4 Steps to a Thriving GI Surgery Center
As the administrator of a surgery center that performs more than 10,000 GI cases and an additional 2,000 other specialty cases per year, Tim Luckett, RN, CRNFA, has developed a set of key strategies for maintaining a smoothly-run ASC. Time management, supply cost containment, contract negotiations and patient feedback are among the crucial strategies he cites for running a profitable and sustainable operation at Advanced Diagnostic and Surgical Center in Alhambra, Calif.
1. Distribute reports of all supply and staff costs to increase awareness. Physicians and surgery staff members are more likely to be conscious of scheduling and supply use if presented with hard data that confirms how these costs affect center profitability, Mr. Luckett says.
"You can't know what you're making unless you know how much you're putting out," he says. "From the time the staff hits the door until the time they leave, I include the time spent in pre-op, what was used — IV, cap, shoe covers, gown, linen, any premedication — the amount of labor, the cost of sterilizing supplies, and how much each room per hour costs per day in an eight-hour day," he says. "I factor all of those things in and come out with a fairly accurate report — it's usually within 10 percent either way."
When Mr. Luckett compiles the reports — a process that typically take several weeks and involves collaboration with the accounting department — he then meets with the medical director and the president of the surgery center board to review all of the statistics, which are later presented at the board meeting.
"The takeaway message shows what cases you make the most money on and the importance of volume," Mr. Luckett says. "It gives them a sense of, 'Yes I know what's going on here, I understand the impact of showing up at 10:30 when I'm requested at 9. I understand that labor costs are fixed, and that [late arrivals] back people up through the whole system.'"
2. Coordinate with other ASCs to contract with biomedical suppliers. Mr. Luckett is currently engaged in an effort to lower the center's biomedical supply and repair costs, which are among the highest costs the center incurs over time. These supply contracts affect many areas of the ASC, he says, including X-ray machines, lasers, anesthesia machines, OR tables, recovery room beds and monitoring equipment.
Biomedical suppliers may charge the center $120 per hour for work, for example, but that cost can be lowered to approximately $50 if a larger group of centers approaches the same supplier seeking contracts. Having had discussions with biomedical suppliers about the discount possibilities, Mr. Luckett aims to form a consortium of ten area ASCs before approaching a supplier for discounted rates.
3. Create a centralized supply room. After joining the center as administrator, Mr. Luckett began to consolidate all of the center's supply rooms into one central location: a 400-square-foot room that formerly held the center's medical records. The room now contains wire racks that hold all of the center's supplies, which simplifies the inventory process and allows Mr. Luckett to ensure that the center is not over- or under-stocked.
"It's very easy to get in and out of racks, and everything is out in the open," he says. "It's easy to keep track of everything that goes in and out of the room."
All operating supplies first enter the centralized stock room to be inventoried before they are brought to the ORs, Mr. Luckett adds. Center staff members come to the stock room every day prior to performing any procedures, and they keep a log of which supplies are taken to the OR. Mr. Luckett says the center is also beginning to implement a scanning system so that staff members can simply scan each item's bar code prior to removing it from the room.
4. Distribute patient surveys. Surgery centers can maximize patient satisfaction by asking for feedback following their procedures at the center. Mr. Luckett says that his center distributes an optional survey to every patient that is printed in both English and Chinese due to the high Asian population in the community.
The survey contains several questions that allow patients to express any concerns they had during their visit to the center: Was there anything you were not prepared for? Could we have done anything different to make your procedure or post-op experience more pleasant? If you could change anything about the treatment, what would it be?
"We get hundreds of surveys back every month, and our satisfaction rate runs 97.5 percent," Mr. Luckett says.
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