American Anesthesiology's commitment to value-based care

March 11, 2020 | by Cheryl Cranick
American Anesthesiology's commitment to value-based care

A commitment to patient safety is the cornerstone of the way our clinicians take great care of our patients. In anesthesia alone, during 2019, we monitored nearly 1.8 million cases and tracked benchmarks to prove we are meeting or exceeding standards of care. Together with programs such as our High Reliability Organization (HRO) Patient Safety Initiative and Clinical Safety App, our organization is not just safe; we are leading patient safety.

When it comes to the numbers, our affiliated practices and their hospital partners agree that a full return on medical care and service must include keeping patients safe. For American Anesthesiology, this year alone, $8.4M of our potential compensation will be driven by our ability to meet quality, performance and patient safety benchmarks. It is not difficult to take this risk because we know our clinicians always put patients’ safety first, every day and in every way.

A blueprint for optimal outcomes

These metrics of care are tracked for compliance in a tool called a Qualified Clinical Data Registry (QCDR). The reporting technology allows our clinicians to collectively gather and analyze deidentified patient information as a whole to determine best-practice outcomes and drive quality and safety advancements. This is the heart of evidence-based medicine.

Metrics are a critical part of developing evidence-based standards. Once a clinical team knows the best way to approach any given medical scenario, a team can follow that blueprint and ideally replicate positive results. Simply put, it’s a matter of doing the right thing at the right time, with facts to back up the treatment decision.  

Leading data collection

“Anesthesia plays a central role in surgery. That means getting those steps right from the beginning assists our clinicians in seeing patients safely through the perioperative process — before, during and after a procedure,” said Kevin Smith, MSN, APN, CRNA, Vice President of Advance Practice Anesthesia for American Anesthesiology.

As a large collaboration of anesthesia providers across 14 states, American Anesthesiology contributes a robust collection of data metrics. In fact, our reporting system is one of only a few anesthesia QCDR registries approved by the Centers for Medicare and Medicaid Services (CMS). “We help set the benchmarks and help develop the standards,” said Smith.

Through our QCDR, we track use and outcomes for safety protocols such as:

  • When and how to administer antibiotics
  • Monitoring and accounting for a patient’s current medications
  • Following clear guidelines to reduce or eliminate post-operative vomiting in both adult and pediatric patients
  • Addressing efficient and effective central line placement through the use of ultrasound guidance

A holistic approach to safety

While we set and meet these standards of care, we take patient safety further through quality initiatives such as our high reliability training. Developed in 2012, this initiative follows a system to change culture. It breaks down the hierarchy in the team care environment to empower all members to speak up in the name of patient safety without fear of retribution and address issues before they can impact patient care. Foundational to this program is mutual respect, trust and effective communication. “The act of reporting leads to accountability, awareness and in many cases tangible change,” said Jeff Shapiro, MD, Director of the Anesthesia HRO program.

A unique addition to our program is our Clinical Safety App (CSA), which provides all clinicians trained in HRO with immediate, on-the-ground digital connection to report safety matters that could affect anesthesia clinicians locally or more broadly within our national medical network. To date, more than 1,000 clinical users in the 27 practices that have completed the training are actively using this app to improve patient safety.

“HRO training teaches our doctors, advance practice providers and nurses to stop, think and act on any concern that could potentially affect the safety of a patient, and share it so others are prepared for similar circumstances,” said Shapiro.