CRNAs: Cost-Effectiveness without Compromising Quality

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One of the hottest debates in anesthesia today is CRNA supervision and integration in the Care Team Model. As there have been considerable increases in the number of CRNAs administering anesthetics each year, hospitals may need to consider how beneficial CRNA-MD Care Models can be. Following the national public education campaign launched by the American Association of Nurse Anesthetists (AANA) in September of 2014, studies on cost-effective, quality anesthesia care have provided insight regarding this highly debated topic.

Cost-efficient medical care continues to be at the forefront of concern for patients, institutions, government offices, and households. Risings costs are driving demand for access to healthcare that mandates high quality and incorporates cost savings and returns. Many hospitals are having to respond to these demands and are finding that including CRNAs in their care teams allows for cost savings that are valuable and contribute to increasing overall performance.

Somnia’s recent webinar sponsored by the Arizona Hospital and Healthcare Association featured Hugh Morgan, Vice President of Quality Assurance and Executive Director of the Somnia Patient Safety Organization. Mr. Morgan spoke on “The Risks of Anesthesia Underperformance” through analysis of the impact of anesthesia on operational and financial performance. In terms of service options, he highlighted the financial benefits of implementing a care team comprised of both MDs and CRNAs. When considering this MD-CRNA care team model, hospitals must recognize the quantitative impacts this decision has on costs.

A 2014 press release from the AANA titled, “Researchers Find No Differences in Care Provided by CRNAs and Anesthesiologists: Cochrane Collaboration,” highlighted the studies done by the Cochrane Collaboration proving the consistency of quality between CRNAs and MDs. The RTI (Research Triangle Institute) conducted a similar study that found that there are no measureable differences in the quality of anesthesia services delivered by MDs and CRNAs. The RTI study is supported by a study performed by Needleman and Minnick, two distinguished anesthesiologists. The study analyzed 369 different hospitals in seven states and collected data regarding anesthesia complications, deaths, and hospital characteristics. It found that “Anesthesia complication rates were lower in the CRNA-only hospitals (0.23 percent) than in the anesthesiologist-only hospitals (0.27 percent).” The multitude of extensive research reports supports the argument to remove barriers CRNAs often face in administering anesthesia in hospitals today.

Growth in the number of CRNAs has taken off in the last five years, and these professionals continue to be a necessity to quality anesthesiology departments. There are over 44,000 practicing CRNAs who administer approximately 40 million anesthetics to patients each year in the United States, which demonstrates just how crucial CRNAs are to bottom-line surgical care. As this field is projected to continue its growth, hospitals must consider the benefits of CRNA-MD Care Models, from cost-effectiveness to exceptional quality service.

http://www.aana.com/resources2/research/documents/nec_mj_10_hogan.pdf

http://www.aana.com/newsandjournal/News/Pages/080310-Study-in-Health-Affairs-Confirms-Quality-Safety-of-Nurse-Anesthetist-Care.aspx

http://www.beckersasc.com/anesthesia/ins-and-outs-of-4-asc-anesthesia-provider-models.html

http://www.ccianesthesia.com/model-work-for-your-anesthesia-team/

https://somniaanesthesiaservices.com/anesthesia-thought-leadership/somnia-anesthesia-blog/january-2015/celebrating-crnas-and-why-you-might-want-to-consid#.VipkfNKrTcs

http://www.aana.com/resources2/research/Documents/guestedit_0411_p101-105.pdf

https://www.aana.com/resources2/professionalpractice/Documents/Quality%20of%20Care%20in%20Anesthesia%2012102009.pdf

http://www.aana.com/ceandeducation/becomeacrna/Pages/Nurse-Anesthetists-at-a-Glance.aspx

http://www.aana.com/newsandjournal/20102019/resnews-0614-p184-187.pdf

http://www.aana.com/newsandjournal/News/Pages/081314-Researchers-Find-No-Differences-in-Care-Provided-by-CRNAs-and-Anesthesiologists-Cochrane-Collaboration.aspx

https://www.aana.com/newsandjournal/Documents/guestedit_0411_p101-105.pdf

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