Want to know why you lose cases to other facilities?

Use this simple form to answer that question

Would you like to find out why your surgeons are sending cases to other facilities? Increase your caseload? How would you like to achieve both of those goals with one simple form?

This is exactly what has happened at Hanover, MA-based Ambulatory Surgical Centers of America (ASCOA) when Tyler Merrill, vice president of business development, developed a patient exception form for his centers. (See copy of the form.)

"The impetus was to capture all of the cases from the partners that we possibly could and uncover any sort of roadblock that we might not know about at the center," Merrill says.

In sitting down with the schedulers from the physician's offices, surgery center staff realized that there were a number of cases that could have been performed at the surgery centers, but weren't. "We wanted to know why," Merrill says.

The form lists potential reasons that the surgeon might have taken the case to another facility, including patient choice and not enough block time. In some cases, the ASCOA staff realized that the schedulers were relying on outdated information.

For example, in 2007, they thought any lesion smaller than 6 cm was considered to be an office procedure. However, the Centers for Medicare & Medicaid Services had changed the reimbursement policies and would reimburse those cases at surgery centers, Merrill says.

The surgery center staff collected the completed patient exception forms at the end of the month. They looked for the large stacks of paper to see who isn't being best accommodated at the center. "We'd get a process in place to identify problems," Merrill says. "Hopefully, we would see the stacks shrink over time."

While no one likes additional paperwork, the schedulers kept the patient exception forms next to their phones so they were more likely to fill them out. In terms of the physicians, it covers their backs, Merrill says. "At our physician partner meetings, I can look them in the eye and ask, 'Are you doing everything you can at the center?" This is their backup to say, 'I'm doing everything I can. For the cases that didn't come here, here's why.'"

In the case of one very busy ear, nose and throat (ENT) physician, the form indicated that the surgeon needed additional block time. "In the past, patients waited a week and half for tubes that needed to be put in for ear trouble," Merrill says. "Now, we can accommodate them within a week. Opening up more time at the center eliminated that hurdle."