20 ASCs Performing More Than 10,000 Cases Annually
Allied Physicians Surgery Center (South Bend, Ind.)
Annual case volume: More than 10,000 since 2003
Specialties: Orthopedics, podiatry, ophthalmology, pain, ENT, general surgery, gynecology, urology
Details: The Allied Physicians Surgery Center is an AAAHC-accredited facility that opened in Feb. 2000. Just three years after opening, the center started topping 10,000 cases a year. There are seven ORs and two minor procedure rooms with 82 physicians on staff. More than 20,000 procedures have been performed each year since 2007.
Keys to maintaining/building volume: Executive and Clinical Director Chuck M. Strasser, RN, CASC, says much of the ASC's success stems from the commitment by surgeons and staff to maintain high patient satisfaction and excellent clinical outcomes and below benchmark reported infection rates.
"We have a strong commitment to providing excellent surgical care with an economic focus," he says. "We strive to make available most insurance contracts as well as Medicare and Medicaid recipients. We are successfully recruiting surgeons and investigating new procedures (joint replacement and spine surgery)."
Ambulatory Surgery Center of Spartanburg (Spartanburg, S.C.)
Annual case volume: More than 10,000 in the last four years
Specialties: Gastroenterology, ophthalmology, general surgery, orthopedics, ENT, podiatry, pain, gynecology
Details: The ASC of Spartanburg is a joint venture between Spartanburg Regional Medical Center and a group of 34 physicians. It was opened in April 2002 and now has 50 surgeons on staff. The center has seven ORs and two endoscopy procedure rooms, with a bulk of its procedures being GI-related.
Keys to building/maintaining volume: On building and maintaining case volume, Administrator Mike Pankey, RN, MBA, says fast turnovers, a competent staff of busy surgeons and ease of scheduling keeps the volume of cases high.
Mr. Pankey comments that the ASC is actively recruiting new physicians and optimizing scheduling and room utilization in order to further develop the center's growth.
Berks Center for Digestive Health (Wyomissing, Pa.)
Annual case volume: More than 10,000 cases since 2005
Details: Berks Center for Digestive Health opened in Dec. 2001 and has since been accredited by the AAAHC. The center feature three procedure rooms entirely dedicated to GI-related procedures. It is currently a joint venture with 10 physician owners and a management company called Physicians Endoscopy. In total, the staff has 13 physicians, who performed more than 13,000 procedures in 2009 alone.
Keys to maintaining/building success: Administrative Director John Gleason stresses creativity and adaptability as the key components to operating a successful ASC. Since the opening of the facility, hours have been extended to allow cases to end at a later time, schedules have been readjusted and turnover of procedures has been kept up in order to facilitate more procedures.
"We are constantly considering ways to add additional procedures to the schedule so as to increase volume," says Mr. Gleason. "And our staff and doctors have been adaptable enough to change to meet the center needs for the schedule." Mr. Gleason also says the facility is looking to move to a bigger facility to keep up with increasing case volume.
Centennial Surgery Center (Voorhees, N.J.)
Annual case volume: More than 10,000 since 2004
Specialties: Orthopedics, general surgery, urology, gastroenterology, colon/rectal,
plastics, pain management, podiatry
Details: The physician-owned Centennial Surgery Center was established in Sept. 1999 by a group of 16 physicians. Since then, the center has grown to more than 60 physician users with four ORs, two endoscopy rooms and two short procedure rooms.
Keys to building/maintaining volume: Margaret T. Atkinson, BS, CPC, RMC, business manager of the AAAHC-accredited center, says a number of factors play into the center's high case volume. State-of-the-art equipment, the staff, constant physician recruiting ,quick turnaround times and patient satisfaction all play into the growth of the center.
Center for Ambulatory Surgery (West Seneca, N.Y.)
Annual case volume: More than 10,000 cases since 2002
Specialties: Gastroenterology, ophthalmology, orthopedics, general surgery, gynecology, plastics, podiatry, urology and pain management
Details: The Center for Ambulatory Surgery opened in June 2001 and has since been accredited by AAAHC and expanded to include four ORs and five GI procedure rooms. The facility is a joint ownership between 16 physicians and The C/N Group and has more than 100 credentialed physicians on staff.
Keys to maintaining/building success: Rajiv Chopra, principal and CFO for The C/N Group, says the surgery center focuses on building strong physician relationships and tried to identify and respond to clinical or operational issues on a timely basis. "As a result, physician participation in the center's governance is enthusiastic," Mr. Chopra says. Other factors contributing to the surgery center's success include focusing on hiring and retaining experienced staff, working with high quality anesthesia team and maintaining efficiency to drive operations. "For example, endoscopy and surgical operations have separate locations within the building due to the velocity of GI cases," he says.
Mr. Chopra also acknowledges the facility's emphasis financial discipline in order to make resources available over the long haul to support new specialties and physicians.
