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10 Traits of Highly Successful Surgery Center Administrators

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A great administrator is essential to the success of an ambulatory surgery center. Tasked with reducing costs, increasing revenue, boosting morale, satisfying surgeons and preparing for the future, administrators must be capable in multiple areas if they are to lead an extraordinary facility.

Five ASC industry veterans discuss 10 of the traits that make highly successful surgery center administrators.

1. They respond quickly.
Great administrators are responsive to their physicians and personnel, says Greg Zoch, partner and managing director at Kaye/Bassman International Corp., an executive search firm specializing in the ASC industry. When they hear about a problem, they provide a solution as soon as possible, rather than listening to give an appearance of commitment and then immediately forgetting the issue when the employee leaves the administrator's office. If an administrator does not follow up on problems, employees will stop bringing them up, and issues will fester and grow until dissatisfaction has spread across the facility. If an administrator regularly provides prompt solutions or supports employees in resolving the issues themselves, staff members will trust the administrator to respond appropriately when a serious issue arises.

Linda Deeming, facility administrator of Longmont (Colo.) Surgery Center, says a fast response time is essential when responding to patient issues as well. If you ignore a patient complaint, you can expect the patient will talk to their friends and family and could damage your ASC's reputation in the community. If you jump on the issue immediately and apologize and offer a solution, you will show your respect for the patient's business.

2. They hold themselves and others accountable.
"Great administrators accept responsibility, and they also expect it from others," Mr. Zoch says. He says the promotion of accountability is a symbiotic relationship: If administrators shows leadership by taking responsibility for their actions, physicians and staff members will see it and take responsibility themselves.

Administrative accountability means accepting responsibility when something goes wrong, even if the problem is not directly linked to the administrator's actions. "Even if it's a failure of the infection control program, the leader always holds himself accountable for the failure being able to occur," Mr. Zoch says. "A good leader will say, 'I let you down by allowing an environment to exist wherein this could occur. Now what are we going to do to fix it?'" Once accountability has been established, a great administrator will move on to a solution rather than lingering on the problem. Understanding the root cause of a problem is useful, Mr. Zoch says; pointing fingers or assigning blame is not.  

3. They can articulate a clear vision of the future.
Joseph Zasa, co-founder and managing partner with ASD Management, says a successful administrator will have a clear idea of the center's direction and will not easily flip-flop on that vision. "They convey the mission of the center in a clear fashion and follow through," he says.

Mr. Zoch says a great administrator will articulate the vision so well that employees and physicians at the center will buy into the vision too. "Their buy-in will be visible in the way they approach their jobs, as well as in their attitudes and their quality of work," Mr. Zoch says. He says the center's vision should be a team vision rather than the administrator's individual agenda.

However, the ability to articulate this vision does not mean the administrator should articulate it constantly. "The last thing I want is somebody who's going to sit in their office all day and create pie charts and talk about the direction of the center and then leave the day-to-day operations to the staff," Mr. Zasa says. The center's mission and vision should be articulated semi-regularly and then demonstrated through cost-cutting actions, recruitment or relationship-building with other facilities.

4. They pay attention to detail.
It is a rare leader who can keep an eye on the details while understanding the bigger picture of the center's direction — but Mr. Zoch says both qualities are essential for a top administrator. "They can drill down and focus on the details, but they can also back off and let people do their jobs," he says. "It's about delegating and respect. The poor manager gets into the details and then micromanages and never lets go." He says an effective administrator will understand the details of the surgery center and keep up-to-date on financials and performance — but will not meddle in duties that belong to other members of the team.

Mr. Zasa agrees that the ASC administrator should be able to control the key cost indicators that drive a center's success. "You need somebody there on site who's focused on supply costs, physician satisfaction, clinical objectives — all the key things that make centers good," he says.

5. They understand their employees.
The ASC industry is a people-oriented business, Mr. Zasa says. "Particularly with the staff and the surgeons, you can't treat them all the same," he says. "Great administrators are really good with people and [are able] to motivate them to meet the objectives of the center." He says when people think of motivation, they often think of inspirational speeches, but the real work can be much more subtle than that. Great administrators understand what drives different personalities, and they know whether to lead by example, give direct coaching or ask for suggestions based on the individual. He says this level of understanding also helps when an administrator needs to deal with an upset employee.

