Optimizing surgical operations: Strategies for enhancing efficiency and revenue 

In the evolving landscape of surgical optimization, healthcare organizations face several key challenges that impact both operational efficiency and financial performance. One of the biggest hurdles they encounter is maintaining alignment between preference cards and their supply chain management system, which is essential for accurate inventory control, reducing waste and ensuring the availability of necessary supplies. High procedure cancellation rates further complicate operational stability, leading to inefficiencies and potential revenue loss. Additionally, the synchronization of Current Procedural Terminology (CPT) codes is crucial for minimizing billing errors, ensuring revenue integrity and improving overall efficiency. To address these issues effectively, a comprehensive approach is required to align systems, streamline processes and uphold the accuracy of coding practices to optimize both clinical and financial outcomes. 

Enhancing surgical operations through optimization strategies 

Optimizing surgical operations involves several critical strategies to ensure your health system functions efficiently and delivers optimal patient care, including: 

1. Enhanced Epic Procedure Pass: Implementing a more robust Epic Procedure Pass helps reduce surgical cancellations and improve patient safety by streamlining the scheduling and preparation process. This approach ensures that surgical operations proceed as planned and minimizes disruptions, resulting in enhanced overall patient care. 
2. Closed-loop supply system: Creating a closed-loop system for the "Life of a Supply" is essential for securing revenue integrity and reducing billing errors. By managing every step of the supply lifecycle—from procurement and inventory management to usage documentation and claims submission—this comprehensive approach ensures accurate billing and minimizes the risk of claim denials, resulting in protecting revenue. 
3. Improved charge capture: Enhancing charge capture for billable services and supplies is vital for maximizing revenue. Implementing more precise methods for documenting and charging for services ensures that all billable activities are captured accurately, leading to better financial outcomes. 
4. Optimized scheduling: Streamlining scheduling processes to enhance efficiency and revenue generation is another key strategy. By optimizing surgical schedules, health systems can improve operational efficiency, reduce delays and improve the overall productivity of surgical teams. 
5. Streamlined documentation workflows: Simplifying documentation workflows leads to faster revenue cycle turnover. By improving the efficiency of documentation processes, healthcare organizations can accelerate billing and claims processing, reducing administrative burdens and improving cash flow. 
6. Review and audit of preference cards: Establishing regular review and audit of preference cards ensures that supplies and implants are consistently aligned with procedural areas. This prevents delays in claim submission and maintains accuracy in supply management, contributing to smoother operational processes and fewer billing issues. 

By focusing on these recommendations, healthcare organizations can enhance operational efficiency, optimize revenue management and improve patient care delivery. 

Assessing the situation and uncovering potential 

An assessment to identify opportunities for enhancing efficiency, streamlining workflows, and maximizing revenue generation while maintaining high standards of patient care can help your organization get started. When conducting the assessment, key activities should include the following: 

• Conduct a thorough review of procedural items, item master setup, and Charge Description Master (CDM) to ensure accuracy and completeness. The CDM, also known as the Chargemaster, is a comprehensive listing of items billable to a hospital patient or a patient's health insurance provider. 
• Verify the functionality and accuracy of Epic Procedure Pass to improve data integrity and streamline documentation processes. This is a feature within the Epic electronic health record (EHR) system that helps healthcare providers manage and streamline the scheduling, documentation and billing of medical procedures. 
• Assess the current preference card maintenance strategy to ensure alignments with clinical workflows and surgeon preferences. These preferences refer to the specific instruments, supplies and equipment that individual surgeons prefer to use during their procedures. They are detailed in preference cards, which are customized lists that outline everything needed for a particular type of surgery performed by a specific surgeon. 
• Conduct a thorough review of charging processes to identify potential revenue leakage and opportunities for improvement. 

Maximizing financial impact and self-sufficiency 

Focusing on improving surgical operations efficiency can deliver measurable value to healthcare organizations. When conducted collaboratively across Revenue Cycle, OR Operations, and IT teams throughout the process, healthcare organizations set themselves up for long term success by making ongoing improvements to their system and workflows. 

Baker Tilly utilizes these surgical optimization strategies to work with our clients to implement repeatable targeted processes, conduct comprehensive data-driven assessments, identify the best opportunities for improvement and leverage our industry experts for remediation planning that drive results. 

By adopting this surgical optimization approach, healthcare organizations can enhance data consistency, improve patient care by reducing inefficiencies and prevent revenue loss by streamlining workflows. 

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