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Using Visual and Narrative Methods to Achieve Fair Process in Clinical Care

Using Visual and Narrative Methods to Achieve Fair Process in Clinical Care

Published on: February 16, 2011

Frameworks for value-based care in the nonoperating room setting.

Aakash Keswani¹, Brian Licht¹, Richard D Urman²

¹Department of Anesthesiology, Perioperative and Pain Medicine, Icahn School of Medicine at Mount Sinai, New York, New York.

Current Opinion in Anaesthesiology

|July 21, 2022

Summary

Anesthesiologists can maximize value in nonoperating room anesthesia (NORA) by improving clinical outcomes, quality, and patient-reported outcomes while reducing costs. A framework is presented for applying value-based care principles in NORA settings.

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Area of Science:

Anesthesiology
Healthcare Management
Value-Based Care

Background:

Nonoperating room anesthesia (NORA) offers a distinct setting for implementing value-based care (VBC) principles.
VBC in NORA involves optimizing care in office-based and nonoperating room inpatient settings.

Purpose of the Study:

To review the definition of value in NORA.
To identify principles enabling anesthesiologists to maximize value in NORA.

Main Methods:

Review of VBC principles and their application to NORA.
Adaptation of existing VBC frameworks from operating room anesthesia.

Main Results:

Value in NORA is defined as clinical outcomes, quality, patient-reported outcomes, and efficiency, divided by costs.
Strategies include improving clinical outcomes (e.g., reducing death, over-sedation), focusing on intermediate outcomes (e.g., nausea, pain), incorporating patient-reported outcomes (PROs), and reducing costs through efficiencies.
Key enablers include prioritizing safety, selecting appropriate patients, optimizing comorbidities, and efficient resource deployment.

Conclusions:

A novel framework is proposed for applying VBC to NORA.
This framework adapts current VBC practices from operating room anesthesia to the NORA environment.