OR management.

Abstract

Market forces throughout the US, especially in specific geographic areas, have brought about profound changes in health care delivery. One of the most significant is the move to managed and capitated care with the resulting impact on hospital reimbursement. As these forces gain momentum, continually moving further from fee for-service, the hospital portion of the healthcare dollar continues to contract. In response, healthcare delivery organizations are developing innovative strategies to ensure the continual provision of cost effective care. Emphasis is placed upon keeping resources close to the point-of-care delivery. Necessary savings, reductions, and efficiencies must come from structural change, reengineering, best practice development, and more cost effective care delivery with highly standardized use of resources. Healthcare is in a transitionary stage. The transition has been from providing acute inpatient care to managing the continuum of care, from treating illness in individuals to providing education and maintaining wellness in the defined population. Revenue centers are no longer recognized; rather, in this increasingly capitated market, all, including operating rooms, are cost centers. The focus is no longer on filling beds, ORs, radiology suites, etc. The challenge is to find effective methods to minimize the needed resources to deliver high quality, cost effective care while maintaining and increasing patient and physician satisfaction. This article focuses on surgery in a large integrated system, Sharp Health care (San Diego, CA), a network of organizations providing, or arranging to provide, a coordinated continuum of services to a defined population.