Additional Information
Book Details
Abstract
This issue will cover novel approaches to demonstrating value by anesthesiologists. Articles will include Value from the Patient and Payer Perspectives, Perioperative Surgical Home, Demonstrating Value: A British perspective, Demonstrating value: A case study of enhanced recovery, Acute Pain Management/Regional, Measuring Outcomes as Demonstrating Value and many more!
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | Cover | ||
| Value-Based Care | i | ||
| Copyright | ii | ||
| Contributors | iii | ||
| EDITOR | iii | ||
| AUTHORS | iii | ||
| Contents | vii | ||
| Erratum | vii | ||
| Preface: Value—The Current Cure for Health Care’s Ailments? | vii | ||
| Perioperative Medicine: The Value Proposition for Anesthesia?: A UK Perspective on Delivering Value from Anesthesiology | vii | ||
| Demonstrating Value: A Case Study of Enhanced Recovery | vii | ||
| Value from the Patients’ and Payers’ Perspectives | vii | ||
| “What Have We Done for Us Lately?” – Defining Performance and Value at the Individual Clinician Level | viii | ||
| Performance Measurement to Demonstrate Value | viii | ||
| Optimizing Operating Room Scheduling | viii | ||
| Lean Strategies in the Operating Room | viii | ||
| Providing Value in Ambulatory Anesthesia in 2015 | ix | ||
| Acute Pain Management/Regional Anesthesia | ix | ||
| Examining Health Care Costs: Opportunities to Provide Value in the Intensive Care Unit | ix | ||
| Perioperative Surgical Home: Perspective II | ix | ||
| The Pain Medical Home: A Patient-Centered Medical Home Model of Care for Patients with Chronic Pain | x | ||
| ANESTHESIOLOGY CLINICS | xi | ||
| FORTHCOMING ISSUES | xi | ||
| March 2016 | xi | ||
| June 2016 | xi | ||
| September 2016 | xi | ||
| RECENT ISSUES | xi | ||
| September 2015 | xi | ||
| June 2015 | xi | ||
| March 2015 | xi | ||
| Erratum | xiii | ||
| Preface: Value—The Current Cure for Health Care’s Ailments? | xv | ||
| REFERENCES | xvi | ||
| Perioperative Medicine: The Value Proposition for Anesthesia? | 617 | ||
| Key points | 617 | ||
| INTRODUCTION | 618 | ||
| HEALTH CARE DELIVERY IS RESOURCE CONSTRAINED | 618 | ||
| HEALTH CARE ECONOMICS AND MARKET FAILURE | 619 | ||
| DEFINING VALUE IN HEALTH CARE | 620 | ||
| WHY FOCUS ON VALUE? | 622 | ||
| DEFINING PERIOPERATIVE MEDICINE | 622 | ||
| WHAT CONSTITUTES PERIOPERATIVE MEDICINE | 623 | ||
| PERIOPERATIVE MEDICINE IN THE UNITED KINGDOM | 623 | ||
| FIVE KEY OPPORTUNITIES FOR VALUE IN THE PERIOPERATIVE JOURNEY | 625 | ||
| Collaborative Decision Making | 625 | ||
| Lifestyle Modification Before Surgery | 625 | ||
| Standardized In-Hospital Perioperative Care—Process Mapping and Improvement | 625 | ||
| Achieving Full Recovery | 626 | ||
| Using Clinical Data for Quality Improvement | 626 | ||
| FUTURE CONSIDERATIONS/SUMMARY | 626 | ||
| REFERENCES | 626 | ||
| Demonstrating Value | 629 | ||
| Key points | 629 | ||
| INTRODUCTION | 629 | ||
| WHAT IS VALUE? | 630 | ||
| Reducing the Denominator in Value | 630 | ||
| Value in the Context of the Affordable Care Act | 630 | ||
| How Is the Numerator Enhanced? | 630 | ||
| INTRODUCTION TO ENHANCED RECOVERY AFTER SURGERY PROTOCOLS | 631 | ||
| Team Approach | 642 | ||
| ELEMENTS OF THE ENHANCED RECOVERY AFTER SURGERY PROTOCOLS THAT HAVE BEEN SHOWN TO ENHANCE VALUE | 642 | ||
| Surgical Approaches That Add or Subtract Value | 642 | ||
| Laparoscopic versus open | 642 | ||
| Routine use of nasogastric or nasojejunal decompression | 642 | ||
| Routine use of perianastomotic drains | 643 | ||
| Routine use of oral bowel preparation | 643 | ||
| Urinary bladder catheterization | 643 | ||
| Gum chewing | 643 | ||
