Susan Kizirian, chief operating officer for ASCOA, identifies three sets of data ASCs often do not routinely track and explains why it is important that they do so.
1. Clinical hours per case. This assures that ASCs are staffing for quality of care while controlling payroll costs. On average, clinical man hours per case (mhc) should run 9-9.5 mhc. In busy GI, pain management or eye centers, the clinical mhc should be low (4-5 mhc), as patients move through the center quickly and efficiently. In a heavy orthopedic/spine center, the mhc would be higher, closer to 10. Centers with low volume may run higher hours, especially if the cases are spread out over the day rather than compressed.
2. Percent of ORs utilized. If there is low OR utilization, then this is an indicator ORs need to be compressed to reduce costs. This can be accomplished by running fewer ORs or reducing number of days opened. If there is high OR utilization or OR utilization is climbing, then this indicates the need to increase capacity by extending OR hours or opening on Saturdays, for example.
3. On-time starts for both surgeons and anesthesia providers. If some providers are wasting time by starting late, this can result in myriad inefficiencies and increase costs on many levels. If you have surgeons or anesthesia providers who routinely start late, you must address this and work out the issues immediately. Don't ignore the problem and then try to fix it down the road — this is difficult since the late start will have become an established pattern of "accepted" behavior. You will need to set it as an agenda item and get your leadership behind it if it is already an ingrained behavior.
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