

“If you had a clinic in Hollywood and had only movie stars as patients, you might not want to ever make them wait longer,” Lawrence points out. “So the administrator would assign a much higher relative value for increased patient waiting time.”

In contrast, LaGanga’s clinic places a high value on its ability to serve more people. “We want to stop turning people away because of lack of capacity. Seeing one more person in the morning and afternoon could make a great difference,” she says.

The study examined a wide range of clinic sizes and no-show rates, which can be as low as 3 percent and as high as 80 percent. Typically, overbooking was most beneficial to clinics that serve a large number of patients, had higher no-show rates and had appointments that did not vary greatly in length. However, the study found that many clinics achieve positive results with overbooking even if appointments varied greatly in length.

Deadline Nears for HIMSS 2008 Davies Awards of Excellence

The Healthcare Information and Management Systems Society (HIMSS) is soliciting applications for the 2008 Davies Awards of Excellence Program. For the past 14 years, HIMSS has honored organizations that have successfully achieved value from electronic health (EHR) records to improve healthcare delivery.

“The HIMSS Davies Award of Excellence program truly demonstrates the benefits of the electronic health record by recognizing organizations that had the vision and determination to implement this technology,” notes Patricia Wise, RN, MA, MSN, vice president of healthcare information systems for HIMSS. “The award recipients represent some of the most strategic healthcare leaders in the country because they have implemented health information technology in their respective organizations to improve the delivery of patient care.”

The HIMSS Nicholas E. Davies Awards of Excellence recognize excellence in the implementation and use of health information technology (IT), specifically EHRs, for healthcare organizations, private practices and public health systems. Originally created by CPRI-HOST in 1994, the first three recipients of the Davies Organizational Award were recognized in 1995. CPRIHOST merged with HIMSS in 2002, and HIMSS now manages the program.

The award honors the late Dr. Nicholas E. Davies, an Atlanta-based practicing physician, president-elect of the American College of Physicians, and a member of the Institute of Medicine Committee on Improving the Patient Record, who tragically died in an airplane crash in 1991 with Senator John Tower. Davies believed that the computer-based patient record was needed to improve patient care.

Award applicants must provide assessment and documentation of their health IT implementation progress based on four key areas including management, functionality, technology and overall value. The Davies Award for healthcare organizations is a two-step process that includes a site visit to each of the finalists’ organizations. Since its inception in 1994, the Davies Award program has honored 49 recipients in three award categories.

Application deadline for the Davies Ambulatory Care Award for Independent Ambulatory Care Practices is April 30. For more information on criteria and how to apply, visit www.himss.org/davies. 

“Fraud Fighters Handbook”

The National Health Care Anti-Fraud Association (NHCAA) developed a handbook that provides healthcare fraud professionals and other stakeholders’ critical information and tools to detect, investigate and, when appropriate, prosecute fraudulent activities.

“This handbook is designed to offer Special Investigation Unit (SIU) managers the tools to develop an efficient and effective investigation unit as well as offering seasoned and novice investigators alike the knowledge and insight that will assist them in conducting successful healthcare fraud investigations,” says Louis Saccoccio, NHCAA executive director. “This handbook is essential for anyone involved or interested in the mission, authority, goals and other considerations of combating healthcare fraud.”

NHCAA estimates that between 3 percent and 5 percent of the nation’s total spending on healthcare is lost to fraud.

The “Fraud Fighters Handbook” is divided in two key sections: The Investigation Unit and A Health Care Fraud Investigation. Each element contains information for investigators. For more information, visit www.nhcaa.org. 

CMS Fee Schedule Fact Sheet Available for ASCs

The Ambulatory Surgical Center (ASC) Fee Schedule Fact Sheet, which provides general information about the ASC fee schedule, ASC payments and how ASC payment amounts are determined, is now available for download from the Centers for Medicare & Medicaid Services (CMS) Medicare Learning Network.

It can be accessed at www.cms.hhs.gov/MLNProducts/downloads/AmbSurgCtrFeepymtfctsht508.pdf. 

