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6 Case Volume Metrics to Manage in a Surgery Center

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Case volume is the lifeblood of a successful center: Without it, operating rooms stay empty and robust reimbursement rates are much less useful. Here Jessica Nantz, president and CEO of the consulting firm Outpatient HealthCare Strategies, discusses six case volume metrics that, when measured and improved, bolster ASC profitability and physician satisfaction.

1. Block scheduling and utilization. One of the most important case volume metrics to measure is block scheduling and utilization, Ms. Nantz says. Block scheduling is one of the most effective tools an administrator can use to evaluate which physicians and specialties are supporting their center by tracking their utilization. Ms. Nantz recommends setting a utilization percentage goal — most administrators recommend between 70 and 90 percent — and then measuring how many physicians are meeting that goal.

If your surgery center has a "release block policy," meaning physicians can release their block time to other providers if they don't have cases to schedule, you can also measure how often your physicians release their block time. Ms. Nantz recommends tracking whether the physicians are releasing their block time according to the center's policy, which allows the surgery center to fill the time with other cases.

Once you understand which physicians are filling their block time, you can sit down with the ones that aren't to discuss the cause. Maybe the physician scheduler is taking cases elsewhere, or the physician is dissatisfied in some way with the surgery center. Managing this metric will help determine which physicians are supporting the surgery center and how you can improve physician relations to increase case volume from every provider.

2. Scheduler relations. Your scheduling process must be as simple and painless as possible if you want to increase your case volume, according to Ms. Nantz. She recommends auditing the scheduler in your front office, as well as examining relations with physicians' schedulers. "You need to monitor your scheduler from time to time," Ms. Nantz says. "When I perform an on-site operational assessment, a key component is observing and assessing the responsiveness of the scheduler." She examines the scheduler's reaction to scheduling issues: For example, if a physician's office calls and wants a case during a closed slot, does the scheduler simply say no, or does she look for an alternative? It's essential to know how your scheduler and their back-up staff handle incoming calls, since they directly impact your case volume.

Ms. Nantz says the administrator should also talk to physicians' office schedulers on a regular basis to determine whether they have issues with the ASC scheduling process. "They want to get the schedule on the books with ease," she says. She says regular meetings are also an opportunity to talk about releasing block time. If the physician had three hours of block time that were never used, the administrator should explain that the surgery center could add cases in that time. During these meetings, the administrator will also be able to hear any concerns about the surgery center that the physician shared with his or her staff.

3. Turnaround times. Turnaround times — the amount of time it takes staff to "turn over" a room from one patient to another — have a huge impact on the efficiency of a surgery center. According to Ms. Nantz, surgery center administrators should review turnaround times every month and provide feedback to clinical staff. If staff members know they are being held to a certain benchmark, they will work together to meet the goal.  

4. Flexing of operating rooms. You may need more or fewer open operating rooms based on your case volume, and the number should never stay stagnant from week to week regardless of the number of cases. Ms. Nantz strongly urges the administrator to track several metrics — cases per operating room, cases per CPT code and cases per specialty. Once you know how many cases your surgery center is taking in, you can decide how many operating rooms to keep open and how to staff them.

If the surgery center has more cases than usual, you can open an OR and/or call in PRN staff; if the center has fewer cases than usual, you can close or compress your ORs and send some staff home. These metrics should be measured on a daily basis to make sure you are never staffing more people than necessary.  

5. Equipment quality. The quality of your equipment will have a significant impact on your case volume, as low-quality equipment or incorrect equipment levels will discourage physicians from scheduling cases. Ms. Nantz recommends that the administrator or clinical manager be in constant communication with the sterile processing department to make sure everyone is aware of any equipment malfunctions or needs.

She also suggests the OR staff report to the clinical manager on a daily basis regarding any issues physicians have with the equipment. "If the doctors say, 'I need this' or 'we didn't have this', that feedback is key, and the problem should be corrected without delay" she says.

6. Employee satisfaction. Employee morale affects case volume by attracting physicians to the center or turning them away, according to Ms. Nantz. Make sure to keep an eye on the "attitude" of your team by having regular conversations with staff members and addressing any questions, concerns or complaints.

Your surgery center should also conduct an annual employee satisfaction survey to determine any common themes of dissatisfaction among different employees. "The administrator plays a key role in the overall morale of the center," Ms. Nantz says. "They set the tone, and the tone will affect whether physicians enjoy coming to the center and bringing their cases."

Contact Jessica Nantz at Jessica@outpatienthcs.com.

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