Innovations in Inpatient & Outpatient Surgical Care

Trends to Watch in 2024

Inpatient & Outpatient Surgical Care

The year ahead will see nurses and healthcare leaders tackling longstanding challenges using new solutions. Sci-Fi tech like artificial intelligence (AI) and task-oriented robots will drive safe, efficient care. Data-driven planning and new models of staffing will strengthen our workforce. And we’ll see improved patient care by applying what we know about social determinants of health.

These are just a few of the big developments in 2024 surgical care, according to industry leaders Linda Groah, AORN CEO/Executive Director and Jan Davidson, Board Chair of the Accreditation Association for Ambulatory Care (AAAHC).

Linda Groah MSN, RN, CNOR, NEA-BC, FAAN	Jan Davidson MSN, RN, CNOR

Periop Today asked them for their unique takes on 2024 trends in inpatient and outpatient care. Here are eight areas they see evolving in the year ahead:

1. Short Staffing is Getting a Closer Look

Turnover and labor shortages continue to impact inpatient and outpatient care, making adequate staffing an important priority in 2024. Davidson says AAAHC Surveyors observed inadequate staffing numbers in outpatient settings last year.

They also noted a shortage of qualified and supervised staff to adequately provide healthcare services.

While these shortages in themselves aren’t necessarily associated with a specific survey citation, “personnel issues could be attributed to other increases in Standards deficiencies such as ensuring that the healthcare provided is consistent with the standard of care and continuity of care, and patient follow-up occurs when appropriate,” Davidson adds. “Therefore, we see this as an important priority for 2024.”

2. Robots and AI are Automating Tasks

AORN’s Groah agrees that labor shortages remain a challenge in periop care. This is based on feedback she is hearing from leaders in both inpatient and outpatient settings. But she is also hearing about creative solutions such as leveraging technology to mitigate staffing challenges.

“Technology is helping teams address old problems with new solutions,” Groah explains. For example, several major surgical leaders are trialing robots to automate tasks. Picture robots moving supplies back and forth from central sterile in inpatient settings. The goal being to give nurses more time to focus on patient care.

AI and tools such as ChatGPT are being explored to help with charting and administrative work, Groah adds.

Davidson says AI also offers a new tool to communicate with patients. For example, “AI can help interpret medical information for patients.”

3. Wellness is Starting to Become Habit

Beyond technology, new models of staffing that prioritize wellness and mental health are being explored, Groah shares. For example, licensed professionals such as LPNs and surgical technologists are supporting teams in new ways. And some leaders are testing changing breaks from 15 minutes to 30 minutes to give staff members a better chance to recharge.

4. Teams are Testing Evidence-Based Solutions to Inequities

In 2024 outpatient and acute facilities will do more to apply the learnings around how social determinants of health impact surgical patients, Groah explains. “We know black and brown patients do not have equal access to healthcare and research is demonstrating how this negatively influences the outcomes.”

ERAS protocols offer a perfect example of how established practices can also advance health equity. “With ERAS, if you are black, brown, yellow, or white, you will have the same consistency of care," Groah says. "We’ll see more hospitals picking up on this.” ERAS also emphasizes opioid-sparing pain management. This is an important way to reduce postop addiction for surgical patients.   

5. Access to Rural and Senior Care is an Increasing Priority

Davidson is hearing more conversation around the role ASCs could play in serving rural patient populations. This could include expansion of telehealth and access to in-home care that could improve care access for rural patients. These care options can also support seniors in their postop recovery for inpatient and outpatient care.

6. Facilities Need More Disaster Planning

“There is still work to do in ASC emergency preparedness,” Davidson stresses. Ineffective drills remain a top deficiency in preparedness in AAAHC-Accredited ASCs. Davidson recommends that clinicians conduct drills and support each effort with documentation and evaluation.

Supply chain disruptions should be part of disaster planning, according to Groah. She suggests healthcare teams follow and discuss action plans to ensure safe care when supplies are not available.

For example, inpatient and outpatient teams alike can track usage for frequently used supplies. Perioperative leaders should stay up to date on shortages through sources such as the FDA’s Medical Device Shortages list. Groah also recommends following ongoing developments by the White House to address disaster readiness as it applies to healthcare.

7. Clinical Safety Is in Focus

Teams should continue to stay focused on patient safety despite practice challenges such as staffing shortages.

One important example is to ensure medication safety, especially with updated requirements for safe medication handling and compounding from US Pharmacopeia (USP), Davidson notes. “Not only do these standards affect pharmacists and technicians, but they also affect nurses, physicians, dentists, and other healthcare providers in all places, including medical and surgical patient treatment sites, office-based surgeries, and other outpatient facilities.

AORN’s Medication Safety guideline provides guidance reflecting these USP updates, Groah explains. For example, Recommendation 3 in this guideline discusses why a facility should procure compounded medications from a manufacturer or from an FDA-registered outsourcing facility, when possible.

8. Environmental Health Leaders are in the Spotlight

A global focus on decarbonization is driving more facilities to reduce waste and building emissions. “Improvements may reap additional financial rewards for healthcare providers,” Davidson notes.

As more facilities study this topic and test solutions, she hopes their work can be shared to inspire others. For example, one AAAHC-Accredited facility recently received the Bernard A. Kershner Innovations in Quality Improvement Award for a QI study. It involved better waste management and triage of hazardous vs. non-hazardous waste and more.

Both Davidson and Groah predict more organizations will emulate such initiatives. Especially as climate change continues to impact healthcare on many fronts.

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