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ASC Benchmarking in 2014: Where to Start & Best Practices

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As data grows in importance and accessibility, opportunities for benchmarking in ambulatory surgery centers continue to unfold.

Kyle McAndrewsKyle McAndrews, a Project Analyst with Facility Development and Management, Stephanie Martinshares insight into FDM's new benchmarking program and how it is being used in a number of ASCs. Additionally, Stephanie Martin, BSN, RN, CNOR, CASC, Administrator of St. Augustine (Fla.). Surgery Center describes her center's strategies and offers a view of benchmarking from the trenches.

Financial benchmarking
"Effectively planning the goals of your benchmarking projects is just as important as the actual execution of the project," says Mr. McAndrews. While clinical and operational benchmarks are incredibly important, he suggests financial benchmarking serves as the best place to start. "Case costing in your most successful specialty should be where every center begins," says Mr. McAndrews. At FDM centers, GI cases represent the highest volume. Through the FDM benchmarking program, case costing tracks upper and lower endoscopy procedures by:

•    Total number of cases per quarter by CPT code
•    Disposable supply costs per case
•    Average procedure time
•    Average turnover time
•    Allotted block time for physicians

Tracking each of these five points is relatively simple and can bear much fruit. The results from case costing pave the road for future quality improvement projects and create a gold standard in an area where the ASC is flourishing, says Mr. McAndrews.

Operational benchmarking
In 2014, FDM is focusing on cancellations, patient satisfaction surveys and medical records report compliance. Based on results extracted from the 2013 program, FDM centers implemented scheduling coordination changes and set goals to reduce cancellations. This year, the centers are carefully tracking these benchmarks to determine how well the policies work. Medical records report compliance serves as a chart audit that can be benchmarked against industry standards. "The data to track is relatively straightforward. Our goal is to really bring to light how reimbursement is affected by dictation and chart delays," says Mr. McAndrews.

Internal vs. external benchmarking
Internal benchmarking is an important tool for ASC leaders to measure their center's progress against a starting point, but it has its limitations. "It is easy to believe that the level of quality and service that is being provided is the best, until you learn that someone else is doing it better," says Ms. Martin. External benchmarking allows ASC leaders to pull data from a much larger pool, identify overarching trends and create strategies to stay on par with, or outstrip, the group's performance levels.

Administrator's daily dashboard
Successful benchmarking projects are carefully monitored. "This daily dashboard covers a variety of areas to give me a cross-section view across the center and allows early identification of potential issues," says Ms. Martin. These benchmarks include:
•    Cases scheduled
•    Cases completed
•    Cases cancelled
•    Number of cases per OR
•    Turn over time
•    Billed charges
•    Collections
•    A/R days
•    Account payable
•    Aging

Gathering and putting the data to work
Data collection can seem like large task to tackle, but if approached appropriately it can be a manageable project that produces meaningful results. "We involve the staff in collecting data, especially when they can impact the outcome, such as the scheduler documenting the number of cases per OR," says Ms. Martin. "We share the data with the physicians for items they can have an impact on." Open communication is vital. Strong benchmarking projects will have involvement and support from a surgery center's entire team.

While data collection is the foundation of benchmarking, it is what you do with the data that truly matters. "The whole idea is to create opportunities to help the center run more efficiently and managing a successful benchmarking program could be the backbone to running an efficient and prosperous center." says Mr. McAndrews.

"While you should always have a clear set of goals and benefits determined before you start one of these projects, it is not difficult to discover attributes about your center that alter these preconceived objectives. Be adaptable, open minded and creative in your planning but the three most important factors as the foundation of your projects should always be enhancing patient care, increasing reimbursement and expense reduction."

More Articles on ASC Issues:
Beyond the Numbers: Benchmarking ASCs to Operational & Financial Success From SOIX
Achieve Seamless ASC Staff & Schedule Operations: 4 Essentials From Administrator Nicole Vit
Maximize ASC OR Time: 10 Key Concepts

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