Patients may follow their surgeons to an ASC, but whether they come back depends on what happens between the front desk and discharge.
That was the throughline of a patient loyalty panel at Becker’s 32nd Annual Business and Operations of ASCs in Chicago, where four leaders shared how their centers keep patients loyal without spending heavily to do it.
Treat patients as individuals, not numbers
What patients want is simple, Kelly Segura, RN, director of nursing at CenterPoint Surgical in Palos Heights, Ill., said. “They just want to be heard, they want to be talked to, and they want to be looked at as an individual, not as a number.”
That starts with a person — not an automated system — answering the phone. CenterPoint nurses call every patient with an arrival time, and a nurse line rings directly to the nurse station and, on weekends, to Ms. Segura.
The center also created what it calls the CenterPoint Experience, which treats anxiety as more than a medication question. “It’s, ‘what can I do to offer you some more comfort?’ Is it aromatherapy? Is it music? Do you want me to dim the lights?” she said. “Some people don’t even realize that that’s something that they need.”
Fewer faces build more trust
For Jeffrey Flynn, COO and administrator of Gramercy Surgery Center in New York City and president of the New York State Association of Ambulatory Surgery Centers, dignity is the line ASCs can’t cross. “Hands down, we allow the patients to have dignity, and we can never fail at that,” he said.
He said hospitals can feel chaotic, while ASC patients deal with fewer staff members and build trust faster. “You see that in patient satisfaction [surveys] where they’re naming the nurse by name, because they didn’t talk to six nurses, they talked to just two,” he said. When too many people cycle through, the day becomes “a blur” and patients feel rushed out.
He also urged leaders not to underestimate cleanliness. “The worst thing is a patient can go into the restroom prior to surgery and it will be a dirty restroom, and it’s going to go through their mind: I wonder if the OR is clean,” he said.
Convenience, communication, confidence — and cleanliness
Tammy Straub, vice president of ASC operations at Philadelphia-based Jefferson Health, rounds on what she calls the three C’s: convenience, communication and confidence. She added a fourth, cleanliness, during the panel.
Staff confidence carries over to patients, she said: If patients don’t see it, “they don’t have faith and trust in our center.” She wants staff to “own their center rather than rent.”
Patients still largely follow their physicians, Ms. Straub said, but they compare experiences, too. “If I know that I have five different places to go, I know what my favorite place is, and I’m going to ask my physician to support me in that endeavor.”
Narrate the care
Brandon Nelson, RN, administrator of Sutter Sierra Surgery Center in Roseville, Calif., part of Sacramento, Calif.-based Sutter Health, reminds his staff that a surgery center is “a foreign environment to our patients,” even if it’s routine for them. Sutter Sierra recently introduced what it calls three-step communication: a warm welcome, narrating care and a fond farewell.
“First impressions are really great,” he said. “It’s also that last impression that is really important. That’s what they’re going to remember after their experience.”
Head off sticker shock
A surprise bill at check-in can undo everything else. Ms. Straub described patients learning at the front desk that they owe $3,000 and “completely decompensating” because they don’t know how they will pay.
Mr. Flynn aims to tell patients their financial obligation as early as possible — ideally two weeks before surgery — and to walk through payment plans and hardship options. He also coordinates with surgeons’ offices on who should deliver the news, since some patients will take it better from the practice they know. At Sutter, Mr. Nelson said, the billing team reaches out to patients ahead of time so they know what to expect.
Collecting from patients is getting harder in New York, Mr. Flynn said, pointing to two state laws: one barring providers from reporting medical debt and another barring hospitals from suing patients with incomes below 400% of the federal poverty level.
“People are starting to be more savvy,” he said, “and they’re realizing there’s no obligation for me to pay this at all.”
One response is bundled payment arrangements with payers that leave patients with no out-of-pocket cost. “If a patient walks in and they have no responsibility of a copay, that patient is in a much better situation calm-wise than the patient who owes $3,000 as they walk in the door,” he said.
Use technology, but keep a human backstop
Jefferson uses Ease, a Stryker-supported app, to send families personalized updates as their loved one moves through surgery. Ms. Straub said the center tracks which nurses use the platform most and recognizes them for it. CenterPoint uses HST Pathways’ case coordinator status board to text family members at set points, along with One Medical Passport and personalized videos before surgery.
No panelist treated those tools as a substitute for people. When a case runs late, Mr. Flynn’s staff tell the family directly — that the patient is fine and the OR is running about 25 minutes behind. Ms. Segura walks out to the lobby herself.
“There’s a common theme here: That human point still has to be there no matter what technology you’re using,” she said.
Culture starts with leaders on the floor
Whether a system runs 21 centers or 36, culture still comes down to leaders who round, panelists said. “Healthcare is an art and a science,” Ms. Straub said. “We can’t forget the art in what we do.” Small ASC teams, where staff wear multiple hats, make that easier than in a large trauma center, she added.
Mr. Nelson said the tone starts with him. Sutter’s ASC administrators are encouraged to visit one another’s centers to see what is and isn’t working, and his own days center on building relationships with staff and physicians.
Most of what the panelists described costs little beyond staff time: a phone answered by a person, a nurse who explains each step, a bill explained two weeks early.
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.