Central Utah Surgical Center (Provo, Utah)
Annual cases volume: More than 10,000 since 2003
Specialties: Orthopedics, gastroenterology, ophthalmology, otolaryngology, urology, general surgery, podiatry, pediatric dental, pain, OB/GYN, plastics
Details: Central Utah Surgical Center was opened in 1995 by Central Utah Clinic. The facility was syndicated in 1997 with a management company and several dozen physician partners. The facility has since been accredited by The Joint Commission and Medicare. The ASC has six ORs and two procedure rooms.
Keys to maintaining/building success: Administrator Jill Andrews, RN, BSN, CNOR, says several factors have contributed to the continued success of the surgery center, including the board of managers, which allows staff to manage the facility on a daily basis, flexibility with time and scheduling, and maintaining a staff that works well together. "We have good communications with physicians, our own staff and the physicians' office. [We also] have an anesthesia group that works as a team with the facility staff and physicians," she says.
Cincinnati Eye Institute Surgery Center (Cincinnati, Ohio)
Annual case volume: More than 10,000 since 2007
Specialties: Cataract, retina, plastics, glaucoma, cornea, YAG laser, argon laser
Details: The AAAHC-accredited Cincinnati Eye Institute Surgery Center opened in 1985 and now features six ORs and three procedure rooms in a 17,000-square-foot surgery center, with plans to open up two more ORs sometime in the future. A majority of their more than 10,000 surgeries performed annually are cataract surgeries, which make up approximately 7,000 of the cases. The physician-owned facility has 25 physicianusers on staff.
Keys to building/maintaining success: Todd D. Albertz, director of surgical services, says that training and educating staff has helped to maintain success at the Cincinnati Eye Institute. In regards to maintaining volume, he says managing block time has been essential. "[Another key to our success] has been properly managing the surgeons' expectations for block time versus their true needs for block time," he says. Using technology to strategize open block time has been essential in utilizing open OR time with other surgeons.
Cypress Surgery Center (Wichita, Kan.)
Annual case volume: More than 10,000 procedures since 2008
Specialties: Orthopedics, gynecology, ENT, ophthalmology, gastroenterology, urology, general surgery, plastics, oral and maxillofacial, and pain management
Details: Opened in Nov. 2000, the AAAHC-accredited Cyrpress Surgery Center was founded by Medical Director David Grainger, MD; Michael Brown, MD; and Bruce Tjaden, DO. The facility currently has 38 physician-owners and 28 non-investors that work on staff. The surgery center features six ORs, three procedure rooms and two GI suites.
Keys to building/maintaining volume: Judy Graham, administrator at Cypress Surgery Center, says the ASC market is deeply saturated, which makes it important to make sure the physicians stay happy. "We work very hard to meet their needs by accommodating their schedules, having the equipment that they use and not wasting their time," she says. A part of their marketing program in order to bring in and retain staff members is recruiting new surgery and GYN residents from the KU residency program.
Eastside Endoscopy Center (St. Clair Shores, Mich.)
Annual case volume: More than 10,000 since 2008
Details: AAAHC-accredited Eastside Endoscopy Center opened its doors in April 1996 as a joint venture between eight physician owners and St. John Hospital and Medical Center in Detroit. Between two locations, the center collectively has six procedure rooms and 12 physicians performing procedures. As a center that was founded by a gastroenterology private practice, it is dedicated to GI endoscopy.
Key to building/maintaining volume: Administrator Beth Miller, RN, CASC, says paying special attention to patient and referral physician satisfaction, being patient-oriented and offering cost-effective services have all facilitated the growth of the facility.
Fernando Bermudez, MD, Medical Director, says the continuing frequent interaction with primary care physicians, offering continuing education events and marketing are all part of the plan to promote growth in the future. "It has been a team effort among our staff, our physicians and our administrator who has played a significant roll in our success".
Kemp Surgery Center (Everett, Wash.)
Annual case volume: More than 10,000 cases since 2001
Specialties: Gastroenterology, ENT, orthopedics, urology
Details: Kemp Surgery Center was opened in Nov. 1997 by the Everett Clinic. To this day, it is owned by the 300-physician multi-specialty clinic and is now accredited by Medicare. With its primary focus being on GI procedures, the clinic houses four ORs and four GI rooms. The facility has performed more than 16,000 procedures performed in 2009.
Keys to building/maintaining volume: The center offers services that are not immediately available in its community, such as continuous peripheral nerve blocks for orthopedic procedures. Medical Director Nick Marassi, MD, says the focus of the ASC is not only on providing service to patients but also to surgeons and physicians. The center also offers state-of-the-art equipment for surgeons in the facility to utilize in order to maintain high quality care.
"[We plan to] keep one step ahead of the competition, provide a better, cheaper alternative and continue to follow our guiding principle of doing what is right for each patient," he says.
