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O U T P AT I E N T S U R G E R Y M A G A Z I N E O N L I N E | D E C E M B E R 2 0 1 4
Hospitals are
reimbursed for
the costs of
materials, but
surgery cen-
ters incur the
costs. Plus,
sometimes we
require extra
staff on those
days when we're placing lots of catheters. We spend considerable time
on patient education, e-mailing patients educational materials and
making pre-op phone calls to explain how the continuous block will
work. We give patients our cell phone numbers so they can call 24/7
with questions or concerns. We're being told we need to focus on
patient outcomes and quality, yet we're not incentivized to do so yet.
Actually, it's the exact opposite: We're having to invest in good patient
outcomes.
4. Managing patient expectations. The silver lining is
that our patient satisfaction and pain scores are excellent. With out-
comes-based payment coming soon to health care, we expect our
efforts will pay off in the long run. If you asked me to name the major
benefit of pain catheters, I'd probably say that they prevent hospital
readmission for pain control, which for some procedures (shoulder
and foot and ankle cases, for example) is as high as 5%. We follow
patients for 48 hours when they're at home, and we hardly ever hear of
an ER visit for pain. They have less nausea and constipation, they
sleep better and they're better able to do their physical therapy. To
manage expectations, tell your patients that the pain catheter will
P O S T - O P P A I N
NO MEDS NEEDED An ultrasound image of a supraclavicular
catheter placed for a wrist fracture in a patient who had a history
of difficulty managing pain. She didn't need post-op opioids.
Vincent
P.
Kasper
Jr.,
MD
