Breaking Through the Economic Barriers of Anesthesia Information Management Systems.

Anesthesia information management systems (AIMS) are being increasingly used to assist the delivery and documentation of anesthesia services in the United States. The major benefits of AIMS cited in the literature are the ability to (1) reduce costs, (2) facilitate quality assurance and quality improvement processes, (3) increase the accuracy and completeness of the anesthesia record, and (4) improve adherence to recommended guidelines. The major drawback, especially for rural hospitals, is the cost. This article identifies 2 of the main elements of AIMS that exist in information technology and data systems already present in a hospital. In this project, the medication dispensing system was used to achieve a 70% reduction in drug costs, and a simple electronic database was created, which detected adverse events that were missed with the legacy quality assurance system. There was no additional cost to the hospital to realize these benefits because this project utilized technologies and data systems already in place and staff time was part of the normal workload. This project showed that it is possible to achieve 2 of the major benefits of an AIMS without the major cost of purchasing one.

Evidence-based management assessment of return on investment from anesthesia information management systems.

A systematic and comprehensive review of the scientific literature revealed 4 evidence-based methods that contribute to a positive return on investment from anesthesia information management systems (AIMS): reducing anesthetic-related drug costs, improving staff scheduling and reducing staffing costs, increasing anesthesia billing and capture of anesthesia-related charges, and increased hospital reimbursement through improved hospital coding. There were common features to these interventions. Whereas an AIMS may be the ideal choice to achieve these cost reductions and revenue increases, alternative existing systems may be satisfactory for the studied applications (i.e., the incremental advantage to the AIMS may be less than predicted from applying each study to each facility). Savings are likely heterogeneous among institutions, making an internal survey using standard accounting methods necessary to perform a valid return on investment analysis. Financial advantages can be marked for the anesthesia providers, although hospitals are more likely to purchase the AIMS.

Assigning surgical cases with regional anesthetic blocks to anesthetists and operating rooms based on operating room efficiency.

The popularity of regional anesthesia blocks for both intraoperative anesthesia and postoperative pain management supports the inclusion of the administration of regional anesthesia into discussions about operating room (OR) efficiency. This article reviews the literature on OR efficiency with a focus on day-of-surgery decision making. Vignettes show regional anesthesia block placement is a variable that can affect the efficiency of use of OR time. Clinical examples highlight OR management issues and staff assignment decisions on the day of surgery. Regional anesthetic block placement can affect surgical schedules, and thus OR efficiency. When patient safety is unaffected, rearranging OR schedules on the day of surgery to place regional blocks, meet surgeon requests, or move up incision times should generally not be done if doing so results in otherwise unnecessary increases in overutilized OR time.

Economics and the education of nurse anesthetists: Part 2.

Economic assumptions and other factors affecting the economics of nurse anesthesia education are presented in Part 2 of this 2-part column. In Part 1, published in the October 2004 issue of the AANA Journal, general economic principles and healthcare economic principles in particular were described, explained, and related to the current US healthcare system.