CMS Survival Series

The CMS Survival Series, a series of Webinars produced by today’s surgicenter magazine, was designed to help the ASC industry survive the recent Centers for Medicare & Medicaid Services (CMS) changes. The Series has wrapped up and is now available for free download on the today’s surgicenter Web site at www.surgicenteronline.com/webinars/webinar_display.asp. 

This four-part series, accessible online from any location, maps out all of the challenges the final rule presents and is coupled with comprehensive guidance from several of the experts in the industry for any ASC — with any specialty mix — to flourish.

Part I: Legal Implications and Considerations: What every center needs to know before the January 1 implementation date.
Speaker: Lorin Patterson, JD, partner, Reed Smith LLP 

Part II: Bandaging Your Bottom Line: An in-depth look at reimbursement. How the final rule will affect your center and tips on how to best survive.
Speakers: Caryl Serbin, RN, BSN, LHRM, president and founder of Surgery Consultants of America and Serbin Surgery Center Billing; and Joyce L. Jones, CPC, CPC-H, CCS-P, CPCASC, instructor and member of the American Academy of Professional Coders (AAPC), and director of business operations at AmSurg.

Part III: The today’s surgicenter Survival Guide for Pain and GI — help for those hardest hit.
Speakers: John Poisson, executive vice president and strategic partnerships officer with Physicians Endoscopy, LLC; and Laurie Curtis, manager of compliance and quality assurance with MAPS Practice Solutions 

Part IV: ASC Advocacy.
Speakers: Kathy Bryant, president of the Ambulatory Surgery Center Association (ASC Association or ASCA); Rob Schwartz, senior vice president of the state government relations and association development arm of ASCA; and Lorin Patterson, JD, partner, Reed Smith LLP

Carla M. Daley Joins Regent Team

Carla M. Daley, RN, BSN, joined Regent Surgical Health as its clinical director of operations, eastern division. She has 14 years of nursing experience including supervisory roles at Kettering Medical Center, Sycamore, Ohio.

New York State Department of Health Authorizes AAAASF to Accredit Office-Based Surgery

The New York State Department of Health (DOH) has designated the American Association for Accreditation of Ambulatory Surgery Facilities (AAAASF) as an authorized agency to be used by office-based surgery practices to meet new accreditation requirements in New York.

“AAAASF has worked with the State of New York over the last several years to assist in the development of the new law,” says AAAASF president Alan Gold, “and we believe that New York has taken a critical step to help ensure patient safety by requiring careful oversight of the office-based ambulatory medical and surgical care environment. We are appreciative of the confidence the DOH has expressed in AAAASF by choosing us to continue to work with them in the implementation and monitoring of this important legislative initiative.”

The New York law requires office-based surgery performed by physicians requiring moderate sedation, deep sedation, or general anesthesia, and certain liposuction procedures be performed in a setting that has obtained and maintained accreditation from an entity approved by the state health commissioner.

In New York and throughout the country, AAAASF already accredits more office-based surgery facilities than any other accrediting body and is reaching out to all physicians to offer a helping hand. “We offer a concise, user-friendly set of standards that focuses on patient safety and best practices. Over the last several years, we have refined our standards and have tried to eliminate the busywork for facilities,” says Jeff Pearcy, executive director. One component of the law requires reporting of unanticipated events after surgery to the state.

AAAASF has already been requiring this type of reporting along with random case reviews for the last seven years.

AAAASF has been accrediting office-based surgery facilities since 1980 and many members of the board of directors have been key players in the development of the process for over a decade. “I have seen the accreditation industry incubate during my years of service at AAAASF, and my support for the process has never wavered. The significance of third-party inspection, accreditation and peer review has gained tremendous validity as more states are incorporating accreditation concepts into laws, “ says Gold. “CMS recently deferred future Medicare inspections to deeming authorities such as AAAASF,” adds Gold.

“The benefits of the accreditation process have never been so evident,” he concludes.

