Here are six philosophies for resilient ambulatory surgery center administrators in a tough healthcare environment.
1. Don't react to change with fear. When you are merely reacting to the fear of uncertainty, you will miss potential opportunities for taking advantage of a tumultuous time. Instead of fearing potential changes, orthopedic practices should identify their competitive advantages, especially over hospitals, and find ways to exploit them.
"It's hard for large hospital organizations to feel friendly to patients, like a smaller practice does, which is a competitive advantage we could exploit," says John Wipfler, CEO of OA-Centers for Orthopaedics in Portland, Maine. "Large hospital organizations can also be clunky, and one of the things we can do is create a high level of customer service that hospitals find hard to compete with."
Another point that Mr. Wipfler often highlights is the group's ability to spread throughout the community while the hospital is fairly grounded within the walls of a single facility. "A hospital is locked where it is, but we are able to have satellite offices in a number of areas," he says. "Local hospitals can't as easily build somewhere else, but we can be nimble and create facilities that are closer to our patients."
2. Focus on improving what you can control. There are several aspects of the healthcare landscape ASCs can't control, such as payer rates. If you are unable to negotiate more favorable in-network contracts, work on improving efficiency to make an impact on your bottom line.
"Pick your battles — the only thing administrators can control is productivity," says Jim Stilley, former CEO of a large ASC, currently a management consultant and Director of Clinical Workflow Consulting for Versus Technology. "You can control productivity by optimization. Ensure you have the optimal amount of quality and value from your staff."
While surgery centers have always focused on efficiency and increasing patient volume to stay in business, there could be new areas to enhance productivity that have become lax over the years.
"Surgery centers for the past 20 years have gotten into second or third gear in their organization," says Mr. Stilley. "There are other gears that will require capital investment. When I work with ASCs, we pull apart their processes and look at individual steps to see the opportunities for increased efficiency that they didn't realize before."
There are often structural issues with the organization or staff that make a surgery center inefficient. Those areas must be patched to ensure survival.
3. Encourage dialogue and brainstorming. The culture at your surgery center should be open to suggestions from employees at all levels and promote collaboration between different departments at the center.
"Ensure staff meetings at all levels foster an open and collaborative dialogue where employees feel comfortable addressing controversy," says Dr. Jill Sackman, a senior consultant with Numerof & Associates. "It tends to be a hierarchical environment between the surgical and nursing staff, but really try to foster a comfortable atmosphere so employees can put an idea on the table and not be criticized."
You can also designate specific brainstorming sessions to overcome a new problem, or think about new ways to complete old processes. "Get people together and think out of the box," says Dr. Sackman. "Let employees know the results of the session so they know their time is well spent. Individuals in surgery centers are busy and the last thing people think about is whether they are communicating well; it's hard, but very important to communicate when everyone is stressed about what the future will look like."
4. Anticipate change and prepare for it. While not everything heading your way is predictable, there are certain changes within the healthcare system surgery center administrators can anticipate. Instead of waiting to see what others do or holding out until the surgery center has to close its doors, leadership should embrace these changes and use them to their advantage.
"There are a lot of things in the Patient Protection and Affordable Care Act that are somewhat nebulous, such as Accountable Care Organizations," says Rob Carrera, president and CEO of Pinnacle III. "We are wondering how surgery enters are going to fit into ACOs and believe there are going to be a lot of positives for us in that type of system. There's the potential to bring more high acuity cases into the ASC as people look for a more cost-effective setting."
Some physician groups and surgery centers are already forming relationships with other providers and payors in the community to position themselves as a viable partner in future ACOs.
"Surgery centers have to have their eye on the external environment more than ever," says Dr. Sackman. "The leadership team at the surgery center should look at what is happening in the competitive market and where your center is in terms of cost and quality."
5. Make the decision to be positive every day. Lori Martin, administrator of Summit Surgery Center at St. Mary's Galena, bases part of her leadership strategy on "Taking the Stairs: 7 Steps to Achieving True Success," by Rory Vaden. Mr. Vaden tells his readers, "Happiness is not a mood. It is a decision." Ms. Martin tries to live by that philosophy every day; she says that if a leader chooses to be positive, they inevitably spread a culture of positivity throughout the organization.
She says she greets her staff at the beginning of every work day, making sure to smile and say everyone's name. "We're all going to be here for eight or 10 hours, so let's make it good," she says. "I walk in every day and smile, because when you're at work, you've got to put your game face on." She says rather than walking into the ASC and "taking the temperature" of the staff, the administrator should set the temperature upfront.
6. Create a money-saving mindset among staff members from day one. Surgery centers will need to be cost-effective in addition to high-quality care facilities to survive in the future. However, before any cost cutting measures can take place, it is important to first encourage a willingness to participate among every physician and staff member in the process to save money throughout the center, says Arthur E. Casey, CASC, senior vice president of business development for Outpatient Healthcare Strategies.
"It should definitely be part of the culture and philosophy of the facility. In every situation in which you can be talking about the goals of the facility — upon hire, during evaluations, in weekly or monthly staff meetings — you should be driving that home," he says.
It is also important, however, to incentivize staff members without necessarily incorporating a cash bonus program, which may cancel out any cost savings achieved. Alternative ways to recognize staff efficiency and cost cutting include public recognition and smaller rewards. "You should also be highlighting and recognizing your staff members when they are doing what you're asking," he says. "Everyone wants to be acknowledged for doing a good job, and it's extremely important that staff members are publicly recognized or thanked at every opportunity.
Staff members can also be given small incentives, such as a $15 gift card to a coffee shop or a pot luck lunch. "With those sorts of things, you're motivating your staff to do the job that they're supposed to be doing," he says.
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