Defining the Value of Analgesia for Total Knee Arthroplasty Using Time-Driven Activity-Based Costing: A Novel Approach to Clinical Practice Transformation

Tsang, Alvin M; Jagannathan, Ram; Amundson, Adam W.; Smith, Hugh M.; Dankbar, Eugene C.; Zavaleta, Kathryn W.; Abdel, Matthew P.; Jacob, Adam K.

doi:10.1016/j.mayocpiqo.2021.09.005

Cited by 4 publications

(5 citation statements)

References 24 publications

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“…The TD-ABC approach made use of it at one point. Everaert, et al (Wei et al, 2021) (Hussaina & Abdulahad, 2022).outline six processes that must be completed to provide an answer to the research question and calculate activity costs (Tsang et al, 2021). Determine the total cost of all resources, the practical time capacity of all resources, the unit cost of all resources, the estimated time for each activity, and the unit cost of all resources multiplied by the estimated time.…”

Section: Methodsmentioning

confidence: 99%

“…This is because they didn't know how to do a formal cost analysis of their services and operations, and traditional costing was the most common method. In the traditional costing method, direct costs like labor and materials are directly linked to services (Tsang et al, 2021). However, it's different when it comes to Depreciation, training, and power are examples of indirect costs that are often ascribed to certain benefits depending on various factors, such as volume, direct labor, and the number of hours of service (Reis et al, 2021).…”

Section: Literature Reviewmentioning

confidence: 99%

“…Kaplan and Anderson developed the TD-ABC as a cost-management method to address the shortcomings of earlier systems. Based on a basic architecture that only requires two items (Tsang et al, 2021):…”

Section: Literature Reviewmentioning

confidence: 99%

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Using Time-Driven Benchmarking for Measuring Health Services Performance Under COVID-19 Pandemic

Ali¹,

Jabir²,

Kadhim³

et al. 2023

J. Professional Business Review

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Purpose: The aim of this study is to analyze whether time-driven benchmarking might be a helpful tool in assessing healthcare operations during the COVID-19 pandemic. Theoretical framework: The research examines the progress of eleven hospital procedures to analyze and evaluate them. This section also focuses on how time and cost data from the two hospitals we are exploring might be utilized to improve operations and performance, particularly in light of our time-driven benchmark. Design/methodology/approach: The research focuses on how to analyze time-driven benchmarking for Measuring Health Services Performance under COVID-19 Pandemic. This assessment entails the use of a strategic approach to determine the results of the review process from all financial and non-financial components of studies, research, and scientific papers found online and elsewhere. Findings: The results showed that the TD-ABC consisting of perspectives provides an innovative approach to evaluating the requirements for implementing the time-driven benchmarking in Two Iraqi hospitals, which helps Measuring Health Services Performance under COVID-19 Pandemic. Research, Practical & Social implications: The study examined the challenges and constraints of whether time-driven benchmarking might be a helpful tool in assessing healthcare operations during the COVID-19 pandemic. Originality/value: The study's originality value by assessing how to analyze time-driven benchmarking for Measuring Health Services Performance during the COVID-19 Pandemic in Two Iraqi hospitals.

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Section: Methodsmentioning

confidence: 99%

Section: Literature Reviewmentioning

confidence: 99%

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Using Time-Driven Benchmarking for Measuring Health Services Performance Under COVID-19 Pandemic

Ali¹,

Jabir²,

Kadhim³

et al. 2023

J. Professional Business Review

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“…Patient-reported outcomes (PROs) have gained traction as measures of patient-centered value because of their focus on both the immediate impact of care and long-term patient quality of life. Patient-reported outcome measures (PROMs) in anesthesia have been used preoperatively as a standardized tool to measure the overall health status, which provides a baseline against which to assess the trajectory of the patient's perioperative care, especially with respect to pain and one's ability to perform his/her activities of daily living [18,19 ▪▪ ]. Commonly used and high-reliability peri-operative PROMs include EuroQol- 5 Dimension (EQ-5D), 12-Item Short Form Survey (SF-12) and Patient-Reported Outcomes Measurement Information System Global-10 (PROMIS Global-10) [4].…”

Section: Definition Of Value In the Nonoperating Room Anesthesia Settingmentioning

confidence: 99%

“…Where the risk–benefit ratio appears imbalanced or equivocal, POET allows surgeons and anesthesiologists to have an evidence-based conversation regarding delaying the procedure until the patient is sufficiently optimized. Although a final cost/benefit analysis has yet to be reported, the model has already identified numerous patients for preoperative risk modification/coordination with a proportion of those patients delaying their procedure in favor of optimization first [10,17 ▪▪ ,19 ▪▪ ].…”

