Creating staffing models based on historical schedules, not actual case mix, and not planning enough for the future are two big blunders that ASCs have to avoid.
Cross-training staff to be able to cover scheduling holes that do slip through the cracks is crucial to operating efficiently.
Recruiting for the future, and not just the present, is a way that ASCs can always stay one step ahead of competitors.
These two ASC leaders recently connected with Becker’s to talk about some of the biggest mistakes that centers make, and how they overcame those problems at their own centers.
Note: Responses were lightly edited for clarity and length.
Question: What is the biggest structural or staffing mistake you see ASCs make, and what did it take to fix it at your own center?
Melissa Rice. Administrator of Loyola Ambulatory Surgery Center, Trinity Health (Oakbrook Terrace, Ill.): One of the most common structural mistakes I see in ASCs is building staffing models around historical schedules instead of actual case mix, acuity and daily flow variability. Too often, centers rely on templated staffing tied to surgeon blocks rather than aligning RN, tech and anesthesia resources to real-time demand. This leads to predictable inefficiencies — bottlenecks in pre-op and PACU, inconsistent OR utilization and frequent overtime. The issue is often compounded by siloed roles, where limited cross-training prevents teams from flexing when volume shifts throughout the day.
At our center, fixing this required both cultural and operational change. We conducted a detailed throughput analysis to identify strain points, then rebuilt staffing grids based on data rather than legacy assumptions, incorporating flex staffing tied to volume and complexity. Cross-training perioperative staff allowed us to redeploy resources dynamically, while improved scheduling accuracy and daily operational huddles helped us stay ahead of flow issues in real time. The result wasn’t just better staffing — it was a more responsive, efficient system that improved patient flow, reduced burnout and created more predictable performance overall.
Pamela Silva. President of Grand Valley Surgical Center (Grand Rapids, Mich.): At times, centers can get caught up in the here and now and not focus on where the center is going in the future. It is incredibly important to plan for the future and pay attention to the trends in your community as far as staffing shortages, compensation issues, etc. Looking at your target growth areas, opportunities for cross training and not getting too focused on today is important. At Grand Valley Surgical Center, we have hired a lot of part-time staff allowing us to flex time up to cover the extra busy weeks or months. We also have staff that are cross-trained in other areas. For example, circulators that can scrub or help in the PACU, or PACU staff that can do pre-procedure planning. All of this helps with job satisfaction, compensation for staff and maintaining staffing levels as we look at future growth. We are always recruiting for future growth looking ahead at our projections for cases, at specialties and looking at what is going on in our staffs’ lives. This helps us stay ahead of the game when others are a little short staffed, we seem to be doing great.
At the Becker’s 32nd Annual Meeting: The Business and Operations of ASCs, taking place October 29-31 in Chicago, ASC leaders, surgeons and healthcare executives will explore strategies to drive growth, enhance operational performance, navigate reimbursement challenges and prepare for the future of ambulatory surgery. Apply for complimentary registration now.