5 healthcare leaders on what changes paid off in 2022

Five healthcare specialists recently connected with Becker's to share what changes they implemented in 2022 are here to stay.

Q: What changes you made in 2022 are you bringing into 2023? If none, why?

Mark Destache, MD. Associated Anesthesiologists (St. Paul, Minn.): We took over a surgery center in late (December) 2021. I think the only thing we updated or carried over was a commitment to take care of patients of all ages (which was sorely lacking) and a thorough review of medications for anesthesia that represent the best practices with a perspective of environmental best practices.   

We were part of this surgery center six years prior and with a ownership change, we were asked to relook at it. No one should be using desflurane anymore — some countries have banned it.  The risks to our environment are too high and well known. Same with piped-in nitrous. There is so much loss through the piping system; if you need it, go to tanks. Many new surgery centers are being built in with no piped-in nitrous. The environmental impacts of anesthesia need to be recognized and changed.

Barb Draves. Administrator of The Surgery Center (Middleburg Heights, Ohio), Chair of the Ohio Association of Ambulatory Surgery Centers: Somewhere during the fourth quarter it became evident that COVID had wreaked enough havoc on our people and our facility and it was time to get "back to the basics" — the things that made our ASC special in the first place and what is important in an ASC.

COVID could not and would not be an excuse for anything anymore. Turning our focus to our surgeons and our team, what was important to them and getting those components back on track. 

For our surgeons: starting cases on time, having their preferences for their cases, having an OR team that knew their routine and keeping them on schedule.

For our team: having enough people scheduled daily so that everyone could return to regular hours, cross training for those who were interested, obtaining certifications in their specialty areas, meeting time-off requests.

Our team pulled together for over two years, covering for one another when one of them or their family members had COVID; they all worked so hard and many long hours so that we could continue to provide surgical services.

We started 2023 with an "over COVID" attitude; everyone at our facility is back on their game, we have added new physicians and new procedures, we are pretty close to having a full nursing team and COVID is not an excuse for anything here anymore.

Andrew Gerstner, MD. Independent anesthesiologist and consultant: I finally removed myself from private equity and corporatized medicine and changed jobs. I stopped working at giant hospital systems and moved to a smaller, physician-owned hospital and have a much more manageable schedule and am simply just paid fairly for my time … and no longer have to put up with being forced to take on more uncompensated or under-compensated work just because the hospital or staffing company has understaffed everything and expect physicians to pick up the slack for their own business mistakes for free. 

I will carry that through with me for the rest of my career. I will only work at a place like this or do locums work. I will not show any more loyalty to corporatized medicine because their business model relies on taking advantage of physicians and trying to hold them back from their fair market value as highly skilled professionals that went into a ton of debt just to serve society. Medicine in the country will continue to decline all the way down to "pathetic" if physicians do not know their worth because they will just burnout and quit, and it will be all cheap-labor, under-trained people taking care of patients to check a box and send the bill.

Cathy McCue, MSN, RN. Administrator of Uropartners Surgery Center (Des Plaines, Ill.):

I am not making any big changes in 2023. Since the pandemic through 2022, we had an increase in required CMS changes and further in-house changes to meet the CMS mandates. These are slowly being retired. I think it is nice to have a year to review the pandemic changes and results, versus always in a panic to put in the mandated changes.

Maintaining staff is extremely important for me since the pandemic. For many surgery centers, it is increasingly difficult to find and retain staff; it is a buyer’s market, so to speak. Healthcare workers can decide where they want to work. At Uropartners Surgery Center, we have made a concerted effort to find and retain staff. Currently I am 100 percent staffed with full-time, part-time and as-needed staff; I know this is not the norm. I make sure my staff know I respect them and their knowledge; I appreciate their hard work. Monthly, we have an appreciation day. We have done popcorn day, chocolate day and ice cream day, to name a few. This costs a couple hundred dollars, but we feel it is better to spend a little on appreciation than the cost to hire and train new staff. We also do two larger events during the year.

We have a monthly "employee of the month" voted on by staff: The staff member receives a parking space, gift card and trophy. This is so much fun; the parking space next to the ASC is sacred and everyone wants to win just for this space, especially in the winter.

Alan Zneimer, MD. Anesthesiologist at San Leandro (Calif.) Medical Center: We are working on our environmental footprint. In Norcal Kaiser we are eliminating N2O from our use in anesthesia. We now exclusively use sevoflurane and no longer use desflurane. We are trying a new product that also collects our WAG gasses so they are not expelled into the atmosphere.

For patient safety, we are making the use of neuromuscular monitors as routine to try to eliminate postoperative repolarization. We are also working on ways to decrease infections.

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