Bozic Value-Based Health Care in Orthopaedics

Chapter 16: Orthopaedics as a Service Line

TABLE 1 Surgeon Champion Characteristics and Goals

Energetic Motivated to increase volume and improve clinical practice efficiency

Administration Champion Similar to identifying an executive surgeon champion, it is equally important to align with an administration champion who is able to understand a surgeon’s perspective with regard to clinical, perioperative, and postoperative growth, and areas for improvement and optimization. Furthermore, administration leaders have to be willing to work creatively, have endurance to overcome frequent obsta cles, and have the ability to invest time, money and appropriate personnel support to develop a service line. Ultimately, administration champions are responsible for ensuring return on investment through appropriate surgical volume with decreased expenditure in the correct site of care in conjunction with the surgeon. Core Conflicts Surgeons often have difficulty dividing their focus and attention between patient care and hospital management and administrative duties. Surgeons who are unable to allocate their time appropriately to meet clinical and administrative duties can often experience burnout. Burnout syndrome is marked with emotional exhaustion, depersonalization, and low job satisfaction and outcomes. 17 This is especially relevant as burnout rates among orthopaedic surgeons are substan tially higher than those in the general population and many other medical sub specialties. 17 Surgeons also face a clash between goals and demands (providing value-based health care versus optimizing revenue but mitigating costs). Due to their innate nature, most surgeons may think that they possess the ability to per sonally fix all problems. It is important to realize that success in establishing a service line, and its longitudinal productivity, is an evolving process that requires constant learning, growth and potential for improvement by making and learning from mistakes. Unlike some orthopaedic complications that can often be rectified immediately in the short term, problems occurring during the business of running a service line may take longer to solve. Nonclinical leaders may have difficulty seeing past costs to initiate a service line and through adoption of technologies that may require capital investment. Hospitals and surgery departments are often working with decreasing capital Team player with administration and staff Interested in controlling hospital costs Supports the operational team and establishes a productive and positive operating room culture Uses data and research to drive change Copyright © 20 Wolters Kluwer, Inc. Unauthorized reproduction of the content is prohibited. 23

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Value-Based Health Care in Orthopaedics