Source: AAAASF

Cirrus Health Develops Multi-specialty Hospital in Texas

Cirrus Health is developing a 50,000-square-foot, multi-specialty hospital within the Craig Ranch 2000-acre master-planned, mixed-use development in McKinney, Texas. With completion scheduled for the fourth quarter of 2008, the new hospital site will also provide physicians with a 60,000-square-foot medical office building. Located just north of Highway 121 on Alma Road, adjacent to the Michael Johnson Performance Training Center at Craig Ranch, the hospital will host six operating suites, two procedure rooms, 28 pre-op and post-op beds, four ICU beds, and 16 private rooms. The Cirrus Group, LLC will oversee construction of the facilities as well as manage the medical office building. The project will also provide a 450-space parking garage for physicians, patients and their guests.

INDUSTRY EVENTS

MARCH 
American College of Healthcare Executives
March 10-13 
Chicago, Ill.
www.ache.org 

Accreditation Association for Ambulatory Health Care (AAAHC) 
Achieving Accreditation 
March 14-15 
Tampa, Fla.
www.aaahc.org 

Association of periOperative Registered Nurses (AORN) 
March 30-April 3 
Anaheim, Calif.
www.aorn.org 

APRIL 
American Society of Laser Medicine and Surgery 
April 2-6 
Kissimmee, Fla.
www.aslms.org 

American Society of Cataract and Refractive Surgery 
April 4-9 
Chicago, Ill.
www.ascrs.org 

American Society of Ophthalmic Administrators 
April 4-9 
San Diego, Calif.
www.asoa.org 

Society of American Gastrointestinal Endoscopic Surgery (SAGES) 
April 9-12 
Philadelphia, Pa.
www.sages.org 

American College of Gastroenterology Gastroenterology Practice and Endoscopic ASCs: Challenges and Opportunities 2008 
April 10–13 Knoxville, Tenn.
www.gastroenterologycourse.com 

Send your upcoming industry event to jschraag@vpico.com 

NEWS GROWTH

Foxhall Ambulatory Surgery Center

Foxhall Ambulatory Surgery Center will be built to provide reproductive and women’s services. It is planned to be built on the grounds of Kingston Hospital in New York. The 5,023-square-foot, $4.2 million building will house two operating rooms, a waiting/reception area, three preparation areas, a nurse station, two changing rooms, four bathrooms, and basement storage areas. The building will be about 10 feet away from Kingston Hospital, but will be attached to the hospital by an enclosed walkway.

New York State Department of Health Approves 52,000-Square-Foot ASC

The University of Rochester Medical Center received state approval to construct an off-site, ambulatory surgery center. The 52,000-square-foot facility will accommodate 10 operating rooms (ORs), two procedure rooms, pre- and post-operative care space, a materials processing unit to sterilize and prepare surgical instruments, and a family and patient waiting space.

The off-campus ASC is expected to aid in handling the 5,000 outpatient surgeries that can’t be accommodated in Strong Memorial’s current ORs, and the project will make possible future renovations of the medical center’s current ORs and pre- and post-anesthesia rooms, while improving all facilities to meet present-day size and technology standards.

URMC could begin construction as early as this spring, with completion slated for summer 2009.

FIU Receives $10 Million for New Facility

Miami-Dade County commissioners approved $10 million for an ambulatory care facility at Florida International University’s College of Medicine.

The $10 million comes from the Building Better Communities general obligation bonds (GOB), approved by voters to construct and improve healthcare facilities to promote accessibility to quality healthcare services. The money will help build an ambulatory care center, part of the new College of Medicine at FIU-University Park. The center will consist of an ambulatory surgery center and an outpatient diagnostic center, open to the entire community for diagnosis, treatment and care.

“The ambulatory care center will be an important component of what will be the only public medical school in South Florida; a new type of medical school, dedicated to training a new generation of doctors with a commitment to serving the community,” says Dr. John Rock, dean of the College of Medicine. “We commend the commissioners, particularly commissioners Joe Martinez and Jose ‘Pepe’ Díaz who sponsored the resolution in support of this measure, for seeing the benefit of investing public funds to help raise the level of healthcare available to Miami-Dade residents.”

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