OR Manager - February 2019 - 19

Finances
Continued from page 17
Reimbursement. If the equipment
will result in a new procedure being offered
to patients, Spring recommends
examining the payer mix to see if the
procedure will be profitable. Even if the
payer mix isn't favorable, other factors,
such as reducing length of stay (LOS),
may save the organization money and
help justify the request.
Hope
Johnson,
DNP, MBA,
RN, CNOR,
NEA-B
Service line impact.
Consider whether the
equipment is part of a
new service line or will
enhance an existing
one. Johnson says
LVHN recently added an
ophthalmologist to increase
the number of
retinal procedures performed.
" We
had to make a
large capital purchase up front for the
equipment, " Johnson says. To quantify
the impact, she notes, it was important
to talk to the surgeon to determine initial
volume and time frame for ramping
up the volume.
Tampa General Hospital is getting
ready to add the Robotic Stereotactic
Assistance robot for performing surgery
related to epilepsy. " This was a brandnew
area for us, but it fit well with our
robust neurosurgery department, " says
Steven Chew, MHA, CPC, senior administrator
for orthopedics and neurosciences
at the hospital.
A review of market share data for
the relevant DRGs and procedure codes
showed that this was an opportunity
to capture surgical patients who don't
currently have a surgical option for their
condition.
Innovative new technologies can also
serve as marketing tools to promote
both the service line and the hospital.
For example, a rural hospital that purchases
a robot can promote the fact
that patients don't have to travel as far
for surgery, Skorupski says.
18
OR Manager | February 2019
More than dollars
One of the most common mistakes new
OR leaders make is failing to understand
the scope of ROI, according to
Johnson. " The tendency is to think of
just the money, but you have to determine
value, " she says. Value includes
time, quality, patient and employee
safety, and staff and physician satisfaction.
" Our
institution [MGH] doesn't just
look at dollar return, " Spring adds.
Other factors include patient outcomes,
LOS, infection rates, readmission rates,
and time saved in the OR or the postanesthesia
care unit. " We take a holistic
approach. "
Here's a closer look at some factors
that may not, at first glance, directly tie
to money.
Steven Chew,
MHA, CPC
Time. Time is a valuable
commodity in the
OR, so whether the
equipment will save
time is worth considering.
But, Chew says,
" OR time can be a red
herring. " Saving 20 minutes
won't make it possible
to schedule another case. However,
that 20 minutes can translate to
possibly less OR time and a shorter
LOS. Chew adds that if the new equipment
can reduce overtime by even a
few minutes, those minutes can add
up. " If you shave off 30 minutes a week
times 2.5 staff, all of a sudden, you're
at a solid number, and it adds up to an
FTE [full-time equivalent]. "
Safety. Employee safety played a
role in determining ROI for the fluid
waste management system at LVHN.
" When somebody is using a suction
container and never has to touch the
waste, it's going to protect our employees, "
Johnson says. " There wasn't a
big ROI on that project [$15,000 over
10 years], but we considered it from the
angle of employee satisfaction, safety,
and environmental concerns, " she says.
Johnson worked with her colleagues in
Questions to ask
before purchasing
new equipment
➤ What is the cost of the equipment?
➤ What is the cost of consumables
used with the equipment?
➤ Are there any disposables that will
need to be used outside of the OR
(for example, on inpatient units for
postoperative care) as a result of
the purchase?
➤ What is the cost of maintenance,
including service contracts?
➤ Will the new equipment replace
something?
➤ Will it change patient volume?
➤ How will it affect market share?
➤ What will be the effect on service
line(s)?
➤ How will it affect reimbursement?
➤ What current expenses will it reduce
or eliminate (for example,
repair costs)?
➤ Will it affect staffing?
➤ Will staff/surgeon education be
needed?
➤ Will it save time?
➤ How will it affect staff and
physician satisfaction?
➤ How will it affect staff or patient
safety?
➤ Will it affect patient outcomes?
➤ What will be the impact of not making
the purchase?
risk management and infection prevention
to outline these benefits.
Satisfaction. Physician satisfaction
can make or break an organization. For
example, physicians at LVHN were increasingly
unhappy with the frequent
problems associated with the older
laparoscopy equipment. With the new
equipment, physician satisfaction increased,
which spilled over to better
staff satisfaction because cases ran
more smoothly.
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