THE Aesthetic Show

FIXING THE
PERIOPERATIVE
PATIENT
EXPERIENCE
July 6-9, 2017 The Wynn Las Vegas, NV

Unity Custom Care Inc. All Rights Reserved.

 FIXING THE PERIOPERATIVE PATIENT EXPERIENCE

Good afternoon and welcome!

20 years of experience as a surgical

technologist

10 years as a sales consultant for a high-

end Beverly Hills plastic surgery practice

Experienced business consultant, trainer

and lecturer

Co-founded Unity Custom Care the

Monica Berlin leading provider of perioperative patient
VP Marketing & Sales / Co-Founder
care services
Unity Custom Care Inc.
monica @ unitycustomcare.com
Unity Custom Care Inc. All Rights Reserved.
 FIXING THE PERIOPERATIVE PATIENT EXPERIENCE

DISCUSSION OUTLINE

Whats Wrong
Common shortcomings of the perioperative patient experience today.

Why This Matters Now More Than Ever

Neglecting perioperative care damages your patients and your practice.

A Call to Action
Steps you can take to become a leader in perioperative patient care.

Unity Custom Care Inc. All Rights Reserved.

 FIXING THE PERIOPERATIVE PATIENT EXPERIENCE

A Broader, Patient-Centered Definition of Perioperative

Perioperative: relating to, occurring in, or being
the period around the time of a surgical operation

spanning the entire surgical care continuum

Pre- and Intra-

Pre-Admission Post-Operative Post-Discharge
Operative

Assessment, Surgery Prep,

Outpatient Recovery
Testing, Operating Room, Inpatient (up to 30 days)
Education Post-Anesthesia Recovery
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 FIXING THE PERIOPERATIVE PATIENT EXPERIENCE

For Unhappy Patients, the Culprit is Poor Clinical Care Not Surgical Results

ONLY

OF ONE-STAR REVIEWS CITE

SURGICAL RESULTS
Unhappy patients
overwhelmingly complain
about quality of clinical care
Source: JAMA Facial Plastic Surgery Research Letter, 1/26/17 (dermatologists, plastic surgeons and facial plastic surgeons in 5 major cities 200 reviews meeting stringent criteria)

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 FIXING THE PERIOPERATIVE PATIENT EXPERIENCE

Negative Reviews Tell the Story

Negative Reviews Follow Similar Patterns and Social Media Acts as a Megaphone
EDUCATION &
FOLLOW-UP

After my rhino, no one really taught me about taping

or checked on me. I guess I should have been braver
and asked some questions
BEHAVIOR

Its all about making money - the office staff didnt

STAFF

seem to care about me.

I had a few simple questions before surgery, but

TIMES
WAIT

nobody called me back. When I finally got through,

they couldnt schedule time to see me, not even 10
minutes.

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Do You Recognize Any of These Points of Failure?
Pre-Admission
Overburdened staff rush
patient intake, assessment
and discharge planning.
Pre-operative testing is
disjointed.
Aftercare instructions are not
evidence-based and are
difficult to follow.
Information provided by
surgeons office conflicts with
the surgery center/hospital.
Patients are not prepared for
surgery or outpatient recovery.
FIXING THE PERIOPERATIVE PATIENT EXPERIENCE
Pre- and Intra-Operative
Scheduling problems,
coding errors and missing
paperwork delay start
times.
Poor teamwork on the day
of surgery is noticed by
patients.
Surgery center staff not
sufficiently attentive to
family and caregivers
during surgical procedures.
Patients, family and caregivers
are all more anxious than
they need to be.
Unity Custom Care Inc. All Rights Reserved.
Post-Operative
Clinical systems are unable to
flag when a patient falls
behind clinical pathway
milestones.
Pain, hydration and nausea
not well managed.
Patients not informed about
what to expect, especially
during handoffs.
Staffing and communication
snafus delay patient transfers
and discharge.
Patients are uncomfortable
and their anxiety continues.
Post-Discharge
Chaotic discharge process
leads to confusion around
post-discharge care,
medications and follow-up.
Patients lack single point of
contact for authoritative,
24/7 recovery support when
they have questions.
Infections and other
complications are not caught
early enough to prevent
readmission.
Patients struggle with self-
care and feel alone when
questions or problems arise.
 FIXING THE PERIOPERATIVE PATIENT EXPERIENCE

Why This Matters

Benefits of Becoming a Perioperative Care Leader
BETTER COMPLIANCE DECREASED COSTS
HAPPIER PATIENTS AND MORE BUSINESS
AND OUTCOMES

