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infection? Will it decrease length of stay, nausea, post-op pain or time to ambula-
tion? Can it reduce the time patients spend under anesthesia? That's always a
great selling point. You also need to consider its usability and if it improves
patient safety and helps protect members of your OR team.
Our surgeons made the case to add bupivacaine liposome injectable suspen-
sion to their pain control regimens during large abdominal cases, spine surgeries
and total joint replacements. It's expensive — $285 per vial — but when we con-
sidered the improvements it's made to patients' post-op comfort, how much it
improved their ability to mobilize soon after surgery and decreased post-op
length of stay, and that surgeons were prescribing fewer post-op narcotics when
the injections were used, adding the drug to our offerings was a clinical no-brain-
er. In addition, surgeons' reputations improved in the eyes of patients who will
fill out satisfaction surveys that impact a portion of our hospital's reimburse-
ments. That's the type of downstream benefit you need to consider.
Engage physicians
Ask surgeons who want to add a piece of equipment to discuss their reasons
for doing so during 5-minute presentations in front of the value-analysis commit-
tee. Listen to what they say is best for patients and weigh that against your efforts
to standardize what's used in your ORs and keep purchases in line financially.
We recently studied the financial and clinical considerations of adding robotic
colon surgery to our health system. Some of our general surgeons showed how
the platform decreased their patients' length of stay, discomfort, blood loss and
use of post-op pain medications. We included those clinical factors in our justifi-
cation for adding the technology.
Make sure physicians consider the standardization, cost and clinical outcomes
associated with the equipment they want to add. We recently engaged physicians
and surgical managers to change our skin prep purchasing practices to reduce
the number of agents we use across the health system from 29 to 7. Driving that
standardization across several hospitals reduced costs associated with writing
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