Patients are much more comfortable when they know they can get ahold of you and that you can see them if they need to be seen.
HLM: What ways do you measure patient satisfaction?
Frisch, MD: It can be different everywhere, but for my center it's a bit of a hybrid approach. We have some internal surveys to look at satisfaction and track our patients and their experience. We're actively trying to engage them in that process in terms of ways we can improve their subjective perception of their experience.
We also track functional outcome metrics, which reflect objective information about how patients do after surgery.
HLM: How can ASCs optimize patients' health—and the odds of good outcomes—prior to surgery?
Frisch, MD: An app we use called PeerWell makes my job a lot easier. Unfortunately, we don't have hours and hours to sit down with patients and have multiple discussions to go through all of the material they should understand.
For example, people with poor nutrition may be predisposed to issues with wound healing and infection, so we target nutrition aggressively. For most patients, the content in PeerWell's PreHab program helps patients understand how they should eat. But for patients who need extra assistance, we'll send them to a nutritionist before surgery.
HLM: What's your advice for meeting patients' expectations specifically when it comes to pain management while practicing more careful prescribing? After all, a study published in JAMA Internal Medicine just last month showed that patient satisfaction declines when clinicians say 'no' to their requests.
Frisch, MD: Ambulatory surgery, when it comes to joint replacement, has really pushed what we call perioperative pain management, which uses multimodal protocols.
It used to be that you could give out narcotics and manage the pain, and patients never really called complaining of pain. But it wasn't addressing the problem. It was a reactive approach.
Now, we're proactively targeting pain—which means for a surgery center we have to be organized—so that when patients leave, they have everything they need available. We give patients their prescriptions in advance so they can have them filled, and we have them bring them on the day of surgery. There, we'll go over the medications and a schedule of when to take them. And we try to target non-opioid medications, such as Tylenol, NSAIDs, and gabapentenoids.
Whereas we used to give medications to take as needed, now we've put together a schedule for the first two weeks, in which many of these medications are scheduled for every six to eight hours, so that the only time they need a narcotic is for breakthrough pain.
Debra Shute is the Senior Physicians Editor for HealthLeaders Media.