Sleep Strategies

Below is an article that was recently published in Sleep Diagnosis and Therapy on Sleep Strategies and how we are setting the standards for sleep scoring services.   

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As president and CEO of Sleep Strategies, Natalie Morin aims to bring consistent quality to the business of sleep scoring.

There was a time when sleep study scoring was only outsourced as a last-minute measure to deal with staffing shortages. But what began as a reactive business practice is now a flourishing business model that hospitals and private sleep facilities have embraced in an effort to streamline operations. In fact, several industry authorities claim this is quickly becoming the preferred method for sleep laboratories to have their sleep studies scored. Read the rest of this entry »

It’s no secret that healthcare departments are, by default, expected to find creative ways to accomplish their goals on miniscule budgets—same goes for sleep laboratories. The most viable solution is to partner with a reputable, industry-recognized scoring service. But how do you know when the time is right to bring one on?Ask yourself:

Is your sleep facility constantly over budget?

Do you have a regular turnover of technologists?

Do you have a backlog of patient sleep studies still needing to be scored?

Are you paying overtime to techs for performing additional scoring?

Does it take more than three business days to return scored results?  

Do you have difficulty finding and hiring qualified technologists?

If “yes” is your dominant answer, then partnering with a sleep scoring service just makes sense. Consider this: streamlining is about eliminating structural costs and finding unrecognized savings. It’s also about finding smarter ways to handle repetitive tasks and getting more out of your operational budget without sacrificing patient care. A reputable sleep scoring service becomes a virtual extension of your operation—all of the additional capacity without the bulk of expanding your operation internally. A new decade calls for a smarter, leaner and more reliable approach.

Sleep Strategies will be exhibiting at the Sleep 2010 Meeting in San Antonio, Texas from June 7-9, 2010. Please stop by our Booth 1318 to explore how our scoring services can assist with increasing productivity and heightening efficieniess in your sleep facility.

Technologist shortages, budgetary restraints and administrative negligence are some of the leading causes for sleep lab inefficiency. Below are several questions that can shed light on whether your sleep lab is being the best it can be.

Are any of your sleep studies scored by unregistered technologists?                                                

Registered techs are trained to score at peak efficiency and accuracy. 

Does it take longer than 3 business days for your lab to score patient studies?                                          

If it does, something probably isn’t working right.  

Does your lab do monthly audit and inter-rater reliability tests on the scoring of ALL techs?                    

It’s hard to know where you can improve if you don’t know where the problems are.  

Do you have a wait time of over 1 month?

You shouldn’t. Relieving patient backlogs can become a selling point to set you apart from other facilities.  

Do you have a process to evaluate the quality of your patient’s sleep study hook-up?                   

Efficiency is great, but the quality and accuracy of tests must be made a priority.

Do you have a growing backlog of patient studies that need to be scored?                                       

There’s a way to make it disappears forever.  

If you answered yes to any of these questions, your lab is not alone. Productivity issues can threaten the reputation of your sleep lab and possibly even the health of your patients. Aligning yourself with a third-party, professional scoring company can not only increase lab efficiency but improve patient care. 

When evaluating ways to cut costs, improve performance and generally work smarter, many of the world’s most prominent sleep laboratories are choosing to incorporate sleep scoring services.

Everyday human errors, such as forgetting or overlooking something important, misunderstandings and mix-ups happen even to people who are competent and doing their best to avoid them. Sleep technologists are not immune. Errors in the scoring of patient sleep studies are not isolated problems, but have underlying systemic causes. Just because a sleep studies is analyzed does not mean it has been scored correctly.

Whether your sleep lab is understaffed or technologists are undertrained, the scoring of sleep studies is fundamentally the most important task for diagnosing a patient correctly and must never be taken lightly. Even the most seasoned sleep techs may overlook an event or activity resulting in a patient misdiagnosis. So what can a sleep lab do to ensure that sleep studies are being scored correctly at all times?

Insist on registered technologists. Only these specially trained and BRPT tested, highly experienced professionals can aim to score accurately every-time. 

Self Audit. That is, randomly select patient files and review to ensure internal standards are being met.Routinely review technologists. Even the experts or senior scoring techs can fall into bad habits – perform peer observations to maintain scoring consistency.

Perform Inter-rater reliability testing. It employs a standard agreed upon industry-wide.

Hire a professional scoring service to ensure quality standards are never compromised and that your sleep studies are scored by industry experts and reviewed by internal quality assurance managers. 

