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Become an Agent of Change: 6 Steps for ASC Leaders

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Today's healthcare environment is wrought with uncertainty and it can be difficult to keep up, let alone lead the pack. Ambulatory surgery center administrators have an especially difficult task of innovating with lower reimbursements and higher overhead expenses than ever before. However, with challenge always comes opportunity.

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"This is certainly an exciting time to be an ASC operator," says Dotty Bollinger, COO of Laser Spine Institute, based in Tampa, Fla. "In the midst of healthcare reform, we are waiting in anticipation for what it means from a reimbursement perspective during implementation. Surgery centers are uniquely situated because they are the most efficient in the arena to provide surgical treatment and the infection rate is low, so overall healthcare costs are less. As insurance companies look to squeeze providers and remain profitable, I think ASCs will remain on top."

Here are six steps for surgery center administrators to become agents of change in healthcare today.

1. Stay on the cutting edge.
It's easy to become complacent once you find a procedure and process that works at your ASC, but make sure your surgeons and staff are updated with the cutting edge technology and techniques to keep your surgery center on the forefront of innovation. For many surgeons, this means focusing on minimally invasive techniques.

"Providers are going to figure out how to stay on the cutting edge because what worked yesterday won't work tomorrow from a patient and payor perspective," says Bollinger. "This doesn't mean taking shortcuts for unfavorable outcomes, but focusing on how things can be done more efficiently and better outcomes are achieved."

For providers, this means working hard to advance medicine and accomplish procedures in a less invasive way so recovery time is faster, patients return to work more quickly and the infection rate is lower.

"We are innovators and we spend a lot of time on research and development," says Bollinger. "We have exciting opportunities for patients coming down the pipeline. That's how we will stay in the lead and survive with healthcare reform. We will provide affordable, beneficial options to our patients that insurance carriers will find more favorable than other procedures out there from an economic and outcomes perspective."

2. Expand procedures.
Advanced techniques for traditionally hospital-based procedures are allowing surgeons to bring their cases into the outpatient setting. Surgery centers should be prepared to accommodate for these new, often high acuity, cases.

Dr. Stefan Prada on ASCs"We have added minimally invasive stabilization procedures this year, performing anterior cervical discectomy and fusions, as well as TLIF surgeries in the lumbar spine in our outpatient setting," says Stefan Prada, MD, a spine surgeon with Laser Spine Institute. "We will see this more and more in ASCs across the country. These outpatient procedures can offer quicker recoveries for patients, lower procedure costs and lower infection rates."

Surgeons should also focus on staying up-to-date with the technology and procedures that will allow them to bring more cases into the surgery center. "Laser Spine Institute surgeons are constantly searching for new and more effective ways to offer spine surgery techniques to our patients to ultimately meet their needs," Dr. Prada says.

3. Continuing education and development.
Surgeons and nursing staff must be engaged in continuing educational opportunities and developing their respective fields. If possible, the surgery center should promote a culture of collaboration and development between the specialists within the group as well as within professional organizations.

"We have taken a very aggressive stance on education and training, even more so in the past year as we have been actively looking at how to next expand our practice from a medical perspective," says Bollinger. "We've had conferences that are proprietary for our surgeons where we bring in experts and our surgeon leaders to teach the newest procedures, as well as frequent cadaver labs. These sessions are led by our chief of surgical innovation and chairman of the department of surgery as an opportunity to see how we can make our current procedures better."

These sessions have led to the invention of new tools and techniques. "We won't sit on our laurels looking for better procedures for our patient population," says Ms. Bollinger. "We want to do it first and do it better. In the stem cell space, we have some exciting opportunities over the next few months."

Laser Spine Institute surgeons are involved in the development of the RegenaDISC procedure that promotes regeneration of vertebral discs to help relieve symptoms associated with pain caused by degenerative discs. "The process includes extracting adult stem cells from the patient and transferring them to the affected discs to facilitate pain reduction and tissue regeneration," says Dr. Prada. "[Surgeons] need to be able to innovate or adopt new technologies or new techniques."

4. Promote transparency
. One of the biggest changes coming out of healthcare reform is transparency of clinical data, patient satisfaction and cost of care. Traditionally surgery centers have ranked higher than other providers in all categories, which should make them attractive to patients and payors alike.

"It will be very important in healthcare reform to publish quality outcomes, patient satisfaction, infection control and complication rates," says Ms. Bollinger. "We are very excited about that because we have focused since our inception on marrying high quality with exceptional patient care. We are excited to be able to compare ourselves to other ASCs as part of healthcare reform."

Surgery center administrators should make sure they are focusing on the right metrics now so they will have favorable data to publish in the future.

"It's critical that ASCs focus on improving and maintaining patient satisfaction scores," says Dr. Prada. "This will become more and more important in helping patients make decisions to come to your ASC or practice. In addition, you need to be focused on monitoring and maintaining outcomes."

5. Practice value-driven healthcare.
The most important factor for a successful provider is putting the patient first. Providers should ask themselves how each decision will impact patients, and patients are looking for surgeons who are able to provide the most high-quality, cutting-edge care.

"One of the biggest changes occurring in healthcare today is the emphasis and importance on maintaining high patient satisfaction," says Dr. Prada. "There is a lot of competition in the ASC industry today. At Laser Spine Institute, we are constantly surveying our patients about their experience and making changes to our process to reflect their feedback."

A common saying around Laser Spine Institute is: The patient is waiting. This motto reminds surgeons and staff members to focus on how their decisions will impact patient care.

"Value-driven healthcare increases the patient's ability to choose their providers," says Bollinger. "The consumer is very educated because of the Internet and transparency allows them to compare providers. For providers who are unwilling to adapt and put the patient first, I think their end is near because the consumers won't put up with it. We are excited about that here because that has always been our model."

6. Build a relationship with others.
In a time of constant change and innovation, it will be beneficial for ASCs to partner with others on information sharing ventures. Laser Spine Institute is working to develop agreements with surgeons outside of their network to train them in proprietary procedures.

"We understand that smaller providers may not have the resources to internally do research and development training on their own, but they can partner with others," says Bollinger. "We are developing some of our procedure and creating licensing agreements to teach and train surgeons on them. We can help other practices create relationships with leaders in the industry to help move their practices forward."

More Articles on Surgery Centers:

10 Recent Acquisitions of ASCs

5 Creative Ways for ASCs to Improve Profitability Next Year

6 Steps for ASCs to Participate in New Payment Models



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