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Speaker: Facility, staffing issues contribute to success of spine ASCs
LAS VEGAS — At the International Society for the Advancement of Spine Surgery Annual Meeting, Richard A. Kube II, MD, FACSS, FAAOS, CIME, of Prairie Spine and Pain Institute, in Peoria, Ill., discussed factors he found were important when he began a spine ambulatory surgery center 5 years ago.
“Before you begin, obviously, you have got to figure out whether or not you are going to be able to attain the same surgical results. The patient is always at the middle of the process,” Kube said.
In terms of which procedures are most appropriate to perform at a spine ambulatory surgery center (ASC), he said patient selection is more critical than it is in other settings. A T10 to pelvis procedure is likely out of the question, for example, but Kube said he successfully completed a four-level fusion at his center and the patient was discharged home the next day.
“You have to know your limitations,” Kube said.
Richard A. Kube
He said many considerations that are key to establishing an ASC are issues physicians do not typically face, such as dealing with facility preparedness, state mandates and staffing issues. It is important to know, for example, whether patients in your state need to be discharged in 23 hours, if patients can stay until the next day and, if patients are allowed to stay until the next day, whether an extended stay license is required, he said.
When it comes to selecting staff for a new spine ASC, Kube said to focus on quality and experience.
“Make sure you are hiring the appropriate kind of people. Make sure you are hiring good-quality people. It is worth spending a little extra money to get those types of people in your facility,” he said.
Kube built his facility and suggested that surgeons who have this approach in mind also have “a strong physician leader involved in that process or a strong management leader in that process.”
To date, Kube has performed more than 1,000 cases at his ASC.
“I think we transferred one patient in that time who had an epidural leak. [That] is just not something you can do in our setting,” he said. – by Susan M. Rapp
Reference:
Kube RA 2nd. Symposium: The spine ortho-neuro ASC: Staying ahead of the curve in spine care. Building a spine ASC, 5 key points. Presented at: International Society for the Advancement of Spine Surgery Annual Meeting; April 6-8, 2016; Las Vegas.
Disclosure: Kube owns the Prairie Spine and Pain Institute.