Stephanie Stinson, administrative director for Strictly Pediatrics in Austin, Texas, agrees that personal relations are the biggest driver in administrator success. "The biggest thing is how you talk to someone," she says. "Sometimes you have to bring people in and talk to them more like they're your family than they're your employee. You can't forget that we are all humans and everyone is going to make mistakes." She says a great administrator will also recognize when employees do well. If the administrator recognizes employee achievement and makes those successes known to peers and physicians, everyone will feel motivated to work harder and appreciated for their efforts.

6. They are driven to learn about the business.
Ms. Stinson says in her 10 years in the ASC business, she has had to learn a lot about operating a successful center. "It took a lot of long, hard hours because I wanted to learn it," she says. "That's part of being successful. It's a very demanding position, and you have to have the drive to succeed."

She says one of her biggest challenges was adjusting to the pediatric-driven nature of her ASC. "I had no pediatric experience other than nursing school, and I came to start a facility when it was a concrete slab going to all pediatrics," she says. "I had to learn everything, especially about how you approach pediatric physicians." This quality is essential because the administrator role requires so many different areas of knowledge.

William Prentice, executive director of the Ambulatory Surgery Center Association, says this drive also applies to credentialing. Since the Certified Administrator Surgery Center credential was first awarded in 2002, more than 500 people have elected to become CASC-certified. "Credential holders and many others in the ASC industry routinely tell us that the credential helps them instantly identify those administrators who 'know what they're talking about' and have mastered the unique and complex skill set involved in managing an ASC," he says. "They also say that the certification program has contributed in significant ways to recognizing the unique and valuable role that ASCs play in the U.S. healthcare system today."

7. They get their hands dirty. A great ASC administrator will not always be holed up in his or her office, crunching numbers and keeping out of sight, Mr. Zoch says. Great administrators will show willingness to put on scrubs and find out what's happening in the back of the house.

Mr. Zasa agrees: "They lead by example," he says. "They don't have princess syndrome where they sit in their office telling everyone else what to do. They're back there helping people turn rooms." Mr. Zasa says administrators who do not pitch in during busy times will end up with dissatisfied staff. "If they leave the day-to-day running of the center to the staff, staffing costs will be out of control and staff will be upset all the time because the director doesn't even get in the back with them," he says.

8. They can sense small changes in the tone of the ASC.
Great administrators don't have to be told that staff members are unhappy or physicians are considering hospital employment; they already know, Mr. Zoch says. Administrators should be constantly watching the tone of the surgery center to determine whether changes need to be made. "They're responsive to things that most people wouldn't even notice. They can feel the wind shift a little bit," he says. "It may be something subtle in the mood that seems to be off one day." While the administrator might not react immediately to the shift, they will keep an eye on the change to see if it continues.

The same is true in the healthcare industry overall. A poor administrator will ignore major changes to the industry, such as the advent of accountable care organizations, decreases in reimbursement and the uptick of physician employment, by pretending that everything will be fine. A strong administrator will notice these trends and determine whether the center can survive without major operational changes — or whether partnership with a hospital or management company is essential considering the climate.   

9. They don't play favorites. Choosing "favorite" staff members is the surest way to turn employees against you, Mr. Zasa says. If an administrator favors one nurse over another nurse and shows that favoritism, the center risks losing the unhappy nurse and creating a chasm between employees. "Great administrators are fair and equitable to all staff members," he says.

Ms. Deeming agrees that treating employees fairly is the best way to handle a dispute between disagreeing staff members. Great administrators invite employees to their office individually to discuss their perspective on the problem, rather than pitting employees against each other. They don't say, "This employee was talking about you behind your back," but rather ask if the staff member has input on the atmosphere at the center and then take the answer seriously, she says.

10. They don't crumble in hard times.
The last few years in healthcare have been difficult, especially for small surgery centers with limited case volume and declining reimbursements. But strong administrators have weathered the storm, Mr. Zoch says, and they've done it without ruining relationships or destroying morale. "Too often, when layoffs occur or people are flexed off, it's not done with a degree of empathy or the greatest finesse," he says. "From a human as well as a business perspective, it's good to sit down with the team and explain why things are changing. It communicates respect and value, and it allows you to keep the really good people that you want to keep on board."

He says a great administrator will explain that the center simply doesn't have enough work for all its staff members, and everyone will have to decrease their hours for awhile to make up for lost revenue. "If they feel like it's an edict from on high, they're more likely to look for other work," he says. "If they're brought into the fold and they understand the big picture, they feel like they're part of the team and part of the solution."

Read more about highly successful ASC administrators:

-135 Great Surgery Center Administrators to Know

-5 Ways for a Surgery Center to Flourish Without a Hospital or Corporate Partner

-7 Ways to Achieve a Perfect Score on Your Department of Health Inspection

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