In today’s rapidly evolving ASC and anesthesia landscapes, some leaders feel certified registered nurse anesthetists are positioned to do more than deliver care.
As economic and operational models shift, CRNAs have growing opportunities to shape workflows, drive efficiency and influence clinical leadership, particularly with the rise of CRNA-only ASCs, Jeff Tieder, MSN, CRNA, clinical assistant professor of the nurse anesthesia concentration at the University of Tennessee at Chattanooga, told Becker’s.
According to Mr. Tieder, some ASCs are moving away from the traditional physician-supervised anesthesia model.
“When we look at the economics of reimbursement in the ASC, it just doesn’t often make sense to have a supervising physician anesthesiologist,” Mr. Tieder said. In many facilities, even those affiliated with larger hospital-based anesthesia groups, CRNAs are becoming the sole anesthesia providers in outpatient settings, he explained.
This autonomy comes with new expectations and opportunities, and CRNAs can take ownership of the broader perioperative process, from block utilization to patient recovery times, Mr. Tieder said.
CRNAs can lead by embracing a data-driven approach, Mr. Tieder said. Metrics such as post-anesthesia care unit (PACU) throughput, first-case start delays and patient satisfaction scores provide tangible evidence of anesthesia’s downstream impact. Because these metrics often fall outside the typical scope of surgeon or administrator focus, that creates an opportunity for anesthesia professionals to step up and make the case.
“Generally, CRNAs do a lot of research, but those quality metrics aren’t what we often focus on,” Mr. Tieder said. “I think that’s one of the areas I would love to see a lot more CRNAs pay attention to.”
For example, Mr. Tieder emphasized the impact of peripheral nerve blocks and opioid-sparing techniques on ASC operations.
“If we can demonstrate, from an anesthesia standpoint, that we are utilizing blocks and opioid-free anesthesia — and what that’s translating to in PACU times and discharge times and patient satisfaction scores, we get more buy-in from our surgeons,” he said.
Looking ahead, Mr. Tieder said that CRNAs are likely to play an even more prominent leadership role in ASCs due to the looming physician anesthesia shortage.
“We haven’t even hit the physician anesthesia shortage yet,” he said. “That’s predicted to peak in the next three to five years. As that happens, I think CRNAs are positioned to be more of the leaders, particularly in the ASC.”
To succeed in that role, CRNAs must have strong regional anesthesia skills, especially as reimbursement pressures continue to mount across all specialties.
“Reimbursement just continues to reduce,” Mr. Tieder said. “So it’s all about volume. How can we take care of these real human beings well? How can we get them through this very difficult situation they’re going through — and do that in a way that is both morally responsible to the patient and financially responsible to the ASC?”
That shift also requires a new mindset.
“As more and more things get pushed by reimbursement metrics toward the ASC, you know, we’re just going to see higher and higher volumes,” he said. “And CRNAs and surgeons have to understand that it’s a different mindset t — doing cases at the ASC than it is at the hospital.”
By leveraging their expertise in regional techniques and focusing on patient-centered outcomes, CRNAs can position themselves as indispensable partners in ASC success.
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