The Economic Concerns and Benefits of Developing a
PPAC
What are the costs and benefits of a PPAC, and who ultimately
supports it financially? This question is pertinent because the costs of a PPAC
are borne by one group but the benefits accrue to another. One of the basic principles
Figure 25-22
Preoperative and Preprocedure Assessment Clinic (PPAC)
testing guidelines for the healthy (Form 2).
of economic analysis of a new venture is that comparison and choices must be made
between the existing use of resources and the proposed alternative.
Any financial support given to a PPAC by a hospital will be based
on price, quality, and value. Therefore, a cost analysis of the current system of
preoperative evaluation will describe the problems, effectiveness, and cost of the
traditional system, and the subsequent surgical effectiveness of the new system.
This document is more effective if it is comprehensive and focuses on opportunities
for improvement.
The strategic alliance and partnership with hospital/health system
administration and the departments of nursing and surgery (obstetrics, gynecology,
and radiology) toward the common goals of improvement in quality, cost reductions,
and reduced length of stay through educational programs requires that the financial
support and gains of the PPAC be delegated responsibly and fairly. For example,
the facility and professional staff and the maintenance, equipment, registration,
and phlebotomy personnel associated with the PPAC would incur cost to the hospital/health
system administration. Nursing and educational resources will be supported through
the department of nursing or anesthesia cost center. Similarly, benefits from reductions
in length of stay and reduced OR times and cancellations should be shared among the
parties.
The PPAC staff can be cross-trained to provide services to other
areas of the OR during periods of reduced patient volume. This sharing of resources
would decrease PPAC costs and increase PPAC "profits." An anesthesiologist would
serve as medical director of the PPAC. Table
25-23
lists the sequential elements of a PPAC business plan.