Section: Enabling Principles For Delivering Value In Nonoperating Roo...mentioning

confidence: 99%

Frameworks for value-based care in the nonoperating room setting

Keswani¹,

Licht²,

Urman³

2022

Current Opinion in Anaesthesiology

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Purpose of reviewNonoperating room anesthesia (NORA) presents a unique opportunity for the application of value-based care (VBC) principles to procedures performed in the office-based and nonoperating room inpatient settings. The purpose of this article is to review how value is defined in NORA and enabling principles by which anesthesiologists can maximize value in NORA. Recent findingsIn order to drive value, NORA providers can target improvements in clinical outcomes where NORA lags behind operating room-based anesthesia (death, over-sedation, nerve injury), implement protocols focusing on intermediate outcomes/quality (postoperative nausea and vomiting, pain control, hypothermia, delirium), incorporate patient-reported outcomes (PROs) to assess the trajectory of a patient's perioperative care, and reduce costs (direct and indirect) through operational and supply-based efficiencies. Establishing a culture of patient and provider safety first, appropriate patient selection with targeted, perioperative optimization of comorbidities, and efficient deployment of staff, space, and resources are critical enablers for success. SummaryValue in NORA can be defined as clinical outcomes, quality, patient-reported outcomes, and efficiency divided by the direct and indirect costs for achieving those outcomes. We present a novel framework adapting current VBC practices in operating room anesthesia to the NORA environment.

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Scoping Review: Anesthesiologist Involvement in Alternative Payment Models, Value Measurement, and Nonclinical Capabilities for Success in the United States of America

Sanghvi,

Qian,

Olumuyide

et al. 2024

Anesthesia &Amp; Analgesia

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The US healthcare sector is undergoing significant payment reforms, leading to the emergence of Alternative Payment Models (APMs) aimed at improving clinical outcomes and patient experiences while reducing costs. This scoping review provides an overview of the involvement of anesthesiologists in APMs as found in published literature. It specifically aims to categorize and understand the breadth and depth of their participation, revolving around 3 main axes or “Aims”: (1) shaping APMs through design and implementation, (2) gauging the value and quality of care provided by anesthesiologists within these models, and (3) enhancing nonclinical abilities of anesthesiologists for promoting more value in care. To map out the existing literature, a comprehensive search of relevant electronic databases was conducted, yielding a total of 2173 articles, of which 24 met the inclusion criteria, comprising 21 prospective or retrospective cohort studies, 2 surveys, and 1 case–control cohort study. Eleven publications (45%) discussed value-based, bundled, or episode-based payments, whereas the rest discussed non–payment-based models, such as Enhanced Recovery After Surgery (7 articles, 29%), Perioperative Surgical Home (4 articles, 17%), or other models (3 articles, 13%).The review identified key themes related to each aim. The most prominent themes for aim 1 included protocol standardization (16 articles, 67%), design and implementation leadership (8 articles, 33%), multidisciplinary collaboration (7 articles, 29%), and role expansion (5 articles, 21%). For aim 2, the common themes were Process-Based & Patient-Centric Metrics (1 article, 4%), Shared Accountability (3 articles, 13%), and Time-Driven Activity-Based Costing (TDABC) (3 articles, 13%). Furthermore, we identified a wide range of quality metrics, spanning 8 domains that were used in these studies to evaluate anesthesiologists’ performance. For aim 3, the main extracted themes included Education on Healthcare Transformation and Policies (3 articles, 13%), Exploring Collaborative Leadership Skills (5 articles, 21%), and Embracing Advanced Analytics and Data Transparency (4 articles, 17%).Findings revealed the pivotal role of anesthesiologists in the design, implementation, and refinement of these emerging delivery and payment models. Our results highlight that while payment models are shifting toward value, patient-centered metrics have yet to be widely accepted for use in measuring quality and affecting payment for anesthesiologists. Gaps remain in understanding how anesthesiologists assess their direct impact and strategies for enhancing the sustainability of anesthesia practices. This review underscores the need for future research contributing to the successful adaptation of clinical practices in this new era of healthcare delivery.

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Defining the Value of Analgesia for Total Knee Arthroplasty Using Time-Driven Activity-Based Costing: A Novel Approach to Clinical Practice Transformation

Cited by 4 publications

References 24 publications

Using Time-Driven Benchmarking for Measuring Health Services Performance Under COVID-19 Pandemic

Using Time-Driven Benchmarking for Measuring Health Services Performance Under COVID-19 Pandemic

Frameworks for value-based care in the nonoperating room setting

Scoping Review: Anesthesiologist Involvement in Alternative Payment Models, Value Measurement, and Nonclinical Capabilities for Success in the United States of America

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