10 Best Practices for Surgery Center Improvement From 10 ASC Leaders

Here are 10 quotes from ambulatory surgery centers leaders on important components to running an efficient, profitable and safe ASC. Note: Quotes are listed in alphabetical order of leader's last name.

 

1. W. Jan Allison, RN, CHSP, director of accreditation and survey readiness, clinical services department, Surgical Care Affiliates: "Miscommunication is a common cause of medication errors. Nurses need to remember that it is their duty to question physician orders that are illegible, incomplete, or potentially unsafe. Clarify all orders and verbal orders must be written down and read back. Follow guidelines for approved 'abbreviations' when documenting dosages." From: 8 Steps to Prevent Medication Errors in Surgery Centers

 

2. Lisa Austin, RN, CASC, vice president of ASC operations, Pinnacle III, and president, Colorado ASC Association: "A big consideration for ASCs looking to add spine is looking at the existing staff; oftentimes that is overlooked. Prepping for spine cases is hard work. It requires a little more than setting a room up for a general surgery case. We get the costs of all of the equipment, we've got the doctor all set and then all of a sudden you find out that your staff really hasn't bought into bringing this type of new case into the facility. You just want to assess your staff, get them involved from the beginning and provide any education they need to feel confident in doing these types of cases." From: 5 Critical Questions to Ask Before a Surgery Center Invests in Spine

 

3. Buddy Bacon, CEO, Meridian Surgical Partners: "The best way for ASCs to approach physician specialties with less historical involvement is to let your physician partners do the selling for you. For example, we certainly make efforts to spread the word about our achievements related to incorporating minimally invasive spine into our outpatient facilities. However, I believe there is no better way to make that happen than through peer selling between physicians. Our physicians do a great job of sharing their success and satisfaction with other physicians." From: Recruiting ASC Physician Investors in 2011


4. Mike Lipomi, president and CEO, Surgical Management Professionals: "You should definitely look at your overhead and your supplies. People tend to look at these items later, if at all, because they think, 'I'm always going to need to keep the lights on and I'm always going to need supplies.' The easy pickings seem to be on the salary side. But you can in fact find considerable savings by taking steps like renegotiating vendor agreements, or finding new vendors or persuading your physicians to use a less expensive device. These strategies take some work, but they don't cut into the muscle and bone of the organization like taking the easy route and cutting essential staff. Persuading physicians to switch their supplies means pinpointing the waste and presenting the information to them." From: Best Practices for ASCs in a Bad Economy

 

5. Beth Johnson, vice president of clinical systems, Blue Chip Surgical Center Partners: "One of the first things that has to be done [in an ASC] from a materials management perspective is for the facility or the management entity to develop clear policies related to how inventory is set up (physically and within the information database), controls for purchasing and receiving and how the entity plans to handle requests for new items." From: 6 Supply Chain Mistakes That Drain an ASC's Budget


6. Dawn Q. McLane, RN, MSA, CASC, CNOR, regional vice president of operations, Health Inventures: "Scheduling can certainly impact the number of cases you're doing in the OR. New centers will sometimes intentionally keep rooms open even though they don't have them filled because they're in ramp-up, trying to fill them and the only way they can do it is to make sure the time is available so the surgeons can get on the schedule as the practice changes patterns. But you can't survive for very long when you have a lot of holes in your schedule. In order to improve utilization, you have to close those gaps eventually. A few additional cases scheduled into the gaps can make an amazing difference in the efficiency of the center and a positive impact on benchmarking indicators like hours per case." From: How to Ensure Maximum Operating Room Utilization in a Surgery Center

 

7. Michael Orseno, revenue cycle director, Regent Surgical Health: "One of the easiest ways to decrease your days outstanding is to manage your lags and turnaround time. The charge entry lag is measured from the date of service to the date charges are entered. This number should be less than five days, with the gold standard less than two and a half days. Claims should always be sent the same day charges are entered, so the claim lag should be the same as the charge lag. If centers are experiencing a significant difference between the two, this is an indication that your billing department may be holding claims or that they're entering charges prior to receiving the operative report." From: Tips for Proper Surgery Center Billing and Coding

 

8. Larry Taylor, CEO, Practice Partners in Healthcare: "Equipment service programs can be very lucrative to vendors but may not be useful to the center. To understand your ultimate need for these contracts, review the service level you are paying for and figure out the service level you actually need." From: 5 Ways ASCs Can Cut Costs

 

9. Robert Westergard, CFO, Ambulatory Surgical Centers of America: "We feel benchmarking is a critical part of running an ASC well because it provides information needed to make good decisions and because it helps keep everyone focused on the right things. Having goals and standards is good, but when you have a whiteboard up on the wall and update your key metrics every day, everybody looks at it and sees exactly where we stand in relation to our goals, it tends to result in a laser focus on the important things." From: 6 Questions About Surgery Center Financial Benchmarking

 

10. Robert Zasa, managing partner, ASD Management: "Doctors really desire control of the operating room itself — the people, the supplies and instrumentation they use, right down to the flow of the room. Having the same nurse for your procedures and having a small group of the same anesthesiologists has a big impact on efficiency." From: 5 Reasons Why Surgeons Still Join Surgery Centers

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