"You've got to keep in mind, these aren't 'greedy' doctors. Hospitals are really difficult, complex mechanisms, and if they don't bring in revenue, they have to close their doors eventually. The surgeon wants to operate; the patients don't want to be delayed. If a surgery is postponed, it has a ripple effect," he says.
"Patients often have to travel a great distance for the procedures, so hospital delays become expensive for both them and the care providers," he adds.
Golden proposes four solutions:
1.Add more flexibility in post-operative room assignments. While there is a standard post-operative ICU in each service line, "there might be other beds in the hospital that would be able to take a patient and allow the patient to recover more fully," Golden's report says.
Since patients with co-morbidities, for example, may have higher readmission rates, "patients discharged from a highly utilized unit are more likely to be readmitted to the hospital after surgery. Because the discharge rates increase when utilization is high, extra time in the post-operative unit for these patients might help lower the probability that they are readmitted."
Though such procedures may increase costs in the short run, discharging patients who then quickly return to the hospital offers no long-term savings, and decreases quality of care, he says.