You might never know that a sleep study has been incorrectly scored – until it’s too late. Until a patient realizes they’ve been misdiagnosed. Until a chance occurrence reveals staff inadequacies. Until you lose accreditation for not adhering to regulatory guidelines.  Ensure that your sleep facility’s quality assurance program is being practiced at all times

We are slowly seeing the sleep medicine industry rebound. The current economic downturn has affected all industries and sleep medicine was no exception. Those sleep labs that are boldly committed to savvy business decisions have been able to ride the downturn out rather unscathed. Did your sleep laboratory incorporate these business strategies?                    

• Scaling back the number of nights to avoid lay offs

• Flexible work schedules to distribute available work

• Eliminate unnecessary and redundant positions

• Review and cut business expense policies

• Look at bringing on temporary staff

• Place marketing as a priority

• Contract your sleep scoring to an external service provider

This last point—the outsourcing of sleep scoring—allows you to cut costs while preserving (if not improving) scoring accuracy. It’s a model that allows a sleep facility to pay only for services rendered—without needing to expend unnecessarily on a full-time position and incur extra costs such as employee benefits and training. Other benefits include the reallocation of staff to focus on core competencies and patient care. 

THE RIGHT WAY AND THE WRONG WAY 

To truly claim your sleep laboratory has a rigorous quality assurance system, it takes a little more than status quo. Here are a few points for your sleep laboratory to consider regarding the quality assurance of your sleep studies: 

• Insist on registered technologists. Only these specially trained and BRPT tested, highly experienced professionals can guarantee an accurate interpretation of data.

• Self Audit. Randomly select client files and review to ensure internal standards are being met on a monthly basis.

• Review technologists. Even the experts can fall into bad habits - perform peer observations to maintain scoring consistency.

• Understand the latest guidelines. AASM and HIPAA enforce a base level of service delivery.

• Hire a professional scoring service to ensure quality standards are never compromised.

 The health of your patients and the reputation of our industry depend on accuracy and integrity. There is more than one way to score a sleep study, but in reality there shouldn’t be.  

Sleep Strategies will be exhibiting at the 4th Conference of the Canadian Sleep Society on April 26-28th in Toronto, CANADA.  Please stop by Booth 100 to discuss your sleep scoring and laboratory needs.  

Natalie Morin, President & CEO of Sleep Strategies will be presenting to the delegates the New AASM Scoring Guidelines, as well as chairing a mock debate on the merits of portable monitoring.

Insurance. You have it on your car, your house, your life. You have it when you travel and you most certainly have it if you own a sleep laboratory. So why do sleep facilities that decide to hire a scoring service rarely find out whether their scoring company or freelancer has it? You need to know if they’ve included general liability and errors and omissions insurances into their scoring business – don’t just assume it’s common business practice. You might consider them an extension of your team and therefore legally bound by your own insurance, but the fact is: they are not. The law considers them a vendor – just like your linen service or IT contractor.

Most hospitals require general liability and errors and omission in order to become a scoring vendor. This is standard practice for the sleep scoring industry. Should you decide to incorporate a scoring service into your facility request a copy of the insurance certificate for your records before moving forward. Remember, selecting a reputable scoring service that practices proper business policies and procedures will ensure that your sleep facility is protected. 

1 RPSGT in India and 2 RPSGT’s in the Philippines – but who is scoring your studies?  

Whether offshore sleep scoring is good or bad has always been a hotly debated topic. Cultural consistency, quality concerns, employee turnover and communications (language) barriers are just some of the issues that might make you think twice before outsourcing offshore. The good news is: most of these hurdles can be easily addressed with a little due diligence. The question that remains: who is scoring these sleep studies? According to the BRPT, there is only one registered sleep technologist in India and four RPSGT’s in the Philippines. 

There is no denying that offshore sleep record outsourcing of patient studies can be an effective business tool. But guaranteeing quality assurance, patient confidentially and comparable standards to those set here in North American should be paramount. The only reliable way to do this is to hire registered technologists to score the studies and incorporate quality measures such as interscorer reliability and audit testing on a routine basis. RPSGT certification is more than a piece of paper. It’s a multi-layered standard and it’s in our best interest to uphold and advocate these certifications. For overseas outsourcing to have longevity scoring technologists need more than industry insurance – they have to become RPSGTs. And I don’t just mean having an RPSGT simply review a study scored by a non-registered technologist either.

So coming back to my original question: who is scoring these studies if there is only a handful of registered technologists abroad?  My guess is as good as yours. The fact is that it likely isn’t an RPSGT or an AASM physician. If saving money is at the top of your list of priorities then offshore outsourcing may be a perfect fit. Just cross your fingers and hope that the one RPSGT in India is the one scoring your studies.