Lourdes' Sacchetti said many physicians, including surgeons, understand that hospital medicine today is a 24/7 business.
"The first day of running an operating room on a Saturday won't be a sellout, but when you're innovative, you go through some bumps. Some places will begin performing catheterizations and colonoscopies at night, so their patients don't have to miss a day of work and can go back the next day," he said.
"There are enough CEOs with the foresight to do this. They may lose money for the first couple months, but this is the wave of the future."
Sacchetti said the improvements have a better chance of taking root when a hospital association adopts them.
"An individual hospital CEO is fighting upstream," he said. "But if you have the state's hospital association supporting this, it becomes easier politically for a hospital CEO to get the medical staff on board."
Victor Almeida, associate director of the emergency department of Monmouth Medical Center in Long Branch, N.J., cautioned that Litvak will face barriers from some surgeons reluctant to change their operating schedules.
"I don't want to sit at the table for that meeting, because you'll need a tank and a flak jacket. They will threaten to move their cases to a competing hospital, and that's a threat hospital administrators take seriously," said Almeida.
"But change has to come. If they [surgeons] are not riding this bus, it's going to run them over."
Litvak said his methods do not improve hospital operations on the backs of surgeons, calling cooperating surgeons and their patients the biggest beneficiaries. He said they enjoy more predictable operating hours, fewer bumped surgeries, and greater surgical volume and revenue potential with improved quality of care.
Jesse Pines, director of the Center for Health Care Quality at George Washington University, said some hospitals have tried to implement surgical smoothing, but failed to achieve results, mostly because of poor leadership.
"Making quality improvements requires good leadership," Pines said. "A successful intervention won't work if the hospital is not ready for it."
But he is optimistic. "In the next few years several E.D. [emergency department] measures will become publicly reported," said Pines, formerly with the University of Pennsylvania. "And study after study has confirmed that what's measured gets fixed."
Litvak said he, too, was confident.
"Americans can always be counted on to do the right thing," he chuckled, channeling Winston Churchill, "after they have exhausted all other possibilities."
Contact Mark Taylor at markic46321@yahoo.com.