Kentucky Surgery Center (Lexington, Ky.)
Annual case volume: More than 10,000 cases since 2007
Specialties: Orthopedics, ENT, gastroenterology, general surgery, plastics, podiatry, dentistry, pain management, urology, vascular, colorectal, and pulmonary
Details: The Kentucky Surgery Center, which opened Dec. 1986 and is accredited by AAAHC and Kentucky Medicare, is a 28,000-square-foot center with seven ORs and three procedure rooms. This physician-owned facility was started by a handful of surgeons and anesthesiologists and now has more than 100 surgeons on staff.
Keys to building/maintaining volume: Administrative Director Glenda Beasley, RN, says maintaining high case volume stems from the staff and physicians jointly providing quality patient care with excellent patient outcomes. "Raising the bar with expectations of only providing care that can be parallel to none is the goal of the center on a daily basis," she says. "Every team member must buy into the notion of bringing their top performance and positive attitude everyday to maintain success on every level."
Lakeland Surgical and Diagnostic Center (Lakeland, Fla.)
Annual case volume: More than 10,000 cases since 2001
Specialties: Endoscopy, pain management, eye, cosmetic surgery, reconstructive surgery, general surgery, eye, gynecology, orthopedics, urology, radiation oncology, podiatry, otorhinolaryngology
Details: The AAAHC-accredited Lakeland Surgical and Diagnostic Center, which is owned by the two largest physician groups in the area and the largest regional medical center, opened in April 1996 as a joint venture by the Watson Clinic and the Lakeland Regional Medical Center. The facility has three locations with a collective six ORs. The main campus houses five procedure rooms. Lakeland Surgical and Diagnostic Center is projected to exceed 20,000 cases for the first time this year.
Keys to maintaining/building volume: The success of the ASC is largely attributed to the facility's leadership and a focused aim for high quality patient care and satisfaction from both patients and physicians.
"We have strong, capable management and attention to every possible operational detail," says CEO David G. Daniel, FACHE. "We plan to continue our past winning formula for success and to settle for nothing less than the very best in every aspect of our operations. If you do that, volume issues seem to take care of themselves."
Menomonee Falls Ambulatory Surgery Center (Menomonee Falls, Wis.)
Annual case volume: More than 10,000 since 2002
Specialties: Gastroenterology, general surgery, orthopedics, pain, ENT, gynecology, podiatry, ophthalmology, urology, plastic surgery
Details: The Menomonee Falls Ambulatory Surgery Center is a joint venture between a community hospital and two large medical groups which started in April 1994. The AAAHC-accredited ASC has five ORs, four GI rooms and a laser room. Approximately 45 surgeons work in the facility on a day-to-day basis. Since 2002, the center has performed over 12,000 procedures every year.
Keys to building/maintaining volume: Dianne Wallace, RN, BSM, BMA, executive director, says that the center's success partly has to do with seeking out new physicians to join and retaining highly skilled staff.
"The latest merger between our hospital owner and a large local academic medical center brings with it many new opportunities," Ms. Wallace says. "Many of the physicians associated with this new partner have never experienced what an ASC has to offer them and their patients. Our plan for continued growth includes recruiting many of these physicians and introducing them to this exciting surgical venue."
Michigan Endoscopy Center (Farmington Hills, Mich.)
Annual case volume: More than 10,000 since 2004
Details: The Michigan Endoscopy Center is a gastroenterology-only specialty center with 13 GI physicians and three colorectal surgeons on its staff. It was opened in Jan. 2003 as a 65 percent physician and 35 percent Physicians Endoscopy joint venture. It has since been accredited by the AAAHC and grown to average 16,000 procedures annually over the past six years.
Keys to building/maintaining volume: Administrator Brien Fausone, MA, MBA, highlights the keys to the center's success were in providing an efficient wok environment for physicians with a clinical support team that prioritizes both the patient and the physician. Mr. Fausone says the future growth plans include recruiting new physicians and negotiating prime vendor arrangements with physician networks.
Northpoint Surgery and Laser Center (West Palm Beach, Fla.)
Annual case volume: More than 10,500 since 2006
Specialties: ENT, gastroenterology, gynecology, ophthalmology, retina, oral/maxillofacial, orthopedics, pain management and podiatry
Details: Northpoint Surgery and Laser Center opened in Sept. 1996 as a limited partnership with 13 physician owners. In 2003, they formed a joint venture with National Surgical Care. The center houses five ORs, two endoscopy suites and a pain management center with its own waiting room, preoperative and postoperative room as well as a procedure room. This AAAHC- and AHCA-accredited facility now has 32 physician owners and 25 other physicians on staff and has performed over 20,000 procedures a year since 2006.
