2 0 • O U T PA T I E N T S U R G E R Y M A G A Z I N E • J A n U A R Y 2 0 1 8
Business Advisor
BA
It goes without saying that you never want to make good on a sur-
gical warranty. The key to making that happen: predictable out-
comes. That means getting your surgeons together to agree on
the best possible way to do the surgeries covered under the war-
ranty. Here's how to make that happen.
• Make sure that the patient truly needs the surgery. "Have
careful, clear documentation of the indications and rationale for
doing procedures and make sure that those are lined up with
appropriate use criteria," says Alfred Casale, MD, associate
chief medical officer and chairman of cardiothoracic surgery at
Geisinger Health in Danville, Pa. Many specialties have organi-
zations, like the American Heart Association, which provide cri-
teria for what types of patients are good candidates for the sur-
gery.
• Establish best practices. Use specialty-specific guidelines for
best practices to make a checklist of things all surgeons doing
the warrantied surgeries should be completing. "Take those best
practices and translate them into absolutely unequivocal deliver-
able behaviors," says Dr. Casale. For example, a guideline might
suggest something vague, like "Use antibiotics appropriately to
minimize infections." In that scenario, meet with your team on
how to establish a universal way of making sure those antibiotics
are really minimizing infections. For Dr. Casale and his col-
leagues, that vague guideline turned into giving every patient an
IV within one hour of the first incision and re-dosing them every 4
hours of the operation based off of a weight-based algorithm. "It
had to be that granular," he says.
PREDICTABLE OUTCOMES
Never Make Good on Your Warranty
