4 things to know about the staffing culture of ASCs

Ambulatory surgery centers have been an important part of the healthcare landscape since the early 1970s.

CMS and private payers continually choose ASCs as the preferred site for elective, non-acute surgeries. Physicians are often eager to perform procedures at and own shares of surgery centers. Patients nationwide are also increasingly choosing ASCs for their outpatient operations.

While there are many reasons why surgery centers have grown in popularity for the past several decades, one that is often overlooked is the staffing culture of ASCs. Here are four things to know about ASC staffing culture and how it contributes to the success of surgery centers nationwide.

1. Cross-training. A key component and trademark of ASCs is a culture of cross-training and staff working together. The old adage that everyone does everything applies in this setting. One of the key reasons that dedicated outpatient surgical centers often outperform traditional hospital surgical environments is that their team approach increases efficiency and patient, surgeon and staff satisfaction when compared to traditional hospital surgical settings.

Cross-training staff in ASCs is an industry expectation. ASCs are built on the premise of lower cost delivery of care and cannot afford or justify staff that have a "not my job" mentality. Cross-training minimizes downtime, and allows for maximum efficiencies and flexibilities with scheduling of cases and throughput of the daily case volumes.

Coordination, flexibility and multitasking of staff allow for improved turnover, faster movement of patients through the system and an immediate sense of accomplishment by the staff for a job well done.

2. Few surprises. ASCs are fortunate in that the cases performed there are routine, scheduled and non-emergent, so the schedule is rarely — if ever — interrupted with emergency add-ons that can disrupt patient flow. This lack of interruptions and their resulting delays is a key reason surgeons and patients chose ASCs. The ASC is also often a safer environment for patients and staff due to the reduced risk of acquired infection since cases are performed only on healthy patients.

3. Optimal work environment. In times where hospitals pay signing bonuses for nursing staff, ASCs often have waiting lists for job applicants. The reason for this includes the flexibility, autonomy, pleasant working conditions, regular and routine schedules, and absence of on-call, night, holiday and weekend time away from friends and family. ASCs are typically open Monday-Friday, 7:00 a.m.-5:00 p.m., with staff having the ability to leave the facility when their job is done. ASC staff looking for extra income can often find PRN work at hospitals and other facilities after the ASC is closed for the day.

4. Emphasis on teamwork. The intimate setting of an ASC allows the staff to be aware of how all of the functions of the ASC impact patient care and the financial viability of the organization, giving staff an increased sense of "ownership" for problem resolution. Teamwork permeates the environment, resulting in greater attention to detail and a commitment to improved patient outcomes.

Engaging the team and infusing a team culture is key to the success of any ASC. The culture flows from administration to the staff. When staff see administration pitching in where they can, they follow suit. Clinical staff in many ASCs help in the business office putting charts together, making or answering phone calls, or stuffing envelopes. RNs and surgical techs also help in central processing by cleaning and wrapping instruments at the end of the day to give everyone a chance to finish early. All staff pitch in and help clean rooms in between cases, and help in other areas of the center by cleaning, stocking, putting away supplies, etc. "Whatever-whenever-whomever" is often a staff motto.

Today's ever-changing healthcare environment requires flexibility, efficiency, cost-effectiveness and innovation. Those are the cornerstones of the ASC staffing culture.

Joan Dentler (jdentler@avanzastrategies.com) is president and CEO of Avanza Healthcare Strategies (formerly ASC Strategies), which provides healthcare organizations with strategic guidance, with a focus on outpatient services and population health management. For more than 25 years Ms. Dentler has been consulting on, developing or operating ambulatory surgery centers, hospital outpatient services and community health initiatives.

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