| Other therapies | 643 | ||
| ANESTHETIC APPROACHES THAT ADD VALUE | 643 | ||
| Low-molecular-weight Heparin | 643 | ||
| Nil by Mouth After Midnight | 643 | ||
| Prophylactic Antibiotic Use | 644 | ||
| Pain Management | 644 | ||
| Postoperative Nausea and Vomiting | 644 | ||
| Euthermia | 644 | ||
| Fluid Administration | 644 | ||
| SUMMARY | 645 | ||
| REFERENCES | 645 | ||
| Value from the Patients’ and Payers’ Perspectives | 651 | ||
| Key points | 651 | ||
| VALUE FROM THE PAYERS’ PERSPECTIVE | 652 | ||
| VALUE FROM THE PATIENTS’ PERSPECTIVE | 654 | ||
| A SPECIFIC EXAMPLE | 655 | ||
| REFERENCES | 657 | ||
| “What Have We Done for Us Lately?” – Defining Performance and Value at the Individual Clinician Level | 659 | ||
| Key points | 659 | ||
| INTRODUCTION | 660 | ||
| Cost of Anesthesiologists and the Economic Climate of 2015 | 660 | ||
| Increasing Value by Taking on New Roles | 661 | ||
| INDIVIDUAL-LEVEL VALUE ASSESSMENT | 664 | ||
| Performance Assessment: a Balanced Scorecard | 664 | ||
| Compensation Models for Anesthesiologists and Related Physicians | 665 | ||
| FUTURE CONSIDERATIONS/SUMMARY | 673 | ||
| REFERENCES | 675 | ||
| Performance Measurement to Demonstrate Value | 679 | ||
| Key points | 679 | ||
| MATCHING MESSAGE TO MEASURES: WHO IS DEMONSTRATING VALUE TO WHOM? | 679 | ||
| HOW IS VALUE MEASURED IN HEALTH CARE? INTRODUCTION TO STRUCTURE, PROCESS, OUTCOME AND EFFICIENCY MEASURES | 680 | ||
| STRUCTURAL MEASURES: LARGELY A RELIC OF THE PAST | 680 | ||
| PROCESS MEASURES | 681 | ||
| Simple, Actionable Targets for Improvement | 681 | ||
| Tenuous Links to Value | 681 | ||
| Process Measures to Demonstrate Value: Geisinger Health System “ProvenCare” | 681 | ||
| Process Measures to Demonstrate Value: Surgical Checklists | 682 | ||
| OUTCOME MEASURES | 682 | ||
| Traditional Means to Demonstrate Value | 682 | ||
| Outcome Measures Have Important Limitations | 682 | ||
| Evolution and Innovation of Outcome Measures: Scoring What Went Right | 682 | ||
| Evolution and Innovation of Outcome Measures: Scoring Patient Experience | 683 | ||
| Complications and Quality May Not Correlate | 683 | ||
| The Case of Venous Thromboembolism as a Quality Measure | 683 | ||
| Statistical Challenges to Meaningful Outcome Comparisons | 683 | ||
| Longer-term Outcomes for Anesthesiologist to Demonstrate Value | 684 | ||
| Challenges with Longer-term Outcomes to Demonstrate Value | 684 | ||
| Can Single Hospitals Benefit from Using Outcome Measures to Demonstrate Value? | 684 | ||
| Additional Considerations About Outcome Measures and Value | 685 | ||
| EFFICIENCY MEASURES | 685 | ||
| More than an Old Idea with a New Name | 685 | ||
| Great Promise for Local Solutions to Demonstrate Value | 686 | ||
| Costs of Care and Reporting of Efficiency | 686 | ||
| Managing Performance Measures to Achieve High-value Care | 686 | ||
| PUBLIC REPORTING TO DRIVE HIGH-VALUE CARE AND DETERMINE PAYMENT | 687 | ||
| Pay for Performance Measurement in Centers for Medicare and Medicaid Services | 687 | ||
| Overview of Centers for Medicare and Medicaid Services Value-based Payment Programs | 687 | ||
| Physician Quality Reporting System | 687 | ||
| Demonstrating Value Beyond Same-specialty Measures | 688 | ||
| Alternative Centers for Medicare and Medicaid Services Programs for Demonstrating Value | 689 | ||
| A CASE STUDY OF PERFORMANCE MEASURE TO DRIVE VALUE AT MAYO CLINIC | 690 | ||
| Collaboration, Cooperation, and Coordination | 691 | ||
| Local Measures to Demonstrate Local Value Improvement | 692 | ||
| Demonstrating Value May Be More Difficult than Delivering Value | 693 | ||
| SUMMARY | 693 | ||
| ACKNOWLEDGMENTS | 693 | ||
