While the COVID-19 pandemic continues to evolve with impacts shifting over time, some of the changes it brought to healthcare—specifically the OR—may be permanent. One trend it accelerated: the rise in new ambulatory surgery centers (ASCs), which specialize in elective or same-day outpatient surgical procedures. While this trend was largely driven at first by patient hesitancy to go to hospitals for fear of contracting COVID-19, other drivers quickly rose to the surface, including efforts to decrease hospital spending and an increase in outpatient procedures that were approved by the Centers for Medicare & Medicaid Services.
Today, according to the Ambulatory Surgery Center Association, more than 80% of surgical procedures are now done in an outpatient setting.
The benefits are clear: ASCs allow hospitals to save OR space for emergency procedures, and they better align with patient preferences that have shifted away from a hospital setting to an outpatient setting. Commercial payers generally favor ASCs as well because they typically involve less cost than a hospital setting thanks to lower infrastructure costs. A recent report from UnitedHealth Group found that shifting common outpatient procedures for non-complex, commercially insured individuals to ASCs would reduce the cost of procedures by an average of 59%, resulting in an average saving for consumers of $684 per procedure.
All of these benefits aside, building and opening an ASC can be overwhelming for OR managers. One surprising ally in the process? Medical supply distributors.
“It’s important to work with a distributor who views you as a partner; who views your success as their success,” says Jason Grzyb, national vice president for ASCs at Cardinal Health. “As part of this relationship, you and your medical supply distributor should be in constant communication throughout the planning, construction, and location launch process, so they can understand your goals to advise you on making better decisions.”
What should OR managers ask their distributors when they are considering opening an ASC? Below are five questions to guide potential conversations with distributors.
According to Grzyb, who supports ASC customers with their distribution needs, it is generally recommended to have an 18- to 24-month head start in supply ordering so a potential distributor can help to achieve opening-day goals.
“Your distributor can work with you to maximize your space, improve storage room planning, and optimize inventory management,” explains Grzyb. He also suggests asking the distributor to review floor plans and designs or consider support in mapping capital equipment such as fluid management systems. “Distributors can bring awareness of implications of minor changes that may, at first, appear insignificant but can directly impact the future of the ASC,” says Grzyb.
Penny Williams, RN, CNOR, CCSVP, senior consultant of clinical operations at Cardinal Health, suggests inviting clinical consultants to walk through the process of reviewing clinical standards—starting with standard procedure packs and recommendations based on services to be provided—for all new ASCs. For instance, if an ASC has existing relationships with physicians, a distributor can take preference cards after they are pulled and support the facility transition.
“Consider an inventory and supply management planning technology service,” says Williams. “Not only do these provide critical insights for product or supply levels—helping inform what to order and when to order—but it can also improve patient care by ensuring that expired or recalled products are never used on a patient.” Before joining Cardinal Health, Williams managed an ASC, and she has led several product trials and conversions.
A distributor should work within the set budget to adjust lists and should provide input and recommendations, according to Grzyb. “You and your vendor should work toward the same goals,” he says. “There may be savings opportunities on shipping and freight costs, which can add up quickly and are often not top of mind.”
He adds that “there also are automated technology platforms available that help OR managers reduce expenses by optimizing shipping, increasing visibility to shipments being made across the ASC, and more. Many of these solutions offer tracking and visibility programs that also help mitigate any shipping delays you might experience from time to time.”
Grzyb recommends working with the distributor to conduct a “dock to doc” walk through, with the goal of creating a clinically integrated supply chain.
When the supply chain is clinically integrated, it can:
• eliminate silos
• increase efficiencies
• increase patient satisfaction
• support savings.
“While managing your supply chain can be overwhelming, your healthcare distributor can be a resource,” says Grzyb. “Data and analytics can be leveraged to improve your supply chain, create efficiencies and savings, and utilize predictive analytics to better plan for the future.” Collaboration between supply chain, clinical specialties, physicians, and finance can promote benefits for physicians, patients, and clinicians.
The ASC accreditation process depends heavily on prompt delivery of the supplies and equipment needed to perform procedures for evaluation, advises Williams.
“Your distributor should offer support in meeting national and state-specific requirements,” she says. “They should have deep experience in making decisions through the accreditation process, acting as a connection to resources you may not be aware of.”
Planning and opening an ASC is rewarding, but it can also be overwhelming. “Remember that you have a partner in your medical supply distributors,” concludes Grzyb. “Ultimately, your distributor should be a source of knowledge and long-term support in ASC development.”