Safety: Breaking Down the Silos

Clear, team-based communication is a safety and satisfaction must.

Clear, concise and open communication between ambulatory surgery centers (ASCs) and physicians’ offices is of the utmost importance in ensuring patient safety and satisfaction throughout the perioperative journey.

Through the cracks

One area where communication gaps commonly occur is in the scheduling process, particularly regarding preoperative instructions, errors in estimating surgery duration and handling special requests.

Although ASCs and physicians’ offices are separate entities, it’s crucial to establish clear communication channels between clinic staff, providers and ASC staff — especially when it comes to scheduling procedures. ASCs operate with limited resources in terms of staff, equipment and instruments, necessitating accurate planning and coordination within the schedule.

It’s important for clinic staff to understand the rationale behind scheduling restrictions and how non-compliance can impact the entire ASC. Failure to address communication challenges can lead to various consequences, including delays, inconveniences, financial headaches, and most significantly, potential risks to patient well-being.

Identifying the underlying causes of miscommunication is key. For instance, conflicting preoperative instructions can create risks, such as aspiration due to fasting discrepancies or heightened bleeding risks from inconsistent guidance on discontinuing anticoagulants. Plus, surgeries scheduled well below or above the actual time can impact the staffing, equipment and instrument plan.

Under-scheduling can lead to staff, equipment and instrument needs earlier than planned, including patients in the recovery room, prior to the arrival of the staff. Over-scheduling inversely impacts those same areas by requiring staff to work longer hours, increasing waiting times for patients and extended NPO periods.

Effective communication must also include the transmission of any special requests, especially those requiring advanced planning, such as implants or the need for interpreters or overnight services.

Let’s look at six actionable tips designed to improve communication with physicians’ offices, minimize case cancellations and safeguard the well-being of your patients.

Standardize communication protocols and processes

Establishing standardized communication protocols ensures consistency and clarity in the information exchange. Create a comprehensive set of guidelines that specifies the preferred modes of communication, expected response times and designated points of contact. For instance, urgent matters could be communicated through direct phone calls or secure messaging to a dedicated scheduling phone number, with an expected response time of within 30 minutes.

Non-urgent matters, on the other hand, may be communicated through a designated email address such as “[email protected]” with a response time of within 24 hours. Develop a clear protocol for communicating critical information, including patient details, surgical requirements, and any scheduling or patient status changes.

Develop standardized templates for specific communication between physicians’ offices and the ASC that includes preoperative checklists, required documentation and confirmation procedures. Standardization reduces errors and ensures that essential information is consistently communicated, thereby reducing the likelihood of cancellations due to missing or incomplete information.

Establish clear scheduling guidelines

Patient selection criteria should be established to identify indications or conditions that warrant further review before scheduling.

To ensure patient safety and optimize efficiency, it is crucial to implement clear scheduling guidelines that encompass robust preoperative assessments and necessary clearances well in advance of the scheduled surgery. This involves conducting comprehensive preoperative medical evaluations, reviewing laboratory results and addressing specific requirements related to the procedure.

Not all patients are candidates for an ASC, and this should be identified prior to the scheduling process. For instance, patients with sleep apnea may require longer recovery periods, including a transfer to the hospital for overnight observation. To operationalize these guidelines effectively, create a document that outlines the ASC’s specific requirements for preoperative testing, patient preparation and necessary documentation. These guidelines should be shared with physicians’ offices and easily accessible to all relevant stakeholders. Regularly review and update these guidelines to ensure alignment with current best practices and regulatory changes.

Conduct periodic performance reviews

Routinely evaluate the communication processes and outcomes between physicians’ offices and the ASC. Pay especially close attention to key metrics such as the number of cancellations, reasons for cancellations and feedback from both parties. Use this data to identify improvement areas and implement targeted strategies to address specific challenges.

Utilize Electronic Health Records (EHRs)

Adopt compatible electronic health record systems (EHRs) to improve communication between physician offices and ASCs. EHRs offer seamless transmission of patient information, including medical history, preoperative evaluations and relevant lab results. Digital integration eliminates the need for time-consuming, error-prone manual data entry, reduces the risk of miscommunication and improves accuracy.

Foster a culture of collaboration

Encourage open and collaborative communication between physicians’ offices and the ASC that promotes information sharing feedback, and suggestions for improvement. Regularly engage in dialogue with physicians’ office staff to address any concerns or challenges and find mutually beneficial solutions. Set up regular communication checkpoints, such as weekly conference calls or monthly meetings, to discuss upcoming cases and ensure everyone is on the same page. This can prevent potential issues before they negatively impact patient safety.

Actively seek patient feedback

Get patients involved in the continuous improvement of communication by seeking out their feedback and suggestions. Keep in mind, a patient’s silence does not necessarily indicate satisfaction. In some cases, patients may have faced difficulties reaching the right contact person or received inadequate information before their visit, but they might hesitate to express their concerns to the surgical team prior to their procedure.

To obtain those valuable insights, incorporate targeted questions on patient satisfaction surveys. Questions like, “Rate your satisfaction with communication between the physicians’ office and the surgery center” help gauge their overall satisfaction.

Finally, provide ample space for patients to elaborate on what aspects of the communication process went well and what areas fell short. Follow up for more details if it seems necessary. By collecting and carefully analyzing the feedback received through patient satisfaction surveys, you can identify specific areas that require further improvement.

Putting it all together

As ASC leaders, it’s ultimately your responsibility to make sure every of the surgical process goes smoothly. By proactively seeking to understand and improve key processes, establishing relationships with clinic leaders and implementing practical strategies that foster optimal communication with physicians’ offices, you can mitigate the risks associated with miscommunication and enhance patient safety. OSM