Frequent employee turnover can damage an ASC in multiple ways. Recruitment and hiring costs money that could be saved by keeping an employee at the center; staff cohesion is disrupted when employees leave; and every new staff member takes time to pick up clinical processes that save time and improve patient care. Melodie Garrobo, CASC, administrator of Golden Ridge Surgery Center in Golden, Colo., supervises 10 staff members who have been with her current center for over seven years. She shares five tips for increasing employee longevity.
1. Physician involvement. Ms. Garrobo credits her center's employee longevity to the strong bond between physicians and staff. In some facilities, physician/staff relationships are damaged because physician owners are too busy to spend time on operational issues at the center, and staff feel brushed off or disrespected by their surgeons. Ms. Garrobo says her surgeons have built a culture of friendship with some staff over the years, an environment she was unsure about when she started at the center. "I still tend to encourage people not to get too friendly or become best friends with their surgeons, but [the friendship between physicians] opens up dialogue for all parties and encourages surgeons and staff alike to share in a common interest in the center," she says. This year, the physician owners and ASC leadership decided to focus on developing and maintaining quality relationships, and the center held its first office party with the main physician group. "That broke down a lot of silos and we learned a lot more about our physicians and their staff" she says. "It's a small enough surgery center that there's a very family-friendly atmosphere."
Ms. Garrobo says it also helps that her physicians are fully invested in the happiness of her employees. When staff members raise an issue with the center, the physicians are first in line to encourage staff and management to work together for a common solution. Ms. Garrobo says this support from the physicians makes staff members feel appreciated and respected. " They value the hard work of the employees and want myself and my colleagues to step up and encourage employee retention, she says.
2. Less emphasis on the chain of command. Ms. Garrobo touts a "bottoms-up" approach at her surgery center, meaning staff members are encouraged to come forward with ideas at any time. She dislikes the environment created by the "chain of command," meaning employees are only supposed to speak to their direct supervisor about ideas for improvement, and communication between administration and lower-level employees is limited. "We really have an open-door policy," she says. "We've had managers who would want to keep their doors shut, and I understand that. Nothing is more frustrating than when you've got to get six things done and the door never stops opening or the phone never stops ringing. But that's the challenge we accepted when we agreed to be the CEOs of our organizations. We have to suck it up and prioritize." She says employees at a surgery center must feel they have the ability to speak up about concerns, ideas and potential changes. Since many ASCs are constantly looking for ways to cut costs, encouraging employee innovation is essential to noticing areas of waste. In addition, employees who are encouraged to speak will feel valued and will be more likely to stay with the center.
3. In-depth orientation. The first few weeks at a new job can be some of the most important. Employees are generally confused, scared or unsure of their roles, and great administrators will take the opportunity to introduce them to the center's culture and set clear expectations for their work. Ms. Garrobo's orientation process assigns new employees to spend one day in the business office, where they learn about policies and procedures, take care of legal documentation and discuss the culture of the center with Ms. Garrobo. "We go into some granular examples of what's worked and what's not worked, and we're very upfront," she says. An in-depth orientation will let new employees know you care about their future at the center and are committed to their success. It should also help dismantle any misconceptions they have about the job — an important process since confusion about responsibilities can significantly increase employee frustration. In addition, employees who don't fit with the center will realize the mismatch more quickly, giving you the opportunity to part ways on positive, mutual terms.
4. Staff input on benchmarking. Like many centers, Ms. Garrobo's facility has installed an employee bonus program based on pre-determined benchmarks. To make sure employees are invested in meeting the benchmarks, Ms. Garrobo asks staff members to meet as a group and decide benchmarks for each department. "I've tried to stay meddle-free and out of their processes," she says. "I don't attend their meetings unless they ask me to guide them along. For the most part, they pick their own benchmarks and choose what's important to them." You might think staff members would take this opportunity to set low benchmarks that are exceedingly easy to meet, but Ms. Garrobo has experienced the opposite problem. She has had to encourage staff members to set their benchmarks slightly lower, as their enthusiasm sometimes overtakes their ability to realistically meet a goal.
Ms. Garrobo also tasks her employees with collecting the data that demonstrates whether benchmarks have been met. She says this process has been harder to embed, as some employees find data collection more difficult. Even so, giving employees ownership over the process has empowered them to find ways to collect and present data.
5. Administrator accountability. If you hold your staff members accountable for meeting benchmarks, you should also demonstrate accountability as an administrator. Your staff members will respect you and view you as part of the center's team if you show that you are invested in improving your leadership skills. "Part of my annual review [focuses on] what I have done to reduce employee turnover and to help maintain and preserve quality relationships," Ms. Garrobo says. "The physicians have demanded that I treat the employees as customers — and I think you hear that lip service in a lot of other facilities, but this is a facility where it's embedded in the culture."
When Ms. Garrobo's staff members are displeased with an administrative decision, the ASC's physician owners prioritize staff opinion. At one point, Ms. Garrobo decided to purchase a biometrics time clock to track employee time at the center. The staff objected, fearing that the clock — which required employee fingerprints to monitor when staff arrived and left — would pose a danger to employee privacy. "My physicians stepped in, acknowledged staff concerns, and we discontinued the installation."
