Debating the merits of nurse anesthetist inclusion and independent practice on an anesthesia care team has been subject for discussion for quite some time. On one side, there are those that believe CRNAs aren’t capable of practicing independently and quality of care is sure to suffer. On the flip side, proponents suggest that as long as CRNAs practice within their scope of practice, they are perfectly capable administering anesthesia in specific, appropriate settings.
Wherever your opinion is, what has become clear is that CRNA integration is expanding, and in an era of high-quality care at the most cost-effective structure, it looks like it’s here to stay. In the March 2013 issue of HealthLeaders, the value provided by the anesthesia department was closely examined by a Washington state hospital.
Providence Regional Medical Center in Everett, WA, a 491-bed acute care facility, was faced with an anesthesia staffing challenge that undermined OR efficiency and clinician effectiveness. The all-physician model was proving to be costly and the push for quality-driven goals weren’t being realized. Hospital administration approached the group about incorporating CRNAs, but there was little receptiveness.
The situation was complicated further when after informing the group that an RFP was to be issued, the group served the hospital a 90-day termination notice. C-suite executives determined to search for alternative options. The final hurdle was surgeon satisfaction. Initially hesitant to change, interim CEO Preston Simmons explains that, “Some surgical leadership who were very much against this, as they became more involved, it became clearer to them that we had irreconcilable differences. Doing something like this is very high risk, so you can’t do this without consensus and a strong partnership with key physician leaders.”
In 2009, the hospital selected Somnia Anesthesia to manage the facility’s anesthesia department., Former PRMC CEO Dave Brooks commented on Somnia’s impact at the hospital and said “Now we’re very aligned, paying less, providing more coverage, and at better quality, we think – we had trouble measuring it in the past – and we believe we have a model built around the future, not the past.”
The right anesthesia partner could be all you need to create better efficiencies and processes in your OR. For further information to see if your current anesthesia group is aligning with your facility’s goals, download “A Hospital’s Guide to Evaluating Anesthesia Services.”