CONTACT: JENNIFER CRONIN
2130 Medical Laboratories
Iowa City IA 52242
(319) 335-5661; fax (319) 335-9917
Release: April 30, 1999
UI researcher shows economic benefit of hospitals fast-tracking
IOWA CITY, Iowa -- Patients used to spend several hours,
sometimes days, in the hospital following surgery. Now, many individuals walk
out the hospital door less than an hour or two after waking up from procedures.
The speedy process is due largely to fast-tracking, which involves keeping
patients who are under general anesthesia in a lighter anesthetized state
so they regain consciousness sooner.
Many hospitals and health care centers have embraced this
new fast-tracking approach as a way to decrease staffing costs while maintaining
quality care. However, a University of Iowa researcher, working with colleagues
at Stanford and Duke universities, has found that the financial benefits of
fast-tracking may vary among institutions.
In an article that appears in the May 1 issue of the journal
Anesthesia and Analgesia, Franklin Dexter, Ph.D., M.D., UI associate professor
of anesthesia, showed that whether fast-tracking allows a hospital to reduce
staffing costs depends highly upon the institution's labor payment structure.
Fast-tracking can decrease an institution's costs because less staffing time
is required. Patients wake up more quickly and can leave the operating room
sooner. In addition, the patients might not have to stay in the recovery room
as long. If a hospital pays its ambulatory surgery center staff an hourly
rate and the fast-tracking reduces substantial overtime, the decrease in labor
costs can be significant. If a hospital pays its staff a set salary, the time
savings may not translate into financial savings.
Despite the varied financial implications, Dexter said
fast-tracking is here to stay.
"From the patient's point-of-view, it's an advantage because
it gets them out of the hospital quicker so they can be at home, be with their
families," Dexter said. "From a hospital's point-of-view, even if large decreases
in costs cannot be expected, fast-tracking will increase the productivity
of the workforce so staff members can do other things with their time. It
may not decrease costs but rest assured that it is going to increase productivity."
Dexter and his colleagues were funded in part by Aspect
Medical Systems Inc. to determine whether fast-tracking could save an institution
money. Aspect Medical Systems has developed technology to measure a patient's
level of consciousness during surgery. The monitor is useful for fast-tracking
because it helps anesthesia staff give patients just enough medicine so they
are unconscious during surgery but in a state from which they can awaken soon
after the procedure.
Aspect Medical Systems representatives
were interested in studying fast-tracking's financial savings to help hospitals
better understand how their monitors can decrease staffing costs. Dexter set
out to determine under what circumstances fast-tracking could save an institution
"What we really found is there is no one, single answer,"
Dexter said. "The economic impact is going to vary among institutions depending
on how people are paid. Many hospitals and ambulatory surgery centers are
considering the adoption of new medicines and monitors so that their patients
can leave within an hour or two after surgery. These institutions can use
our analysis to better predict the financial impact of this fast-tracking."