Keys to building/maintaining success: Administrator Connie Casey, RN, CNOR, LHRM, suggests starting with well-known active physicians in the community and recruiting hospital staff that the physicians are familiar with and trust. "Most physicians are drawn to the fact that they have worked with the same staff and know what to expect," Ms. Casy says. She adds that having physicians add partners to his or her practice is a perfect opportunity for them to recruit for the facility as well.
She says that the center is also considering opening up to different specialties, such as lap banding and other insurance procedures.
Northwest Michigan Surgery Center (Traverse City, Mich.)
Annual case volume: More than 10,000 since 2005
Specialties: Gastroenterology, eye, general surgery, orthopedics, urology, podiatry
Details: This AAAHC-accredited center was opened in April 2004. It is now a joint venture between physicians and Munson Medical Center with 35 physician investors and 83 physician users. The center itself houses six 800-square-foot ORs, three GI suites and one minor procedure room for pain, lithotomy and GI overflow.
Keys to building/maintaining volume: Lisa Warren, quality assurance manager, attributes physician commitment and flexibility of staff and physician schedules to the success of the ASC's high case volume.
Springfield Clinic Ambulatory Surgery & Endoscopy Center (Springfield, Ill.)
Annual case volume: More than 10,000 since 2004
Specialties: Orthopedics, ophthalmology, general surgery, urology, eyes, ENT, plastics, gynecology, pain, endoscopy, colon/rectal, neurosurgery, gastroenterology, podiatry, vascular surgery
Details: The Ambulatory Surgery and Endoscopy Center, opened in April 1994 by Springfield Clinic, is a physician-owned center operating under 159 partners. The AAAHC-accredited ASC houses five ORs and four endoscopy procedure rooms and is currently considering adding other specialties, such as retina and spine. In 2009, the facility performed more than 16,000 procedures.
Keys to building/maintaining volume: Ginny Forrest, RN, director of the ASC, says the center offers great efficiency and attributes consistent patient satisfaction ratings of 98 percent or more to the ASC's success.
To achieve efficiency, the facility audit's operative times for accuracy twice a year, implements staff competency requirements and assures patient readiness for an "on-time" start.
Summit Surgical Center (Voorhees, N.J.)
Annual case volume: More than 10,000 in the last few years
Specialties: ENT, pediatric urology, general surgery, gastroenterology, pain, orthopedics
Details: The AAAHC-accredited Summit Surgical Center was opened in 1985 as part of Virtua Health, a comprehensive health system in southern New Jersey, and became a joint venture in Feb. 2006. It was established with a group of over 40 physician investors currently has an active medical staff of 195 medical professionals. The facility includes seven ORs and two procedure rooms. In 2009 alone, the facility performed more than 25,000 procedures.
Keys to building/maintaining volume: Vice President of Virtua Surgical Services Jo Ann Dower, RN, BS, MGA, notes that physician relationships, alignment with Virtua and its reputation for excellence in care of pediatric patients, which makes up 25-30 percent of total volume of cases, is what helps Summit Surgical Center maintain and grow its high volume of cases.
In efforts to grow and expand, Summit Surgical Center is planning to relocate to a new site on the campus of the new Virtua Voorhees hospital, align the center with Virtua's strategic growth plan and market the center's growth to physicians' interests.
Virginia Eye Institute Surgery Pavilion (Richmond, Va.)
Annual case volume: Approximately 13,000
Specialties: Ophthalmology and ENT
Details: The physician-owned Virginia Eye Institute surgery center opened in May 1987 and is accredited by the AAAHC. With roughly 70 percent of cases specializing in ophthalmology and 30 percent in ENT, the institute offers five ORs, one laser room and one LASIK suite for its 36 privileged physician users. Approximately 16,000 procedures are performed each year at the facility.
Keys to building/maintaining volume: Vice President of Operations J. Eric Hays says safe and efficient operation of the operating rooms is critical for physicians to feel their time is being well spent in the facility. He adds that the aim to accommodate surgeons and focus on organizational objectives is always a focus.
"We always plan with growth in mind," Mr. Hays says. "Our processes and supporting ancillaries are designed to be adaptable and expandable. New clinical geographies and additional specialties are other growth strategies we consider."
United Medical Endoscopy Center (Lancaster, Calif.)
Annual case volume: More than 10,000 cases for the past four years
Specialties: Gastroenterology and pain management
Details: The United Medical Endoscopy Center, which opened in June 2005, is a physician-owned facility that has since been accredited by the AAAHC. The surgery center currently has 12 different physicians users, including ASC founders from High Desert Gastroenterology, two GI rooms and one pain management room. The ASC performed approximately 12,500 procedures in 2008 and 2009.
Keys to maintaining/building success: The ASC has strategically marketed itself as a GI-driven ASC, as all GI physicians in the area work from out of the facility. The facility also relies on physician recruiting and patient referrals to maintain high volume.
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