Leadership Series | Challenges Facing Orthopaedic Surgical Practices - Efficiency in Value-Based Payment Structures | Featuring Dustin Carneal & Daryl Osbahr, M.D.

This blog is the second part of our series of interviews with leaders in orthopaedic surgery management. 

At CaseCTRL, we believe in supporting the orthopaedic community as it strives to elevate the experience for surgical patients while also achieving efficiency and better care coordination throughout the surgical scheduling process to improve quality of care and profitability. With
this in mind, we recently talked with several surgical practice leaders about common challenges and strategies they are employing at their organizations.

Challenge 2: As value-based payment structures continue to take hold, orthopaedic practices are charged with operating more efficiently and nimbly while driving better outcomes.

Managing cost and quality associated with surgical readiness involves complex workflows aligning disparate teams within the practice as well as external stakeholders, from hospital to equipment supplier to insurer to patient.

As practices are challenged to improve cost and care quality, several steps can be key:

  1. Aim for a shared view of workflow. Ensuring multiple users have a real-time view of workflow status can best ensure vital pre-surgical steps, such as obtaining patient medical clearance and ensuring equipment reservation, will complete as needed with least likelihood of duplicative communication or miscommunication.

  2. Include readiness metrics in your practice’s performance dashboard. Practice dashboards should drill beyond on-time starts, giving insights into underlying areas, such as delayed pre-surgical clearance, missing pre-authorizations, inaccurate medical coding and insufficient completion of pre-admission testing. By examining trends over time, your team will be best positioned to adjust workflows around pain points.

  3. Don’t be afraid to innovate. Experts like Dustin Carneal are leading the way in innovation.

    “Such input can be powerful”, notes Dustin Carneal, Clinical Pharmacy Manager at Aurora BayCare Medical Center in Green Bay, Wisconsin. “Working in advance with the surgeon, pharmacists conduct medication reviews, evaluate the patient for clot risk, and identify any medications that can be held in the preoperative setting,” explains Carneal. “This puts us in a better position to lessen the period between inpatient admission and discharge, so patients can go home and have the shortest length of stay possible.”

    Under the program, the pharmacist also reviews medications against allergies, ensures inpatient orders match with the preoperative assessment, identifies opportunities for lower-cost medications, verifies use of DVT prophylaxis and antibiotics as needed, ensures those patients who use insulin receive proper education about administration around the surgery and reviews the patient’s pain management plan.

    Blood sugar management and antibiotic use often present performance opportunities, notes Carneal. “We did an evaluation of infections over a three-year period and identified they all met one of three criteria or a combination of those three criteria: elevated blood sugar after surgery, underdosing of antibiotics or a history of osteomyelitis. So if we can take care of blood sugar and antibiotic dosing, we should be able to really impact a lot of patients at greatest risk for infection complications.”

  4. Create a culture of transparency. Another approach to support quality is using group scorecards that track performance by the individual physician. Transparent performance is a great motivator, notes Daryl Osbahr, MD, Chief of Orthopaedic Surgery and Managing Partner for Rothman Orthopaedics in Florida as well as the Executive Medical Director for the AdventHealth Orthopedic Institute.

    “I’m able to see my scorecard versus every other Rothman physician,” he says. “And we’re able to look for outliers, not to penalize our physicians and surgeons, but to enable them to grow and get better and feel accountable for quality. Achieving high standards stems very much from a culture of transparency and learning.”

As healthcare trends towards value-based care, practices are focusing even more on efficiency while maintaining quality patient care. The key learning is to maximize the resources available, which can be far more rewarding than simply cutting costs.

Maximize your practice's efficiency with a surgery management platform like CaseCTRL.

We are a platform designed to create visibility for the surgery management process, and help increase revenue through recovering cases and decreasing case cancellations. Learn more by booking a demo with us today.

Special thanks to the leaders who have shared their expertise: 

Daryl C Osbahr MDDaryl Osbahr, MD, is Chief of Orthopaedic Surgery and Managing Partner for Rothman Orthopaedics Florida as well as the Executive Medical Director for the AdventHealth Orthopedic Institute, and the Orthopedic Residency Director for AdventHealth.

Read Full Bio Here 


Dustin Carneal

Dustin Carneal, is a clinical pharmacist at Aurora BayCare Medical Center and is chair-elect for the ACCP Perioperative Care Practice and Research Network. In 2022, Dustin received the 2022 Upsher-Smith Excellence in Innovation Award from the Ohio Pharmacists Association. This prestigious award recognizes a pharmacist who has demonstrated innovative pharmacy practice resulting in improved patient care.

Learn More About Aurora BayCare Here

Supercharge your surgical scheduling. See how caseCTRL can work for you. Show me a demo.
Related Posts
Post Topics

Related CaseCTRL News

March 13, 2023
Reaching new surgical patients is vital to driving more surgery scheduling and volume in your practice. There ...
October 2, 2020
With the CaseCTRL platform, surgeons schedule more cases while decreasing the administrative workload for ...
August 20, 2020
The theme of 2020 has been emergency preparedness. Surgical practices across the country have had to navigate ...