Less Anxiety Better Understanding of Fewer Post-Op Calls and

Aftercare Instructions Unplanned Visits
Less Uncertainty More Help in Following More Favorable Reviews
Aftercare Instructions
More Emotional Support Increased Referrals
Fewer Adverse Events
Less Loneliness Easy Way to Satisfy OR
Faster Reaction Time to
Accreditation Requirements
Medical Issues
for Patient Surveys

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 FIXING THE PERIOPERATIVE PATIENT EXPERIENCE

Better Perioperative Care = Lower Cost of Care

Clinical cost reduction modeled for three types of events:
Unplanned post-op patient calls to the clinic
Unplanned post-op patient clinic visits
Adverse events requiring ER or surgeon visit
Assumptions made for:
The amount of time required for each of these event types, for both typical patients and more needy patients
The frequency of these events as experienced by typical aesthetic surgery practices
Estimated cost avoidance for practices with 3-4 surgeries per week is $3,000 to $5,000 per month

Clinical Care Cost Avoidance per Month Assumptions

$9,000 Clinic staff wage rate (fully loaded) $40 per hour
$8,000 Physician wage rate (fully loaded) $600 per hour
$7,000
Typical Patient Needy Patient
$6,000 Clinic staff time per patient call 15 minutes 20 minutes
$5,000 Physician time per patient call 5 minutes 10 minutes

Calls
Cost per patient call $60 $113
$4,000
# calls avoided per patient 2 6
$3,000 Clinic staff time per patient visit 30 minutes 30 minutes

Office
$2,000 Physician time per patient visit

Visits
20 minutes 30 minutes
Cost per patient visit $220 $320
$1,000 # clinic visits avoided per 100 patient 5 15
$0 Clinic staff time per adverse patient event 45 minutes 60 minutes

ER Visits
Physician time per adverse patient event 160 minutes 180 minutes
4 6 8 10 12 14 16 18 20 22 24 Cost per adverse patient event $1,630 $1,840

Number of Surgeries per Month # adverse events avoided per 100 patients 1 2
One in twenty patients are needy (5%) One in seven patients are needy (15%) One in four patients are needy (25%)

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 FIXING THE PERIOPERATIVE PATIENT EXPERIENCE

Why is Now the Time to Step Up?

Lack of Innovation in Perioperative Care Approaches

Opportunity for innovators to make a big impact and stand out from the crowd.

Best Way to Eliminate Negative Reviews

Unhappy patients overwhelmingly cite problems with clinical and perioperative care.

Growth in Male Patients Increases Pressure on Perioperative Care

They ask fewer questions, are less likely to express concerns and dont tolerate downtime or pain
as easily.

Third-Party Providers and Telehealth Tools Now Available

Perioperative care service providers bring technology and expertise to deliver exceptional patient
experiences. New, technology-enabled methods to interact with patients enhance perioperative care.

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 FIXING THE PERIOPERATIVE PATIENT EXPERIENCE

A Call to Action
CHARACTERISTICS OF A SUPERIOR PERIOPERATIVE EXPERIENCE

The Caregiver Is.. The Caregiver Is Not..

DEDICATED PART-TIME
Full-time role, cares for each patient Rushed, juggling other tasks, no
from intake through recovery continuity of care

WHOLE PATIENT FOCUSED CHECKLIST-DRIVEN

Focused as much on emotional Working off a script, focused on
support as medical care record-keeping and recording vitals

EXPERT IN POST-OPERATIVE CARE GENERALIST

Deeply familiar with surgical recovery and Works with many surgeons and
surgeons aftercare instructions specialties

ALWAYS ACCESSIBLE SCHEDULED

24/7 on-demand coverage via Contacts patients via outbound voice
phone and electronic methods calls at scheduled intervals

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 FIXING THE PERIOPERATIVE PATIENT EXPERIENCE

Commit to Being a Leader in Perioperative Care

Update Your Patient Education Materials
1
Readability
Accuracy
Accessibility

2 Demonstrate Leadership and Train Your Office Staff

Culture set from the top: the patient experience matters
Relationship-driven patient interactions: we know you and we care
Proper balance of medical and emotional support
Improve Your Perioperative Processes and Protocols
3
Intake: sufficient time to educate and prepare patient, provide patient portal
Surgery: keep caregivers appraised
Recovery: time commitment, wait times, handoffs, after hours, documentation
Dedicate a Full-Time Perioperative Care Provider to Your Patients
4
Single individual supports 2-3 surgeons, or
Contract with a third-party perioperative care provider
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THANK YOU!