AORN hosts symposium for health care leaders from different disciplines to determine surgical services' future

AORN Journal,  Sept, 2003  by Nancy K. Kuehl

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Sunday, July 20, to Tuesday, July 22, 2003

The future of perioperative nursing is of great concern to AORN and its members. It is vital that surgical team members step out of their silos and start working together to solve the problems that currently exist in health care, as well as the problems health care faces during the next five years. Determining a future direction for both the industry and the Association, however, requires as much information as possible. In light of this, AORN recently sponsored a high-level strategic business forum titled "Executive Symposium: Envisioning the Future of Surgery" at Beaver Creek, Colo. The senior level surgical arena leaders who attended included nurses, surgeons, anesthesiologists, radiologists, association leaders, and members of industry. Speakers included Russell Coile, Jr, editor of Russ Coile's Health Trends and a national health care futurist whose predictions about the future of health care have had a 90% accuracy rate, and Charles H. Scoggin, MD, president and chief executive officer of Sagemed, Inc, Boulder, Colo, a company focused on creating awareness and understanding of new and innovative health care products and services.

SPEAKERS

The conference began on Sunday evening with a cocktail reception sponsored by Karl Storz Endoscopy and dinner. After dinner, Dr Scoggin presented a slide show and spoke about an early period of American history in an entertaining presentation sponsored by Integrated Medical Systems, Inc, titled "A Look at Health Care in the American West." Dr Scoggin told attendees how health care helped shape the American West, from the interesting medical people who populated the region and put their imprint on it, to the impact of tuberculosis, which, according to Dr Scoggin, was largely responsible for the migration west. The higher altitudes in the West were thought to be beneficial to tuberculosis patients. "The association between the West and health care is very strong but often unacknowledged," said Dr Scoggin.

On Monday morning, attendees heard Coile speak on the "Operating Room of the Future: Strategies for a Consumer Driven Market." The session was sponsored by Owens & Minor. In addition, 3M healthcare sponsored distribution of Coile's booklet Futurescan 2003: A Forecast of Healthcare Trends, 2003-2007 to all attendees. During his presentation, Coile discussed factors expected to influence health care in the future. One of these factors is that health care is expected to become a more consumer-led market as patients educate themselves about their health care choices, including alternative and complementary therapies. Coile noted that hospitals will have to cope with increasing consumer demands for health care services as the Baby Boom generation ages. In addition, Baby Boomers want access to the best health care and the latest technology.

Other factors that will influence health care are that "employers and health plans are placing increasing emphasis on demonstrating quality as well as holding down medical costs." Some employers and health care plans are experimenting with paying bonuses to providers who improve quality and patient safety. Hospitals and physicians will have to compete based on quality and technology.

Coile also said that government will play an increasing role in creating "report cards to measure clinical outcomes and patient satisfaction." Government programs, such as Medicare, may provide financial incentives to health care providers who exceed national quality benchmarks; however, as consumers continue to demand more of health care and costs continue to rise, Coile asks "How long will employers and consumers continue to subsidize medical inflation?"

Labor shortages are another issue affecting health care, said Coile, and this is an area where government may step in, as they already have in California, by enacting nurse-to-patient ratios. These programs do not ease the labor shortage, however, and Coile notes that there are no easy answers.

New technology also will have an effect as hospitals install the latest expensive high-tech equipment to meet the demands of Baby Boomer patients. Other technologies that could have an effect include digital (ie, paperless) hospitals, genomics, and the ability to better manage and monitor high-risk patients. After Coile's session, attendees were given the opportunity to discuss his points. Coile then led them in an exercise to create a list of issues they thought would be prevalent in health care in the future. The list attendees created included

* service issues, consumerism, and women as decision makers;

* economics, costs, and revenues;

* technology expansion, education, and standards;

* workforce issues;

* government regulatory issues;

* patient safety;

* culture and collaboration (ie, aligning incentives);

* nontraditional settings;

* algorithm-driven care;

* patient-centered, high-quality care;

* competition based on outcomes data (eg, report cards);