1. Incentivize your coworkers to cut costs. Involve your staff members in finding ways to trim costs on a daily basis. Ms. Simon says her staff has come up with terrific ideas because they know each cost they cut will contribute to an end-of-year bonus shared between the staff members. “Some ideas are very simple but effective,” she says. “When they’re putting together towel packets, they include the non-sterile 4 x 4 gauze sponges, so when they pull the towels, they’ve also got the sponges for the case.” It may be a small measure, but combining the towels and the sponges means Ms. Simon’s ASC doesn’t have to pay extra for another plastic container. “It works beautifully,” she says.
2. Stagger your RN shifts to maximize productivity. Ms. Simon says that giving each RN staggered, 10-hour shifts has completely eliminated the need for overtime. “The admitting nurse comes in at 6:00, the OR nurse comes in at 7:00 and the two recovery nurses come in at 7:30,” she says. “This means they’re leaving earlier because they’re done with their work, and the physicians love that there’s no overtime.”
3. Hire staff members who can fill different roles. If you hire staff members who have the credentials to fill different roles, you decrease your number of FTEs and ensure that you can switch around staff members to cover shifts when necessary. “Every staff member is either a surgery tech or an RN, even the two girls at the front desk,” she says. “If a tech or an RN gets sick, they leave and I step into that role, or, if it’s a tech, I take the front desk and one of the surgery techs at the front desk goes back into the surgery suite to work.”
4. Make every staff member aware of your supply costs. In an ASC, some of your supplies will be high-dollar items, and you need to budget carefully for those items and take care of them. Ms. Simon doesn’t order a supply for a case until the case is scheduled. “I don’t keep them stocked,” she says. “Items that are very expensive — up to $1,000, in some cases — will lose you money if you let them sit and risk outdating. The physicians know when they they schedule a certain case, they have to let me know so I can order the [accompanying] product.”
5. Understand the benefits of working with a hospital. Though some ASCs shy away from developing a close relationship with a hospital, Ms. Simon says the partnership between her ASC and the local hospital has saved her money. Her ASC shares a bin with the hospital that holds ear implants for a surgeon who works at the hospital and the ASC. “When he uses an ear implant for surgery at the hospital, they put the box back in that bin with a patient name on it, so we are able to transfer funds from department to department,” she says.
She says staff members at the ASC pay attention to the hospital’s supplies to make sure the surgery center is using the cheapest supplies available. “When I was in hospital, I noticed the nebulizer they were using for breathing treatments was completely different than the one I used in the surgery center,” she says. “I looked it up and realized it’s cheaper than the one I’m using. In the past, the hospital was the hospital and the clinic was the clinic, but we’re beginning to understand that when we work hand in glove, it will be less expensive for all of us.”
6. Be bold with vendors. Educate your staff members about costs so they know how to respond to vendors who approach your center. Ms. Simon says her staff members ask vendors point-blank if they offer a piece of equipment that costs less than the center’s current equipment. “They’re very bold about that, and it’s to their advantage,” she says.
7. Be honest with your physicians about purchasing. Sometimes a physician will desire a piece of equipment that your center cannot afford. Before you agree to an unwise purchase or make the physician angry by brushing off his or her suggestion, sit down with your physician group to discuss the merits of the equipment. Ms. Simon says her group of ENT physicians sits down every month to discuss how a new piece of equipment will benefit the group as the whole, rather than just one physician. “A physician will go off to a conference and come home with stars in his eyes and some new, incredibly wonderful piece of equipment,” she says. “We’ll look at the equipment, discuss it, trial it, and if it works out, agree that yes, we’re going to change to this.”
8. Inventory your supplies regularly. If you inventory several times a year, you will get a sense of which supplies are being used and which are not, Ms. Simon says. If you notice a particular supply is not being used, you can ask your vendor if you can trade the item for another item that is used more frequently. The vendor will often agree to swap the items, saving you money.
“Inventory also gives you the opportunity to see if somebody has put something in the wrong place because they didn’t have space where it belongs,” Ms. Simon says. “You might have 100 cases of gel foam because someone put cases where they didn’t belong.” Don’t make the mistake of re-ordering supplies you already have because you haven’t taken a proper inventory.
Read more about St. John’s Clinic: Head & Neck Surgery.
