Minor procedure area offers lower costs
Minor procedure rooms offer new revenues to physicians for same-day surgery facilities and advanced technology, while keeping costs low.
At Egleston Children’s Hospital in Atlanta, two minor procedure rooms were built into the day surgery unit. They are staffed by two RNs or one RN and a patient care tech. Those employees are cross trained to handle pre-op testing and day surgery admission and discharge.
The rooms provide a clean but not sterile environment. They contain procedure lights, monitors, and a storage area, and they are wired for lasers. Toys and a VCR are provided in each room, and the ceiling tiles were painted by children.
Only procedures using local or regional anesthesia or sedation are conducted in the rooms. The fee is usually reimbursed by the patient’s insurance. Egleston offers four levels of service in the minor procedure area:
• Limited. Physicians may use the room as an extension of their office. An RN will take vital signs of the patient, but physicians do everything else. For example, they may use the room to remove sutures.
• Intermediate. Physicians use the room for less than an hour, with the assistance of an RN or patient care technician. For example, they may remove a pin from a patient’s foot or perform a neonatal circumcision.
• Conscious or deep sedation. Sometimes pediatric patients need to be sedated for certain dental procedures or lengthier but still minor surgical procedures, such as removal of a cyst from the eye. This level of care requires at least one RN.
• Observation. Some physicians have used the rooms to provide observation of patients during a growth hormone study. This care lasts four to five hours.
The minor procedure area provides a way to add cases and revenue beyond the natural fluctuations of the OR, says Janette Issa, RN, CAPA, administrative director of day surgery and pre-op. And it has an appeal for payers, too. "It’s far more inexpensive than usual hospital care," she notes.
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