Patient Experience Week: Rising to Outpatient Surgery Center Challenges

Communicating with patients is a key to success in achieving a positive patient clinical experience at surgery centers.

HealthLeaders is helping to celebrate Patient Experience Week! In honor of Patient Experience Week, please enjoy this video educational session with top health system executives about patient clinical experience.

The educational session, which focuses on pain points for outpatient surgery patient clinical experience and ways to address them, features Helene Finegold, patient experience officer at Allegheny Health Network's Anesthesia Institute, JP Garcia, director of patient experience at Providence, and Jessie Monnier, senior director of operations—ambulatory surgery centers at Providence.

A primary pain point for outpatient surgery patient clinical experience is managing communication between the physician's office and the surgery center.

One of the unique aspects of the ambulatory surgery center space is the relationship between the surgery center and the physician's office, Monnier says. "Working together on a communication plan for managing patients through their surgical experience oftentimes involves coordination of information between the physician's office and the surgery center such as pre-op labs, the workup that needs to be done so the surgery center can assess patient safety, and communicating to the patients about when they can expect to be contacted by the surgery center. The surgery center makes that initial contact, typically providing preparation details such as home care instructions and even financial responsibility. Then the surgery center provides an avenue for patients to reach out if they have questions about that initial contact and prior to arriving at the facility."

One of the challenges of getting patients from the physician's office to the surgery center is the dynamic nature of a surgery center, Finegold says. "For example, the patient is seen in the office but by the time it is close to surgery they may need a consult, or we may have to change the day of surgery. One of the things that helps us is every day we do a scheduling meeting, which includes anesthesiology, nursing, and communication with the schedulers. We sit together and we look at the schedule. We ask, 'How does it look today?' and 'What is going on this week?' Then we have the schedulers get back to the physician offices to communicate with the patients. We try to make sure when a change occurs, one voice gets back to the patient. When patients hear multiple things, it can be very problematic for them."

Physician offices and surgery centers must stay on the same page when communicating with patients, Garcia says. "If a ball is dropped, or one office says one thing and the schedulers say another, that does not inspire confidence for the patients. Those are human beings in front of you who likely have a lot of anxiety going into a procedure. We don't know what is going on in their minds. We must alleviate that anxiety, and we can do this through a seamless communication process in between all parties who are scheduling these surgical procedures."

Anesthesia and patient clinical experience

Communicating with patients about anesthesia can be a pain point at surgery centers.

The issue is patients often know their surgeon well, but the anesthesia piece remains mysterious for most patients, Finegold says. "For some patients, it is seamless; for others, they do not know what to expect. This can cause a lot of anxiety coming up to the day of surgery. An education program is important to inform patients. What is anesthesia? Who is an anesthesiologist? Who is a nurse anesthetist? What type of anesthetic is going to be used? The terms are confusing for patients."

Patient education and engagement is crucial, she says. "We want to give patients educational materials and give them a way to reach the anesthesia team if they have something bothering them or had a bad experience in the past. At our institute, to promote patient experience, we have created an email link and a phone number if patients have something that is bothering them coming up to surgery, so we can try to address it and optimize their experience. We do not want them waiting six weeks worrying about it."

When it comes to anesthesia, it is pivotal to communicate with patients and set expectations on the front-end, Monnier says. "When we manage expectations around anesthesia, that is one of the things that draws a lot of comments in the experience reports that I have seen. The initial encounter at the bedside with the physician involves talking with the patient about what to expect—things like pain management and nausea post-procedure."

Handling delays in procedures

Another patient clinical experience pain point is when procedures must be delayed at surgery centers.

This is an area where surgery centers can avoid patient suffering, Garcia says. "These wait times that patients are enduring involve suffering, and it is suffering they do not need to experience, especially when they are going into a procedure that they might be terrified of. It is truly important to ensure that patients are aware of any and all sorts of delays. We need to explain the 'why' behind delays. We need to instill confidence in patients. We want to assure them that nothing is wrong—to comfort them and meet them where they are. You need to be transparent about delays and offer reasons why delays occur."

Surgery centers need to pay attention to the schedule throughout the day, Monnier says. "Sometimes, we have cases that run long, and it is a domino effect for the rest of the day. So, you need to ensure that patients are kept apprised of delays before they even arrive at the surgery center. If they can delay their arrival by 30 minutes or an hour, it allows them to be in the comfort of their own home."

When delays occur, surgery center staff need to be honest, respectful, and transparent, Finegold says. "Patients have a right to be upset, and their feelings need to be acknowledged. You do the best you can. If you come up and say, 'I'm sorry,' people will understand."

Related: Patient Experience Week: How to Improve HCAHPS Scores