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6 Ways a Hospital-Based ASC Cut Costs in 2012: Q&A With Ruth Shumaker

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In 2012, Ruth Shumaker, RN, BSN, CNOR, led her hospital-based ASC in a number of cost-saving initiatives, including a sterile processing change that saved the facility around $500,000. Here she discusses improvements made at her hospital in the last year, as well as what lies in store for 2013.

Q: What projects and improvement initiatives did you undertake in 2012?

Ruth Shumaker: According to leadership literature, successful leaders surround themselves with good people, but great leaders surround themselves with people who are even better than they are. I've always surrounded myself with the best and brightest. This year, as in years past, I understood the value of those around me. I promoted the success of others by empowering them to succeed. I made changes in my leadership structure but I set clear expectations for people to succeed. 

Q: How did you cut costs in 2012?

RS: We cut costs in several ways over the course of 2012:

1. Our sterile processing was outsourced and the company provided the FTEs. Over the course of six months, I hired FTEs, and we were able to eliminate the contract. This resulting in a savings of $500,000.

2. Selective use of antibiotic suture.

3. Converted our trocars to a different company.  This cost savings was $64,561. It did require a 90 percent conversion in order to meet these cost savings

4. Ran two elective surgery rooms on Saturday and Sunday. We recently decreased this to one elective room on Saturday until 3:30 p.m. and eliminated all elective Sunday surgery. We encouraged the surgeons to move these cases to the weekday, when the schedule was lighter and we were in need of cases. I was able to reduce FTE costs and increase productivity and utilization during the week.

5. Cross-trained nurses in PACU, pre-op and post-op. We float them based on need.

6. Hired a business office manager with an MBA. She challenges our vendors to offer consistent cost=cutting opportunities and keeps a tight rein on supply inventory. Our outdates in 2011 were $120,000, and we are closely monitoring this and not keeping excesses inventory on our shelves. [We predict we will be able to] cut this in half.

Q: What was harder in 2012 than in previous years?

RS: Juggling between the conflicting interests between administration, surgeons, and patients to maximize the quality of care and productivity of the hospital. [It was also difficult to] maximize operating room utilization and minimize operating room staffing cost and change surgeons' perception that our "turnover times" are within normal range.

Q: What do you have planned for 2013? What do you see as the most pressing issues for your hospital-based ASC?

RS: I have two main goals for the next year:

1. Steadily take cost out of the system (i.e., reduce waste) while maintaining or increasing the quality of care.

2. Improve HCAHPS scores. The intent of the HCAHPS initiative is to provide a standardized survey instrument and data collection methodology for measuring patients' perspectives on hospital care.

While many hospitals have collected information on patient satisfaction, prior to HCAHPS, there was no national standard for collecting or publicly reporting patients' perspectives of care information that would enable valid comparisons to be made across all hospitals. HCAHPS survey items complement the data hospitals currently collect to support improvements in internal customer services and quality related activities.

Related Articles on Surgery Center Turnarounds:
24 Statistics on Surgery Center Case Volume
10 Tactics for Surgery Center Administrators to Communicate Better With Surgeons

8 Strategies for ASCs to Stay Profitable & Accept Medicare

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