2018 MEDICAL DIRECTORSHIPS AT THE WILLIAM W.
BACKUS HOSPITAL
Paul Pudimat, MD.
Director of Perioperative Services
For more than ten years I have allocated a portion of my clinical
time as Medical Director of Perioperative Services. The surgical
services environment, especially at community hospitals, has
undergone a great deal of change during that time – increased
production pressures, focus on outcome measures, everchanging
regulatory requirements, an exodus of cases, payor and case
mix changes, technology innovations and implementation
pressures. Weathering this constant barrage of change requires a
greater degree of alignment than ever before between surgeons/
proceduralists, anesthesiologists, nurses, administration, and all
other branches of allied health.
The model most often cited as best practice for perioperative
governance is the one that we have developed here at the William
W. Backus Hospital, namely a triad of clinical/administrative
leadership. The Chairman of Surgery, the Medical Director of
Perioperative Services, and the Nursing Director of Surgical
Services help navigate the changes necessary to support a clinically
excellent, fiscally sound surgical services program. As a member
of that triad I have worked to help manage resources to satisfy
surgical block requirements, service line growth and development,
appropriate use and expansion of technologies and our facility,
and to ensure regulatory compliance along the way. Two years
ago, Backus’ surgical services was the first area at our hospital
to engage in a Kaizen on the introduction of Lean management
principles throughout the Hartford HealthCare East Region. The
scope of our efforts was extraordinarily broad, which is why we
continue to work on some of those initiatives. We have made
significant changes in resource allocation in response to current
and future service line expansion. Many of the projects continue
to require re-evaluation as we improve our ability to utilize data to
study and adjust. Multiple dashboards have been prepared to permit
a more transparent dissemination of data to all stakeholders.
The recent establishment of the Perioperative Assessment and
Testing Clinic (PATC) is a demonstration of our organization’s
commitment to improving care for our patients. The need for a
uniform, comprehensive evaluation to improve patient experience
and outcome, especially appropriate testing, “pre-habilitation”, and
reduced readmissions, led to the development of the clinic. Further
information on the mission of the PATC and its structure will be
forthcoming.
As previously stated, regulatory requirements are ever-changing
and survey readiness is a high priority for surgical services. The
challenging transition to EPIC as our electronic medical records
system will provide dividends in terms of efficiency, data collection,
and clinical guidance for the care of our patients. I participate
on the Hartford HealthCare Perioperative Council, Hartford
HealthCare Anesthesia Council, and the Hartford HealthCare
ERAS Council – all in an effort to help develop best practice and
patient safety initiatives.
The future of surgical services and the perioperative care of our
patients requires data-driven decision making, and the ability to
make timely changes in service lines and deliver of services to our
patients. Culture change is difficult and often slow, but improved
communication will help insure that we are positioned for the
innovative transformation of the provision of surgical services at our
hospital. n
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