| REFERENCES | 693 | ||
| Optimizing Operating Room Scheduling | 697 | ||
| Key points | 697 | ||
| BLOCK SCHEDULE MANAGEMENT | 698 | ||
| DAILY SCHEDULE MANAGEMENT | 702 | ||
| Operating Room Schedule | 702 | ||
| Determining Case Length | 702 | ||
| Case Order | 704 | ||
| POST ANESTHESIA CARE UNIT FLOW | 705 | ||
| Additional Considerations | 708 | ||
| SUMMARY | 709 | ||
| REFERENCES | 709 | ||
| Lean Strategies in the Operating Room | 713 | ||
| Key points | 713 | ||
| INTRODUCTION | 713 | ||
| LEVEL 1: ENGAGEMENT AND WASTE | 716 | ||
| SEVEN WASTES | 716 | ||
| LEVEL 2: 5S AND VISUAL CONTROLS | 720 | ||
| LEVEL 3: LEVEL LOADING, JUST-IN-TIME, BUILT-IN QUALITY | 722 | ||
| IMPORTANCE OF MANAGEMENT | 728 | ||
| SUMMARY | 729 | ||
| REFERENCES | 730 | ||
| Providing Value in Ambulatory Anesthesia in 2015 | 731 | ||
| Key points | 731 | ||
| POSTOPERATIVE NAUSEA AND VOMITING AND POSTDISCHARGE NAUSEA AND VOMITING | 732 | ||
| CAN PATIENTS WITH OBSTRUCTIVE SLEEP APNEA BE OPERATED ON IN AN AMBULATORY CARE SETTING? | 734 | ||
| OPTIMAL CARE FOR PATIENTS WITH DIABETES MELLITUS TYPES 1 AND 2 | 735 | ||
| OPERATIVE PROCEDURE DURATION, SCOPE, AND “HEALTHSPAN” | 735 | ||
| SUMMARY | 736 | ||
| ACKNOWLEDGMENTS | 736 | ||
| REFERENCES | 736 | ||
| Acute Pain Management/Regional Anesthesia | 739 | ||
| Key points | 739 | ||
| BACKGROUND | 739 | ||
| THE VALUE OF AN ORGANIZED ACUTE PAIN/REGIONAL ANESTHESIA SERVICE | 740 | ||
| Value of Regional Anesthesia to Patients | 742 | ||
| Morbidity, Mortality, and Outcome Benefits | 743 | ||
| COMPLIMENTARY TOOLS TO ADD VALUE TO ACUTE PAIN AND REGIONAL ANESTHESIA SERVICES | 743 | ||
| Complementary and Alternative Medicine | 744 | ||
| Information Technology | 745 | ||
| SUMMARY | 746 | ||
| REFERENCES | 746 | ||
| Examining Health Care Costs | 753 | ||
| Key points | 753 | ||
| THE HEALTH CARE COST CONUNDRUM | 753 | ||
| ECONOMICS OF CRITICAL CARE SERVICES | 754 | ||
| VALUE-BASED HEALTH CARE | 755 | ||
| MEASURING HEALTH CARE COSTS | 755 | ||
| CARDIOVASCULAR DISEASE AND CARDIAC SURGERY IN THE UNITED STATES | 757 | ||
| THE COST OF CARDIAC SURGERY | 758 | ||
| WHAT IS FAST-TRACK CARDIAC SURGERY? | 759 | ||
| DELIRIUM: ASSOCIATED COSTS, RISK FACTORS, AND TREATMENT | 761 | ||
| FUTURE CONSIDERATIONS | 766 | ||
| REFERENCES | 766 | ||
| Perioperative Surgical Home | 771 | ||
| Key points | 771 | ||
| INTRODUCTION | 772 | ||
| POPULATION HEALTH MANAGEMENT | 772 | ||
| “BURNING PLATFORM” OF CHANGING REIMBURSEMENT MODELS | 773 | ||
| WHAT IS VALUE IN HEALTH CARE? | 776 | ||
| STRATEGIES TO INCREASE THE VALUE OF CARE PROVIDED BY THE PERIOPERATIVE SURGICAL HOME | 777 | ||
| THE PERIOPERATIVE SURGICAL HOME AS A NEW VALUE STREAM MAP | 778 | ||
| A PERIOPERATIVE PERSONALIZED CARE MATRIX | 779 | ||
| PYRAMID OF PRACTICE CHANGE: ROLE OF INFORMATICS, ANALYTICS, AND DECISION SUPPORT | 781 | ||
| FUTURE CONSIDERATIONS AND SUMMARY | 782 | ||
| REFERENCES | 783 | ||
| The Pain Medical Home | 785 | ||
| Key points | 785 | ||
| INTRODUCTION | 785 | ||
| THE PATIENT-CENTERED MEDICAL HOME | 786 | ||
| PATIENT-CENTERED MEDICAL HOME-NEIGHBOR | 787 | ||
| THE PAIN MEDICAL HOME | 788 | ||
| Shared Vision | 788 | ||
| Personal Physician | 789 | ||
| Evidence-Based Care | 789 | ||
| Careful Delineation of Roles and Responsibilities | 789 | ||
| Careful Coordination of Care | 789 | ||
| Physician-Directed Care Team | 789 | ||
| Focus on the Person Rather than the Disease | 790 | ||
| Innovative Solutions | 790 | ||
| THE IMPORTANCE OF ASSESSING OUTCOMES IN THE PAIN MEDICAL HOME | 790 | ||
| WHERE IS THE PAIN MEDICAL HOME? | 790 | ||
| SUMMARY AND FUTURE CONSIDERATIONS | 791 | ||
| REFERENCES | 792 | ||
| Index | 795 |