Orthopedic and multispecialty surgery centers are increasingly adding high acuity cases like total joint replacements to their current case mix. How will your hospital deal with this new competition and how can you learn from the best practices of outpatient environments? This webinar will give an overview of how the Orthopedic Surgery Center of Orange County, a subsidiary of Hoag Orthopedic Institute, introduced a 23-hour hip replacement offering. Gabrielle White, RN, CASC, will cover: – Why they do total hip arthroplasty in their ASC – How they select the right patients – How they prepared their center for total hip surgery – Pre-op and post-op care of the patient – Contracting – Quality and satisfaction scores over the years About the Speaker: Gabrielle White, RN, CASC, has over 23 years experience in the health care industry with a background in peri operative nursing and ASC administration. She is currently an Executive Director at Hoag Orthopedic Institute where she has clinical, business and administrative oversight of the Orthopedic Surgery Center of Orange County and leads Network Development for Hoag Orthopedic Institute with a primary focus on bundled payment programs and growth strategy with self-insured employers.

1. GABRIELLE WHITE, RN CASC
EXECUTIVE DIRECTOR AMBULATORY SERVICES AND NETWORK DEVELOPMENT
HOAG ORTHOPEDIC INSTITUTE /
ORTHOPEDIC SURGERY CENTER OF ORANGE COUNTY
GWHITE@OSCOC.COM
WWW.OSCOC.COM
TOTAL HIP ARTHOPLASTY IN AN ASC

2. OUR BACK GROUND
Since 2007
Capacity
Length of stay
Changes in technique and pain management
Space
Time
Very well prepared

3. WHY?
Value – outcomes & satisfaction / cost
Simple for the patient
Younger people needing THA
Safe
Higher RN : patient ratio
More accepted
ACL – > 10 years ago…

4. Getting started
Surgeon & office
Anesthesia
Team
Support
Training
Mock process
Policies and processes

5. Patient selection
BMI
Health History
Insurance
Social support
Willingness

6. Pre admission
MD office
Labs
Communication
Education
Coordination
Skin prep

7. Day of surgery
Pre op
OR
Equipment
Environment – airflow, closed OR
Supplies
team
PACU
23 hour/Extended stay
PT

8. Post op
Medication
Discharge
Follow up
Therapy
DME
Quality data
Satisfaction

9. Equipment
OR positioning
Trays
Implants
Suction
Imaging
Complications
Emergency

10. Costs
Supplies/packs
Space suits
Equipment / trays
Implants
Overnight stay

11. Payers
Why your ASC – safe, value
Know your data – quality, satisfaction
Know your costs
Know what price you need
Implant carve out
23 hour stay
Total hip
CPT 27125 partial THA
CPT 27130 THA

12. After the surgery center
Discharge time
Instructions
Home Health
Follow up