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How Patient-centered Surgery Boosts Hospitals' Bottom Line

Health Governance Report, September 9, 2010

Patient-centered surgery 

Surgical services are a leading source of revenue for many hospitals. The OR increasingly acts as a financial engine for the organization, and more complex surgeries and greater volume typically add up to a better bottom line.

But from the patient’s perspective, surgery is scary and unknown. Whereas hospitals and physicians increasingly depend on surgical volume, patients want to be cut open as infrequently as possible—ideally, never. However, these disparate views on surgical services converge in the growing movement to make healthcare more patient-centered. As one of the most frightening and expensive stages in the care continuum, surgery has the most to gain from a more patient-centric approach. And although there are many idealistic reasons for emphasizing the patient’s needs, doing so is also perhaps one of the best ways to achieve the volume and efficiencies needed for financial success.

“A patient that has a nice experience is going to come back again. They might be one of my best marketers or referrers out there,” says Holly Lorenz, vice president of patient care services and CNO at University of Pittsburgh Medical Center (UPMC) Presbyterian, a 765-staffed-bed trauma center.

So what is the difference between a surgical process that is patient-centered and one that isn’t? The Institute of Medicine defines patient-centered care as establishing a partnership between providers and patients and giving patients the support they need to make decisions and participate in their care.

That’s easier said than done, though. No hospital is as patient-centered as it can be, says Lorenz. There are many reasons patient-centered care remains a struggle: The engaged, highly informed patient of the future is still a rarity; healthcare consumerism has stalled because the system lacks the transparency that makes markets work; and the reimbursement system discourages care coordination and integration.

Despite these obstacles, many providers are making strides in involving patients and families in the surgical care cycle. Those that are successful often enjoy better outcomes, lower costs, and higher overall patient satisfaction. “It’s so much more appropriate and easier to provide a good patient experience than to do service recovery on a bad experience,” says Lorenz.

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