Read more advice on operating a successful surgery center:
-19 Most Frequently Provided Ambulatory Surgery Center Services
-5 Significant Surgery Center Development Mistakes
-Containing Surgery Center Staff Salary Costs: Q&A With Lisa Austin of Pinnacle III
1. Physician involvement. Ms. Garrobo credits her center's employee longevity to the strong bond between physicians and staff. In some facilities, physician/staff relationships are damaged because physician owners are too busy to spend time on operational issues at the center, and staff feel brushed off or disrespected by their surgeons. Ms. Garrobo says her surgeons have built a culture of friendship with some staff over the years, an environment she was unsure about when she started at the center. "I still tend to encourage people not to get too friendly or become best friends with their surgeons, but [the friendship between physicians] opens up dialogue for all parties and encourages surgeons and staff alike to share in a common interest in the center," she says. This year, the physician owners and ASC leadership decided to focus on developing and maintaining quality relationships, and the center held its first office party with the main physician group. "That broke down a lot of silos and we learned a lot more about our physicians and their staff" she says. "It's a small enough surgery center that there's a very family-friendly atmosphere."
Ms. Garrobo says it also helps that her physicians are fully invested in the happiness of her employees. When staff members raise an issue with the center, the physicians are first in line to encourage staff and management to work together for a common solution. Ms. Garrobo says this support from the physicians makes staff members feel appreciated and respected. " They value the hard work of the employees and want myself and my colleagues to step up and encourage employee retention, she says.
2. Less emphasis on the chain of command. Ms. Garrobo touts a "bottoms-up" approach at her surgery center, meaning staff members are encouraged to come forward with ideas at any time. She dislikes the environment created by the "chain of command," meaning employees are only supposed to speak to their direct supervisor about ideas for improvement, and communication between administration and lower-level employees is limited. "We really have an open-door policy," she says. "We've had managers who would want to keep their doors shut, and I understand that. Nothing is more frustrating than when you've got to get six things done and the door never stops opening or the phone never stops ringing. But that's the challenge we accepted when we agreed to be the CEOs of our organizations. We have to suck it up and prioritize." She says employees at a surgery center must feel they have the ability to speak up about concerns, ideas and potential changes. Since many ASCs are constantly looking for ways to cut costs, encouraging employee innovation is essential to noticing areas of waste. In addition, employees who are encouraged to speak will feel valued and will be more likely to stay with the center.
3. In-depth orientation. The first few weeks at a new job can be some of the most important. Employees are generally confused, scared or unsure of their roles, and great administrators will take the opportunity to introduce them to the center's culture and set clear expectations for their work. Ms. Garrobo's orientation process assigns new employees to spend one day in the business office, where they learn about policies and procedures, take care of legal documentation and discuss the culture of the center with Ms. Garrobo. "We go into some granular examples of what's worked and what's not worked, and we're very upfront," she says. An in-depth orientation will let new employees know you care about their future at the center and are committed to their success. It should also help dismantle any misconceptions they have about the job — an important process since confusion about responsibilities can significantly increase employee frustration. In addition, employees who don't fit with the center will realize the mismatch more quickly, giving you the opportunity to part ways on positive, mutual terms.
4. Staff input on benchmarking. Like many centers, Ms. Garrobo's facility has installed an employee bonus program based on pre-determined benchmarks. To make sure employees are invested in meeting the benchmarks, Ms. Garrobo asks staff members to meet as a group and decide benchmarks for each department. "I've tried to stay meddle-free and out of their processes," she says. "I don't attend their meetings unless they ask me to guide them along. For the most part, they pick their own benchmarks and choose what's important to them." You might think staff members would take this opportunity to set low benchmarks that are exceedingly easy to meet, but Ms. Garrobo has experienced the opposite problem. She has had to encourage staff members to set their benchmarks slightly lower, as their enthusiasm sometimes overtakes their ability to realistically meet a goal.
Ms. Garrobo also tasks her employees with collecting the data that demonstrates whether benchmarks have been met. She says this process has been harder to embed, as some employees find data collection more difficult. Even so, giving employees ownership over the process has empowered them to find ways to collect and present data.
5. Administrator accountability. If you hold your staff members accountable for meeting benchmarks, you should also demonstrate accountability as an administrator. Your staff members will respect you and view you as part of the center's team if you show that you are invested in improving your leadership skills. "Part of my annual review [focuses on] what I have done to reduce employee turnover and to help maintain and preserve quality relationships," Ms. Garrobo says. "The physicians have demanded that I treat the employees as customers — and I think you hear that lip service in a lot of other facilities, but this is a facility where it's embedded in the culture."
When Ms. Garrobo's staff members are displeased with an administrative decision, the ASC's physician owners prioritize staff opinion. At one point, Ms. Garrobo decided to purchase a biometrics time clock to track employee time at the center. The staff objected, fearing that the clock — which required employee fingerprints to monitor when staff arrived and left — would pose a danger to employee privacy. "My physicians stepped in, acknowledged staff concerns, and we discontinued the installation."
Read more advice on operating a successful surgery center:
-19 Most Frequently Provided Ambulatory Surgery Center Services
-5 Significant Surgery Center Development Mistakes
-Containing Surgery Center Staff Salary Costs: Q&A With Lisa Austin of Pinnacle III