6 Changes to Improve Physician Productivity in ASCs

Susan Kizirian, MBA, BSN, RN, chief operating office of ASCOA, offers six changes ASCs can immediately make to improve physician productivity.

1. Make scheduling with practice seamless. Work closely with surgeons, paying special attention to their weekly schedules, to maximize efficiencies and the bottom line. This requires convincing surgeons and their practice staff to embrace the ASC's vertical scheduling and schedule compression model. "It takes a great deal of time and energy invested up front to understand each surgeon's individual needs and the give-and-take dialog to reach compromise," Ms. Kizirian says. "But once this is achieved, it is a win-win for the surgeon and the ASC." Creating a productive schedule that takes into account both the needs of both surgeons and the ASC is like putting together "a multi-layered puzzle," she says. It involves dealing with moving targets and implementing continuous improvement.

2. Introduce case-costing and best practices. Analyzing the cost of each case and establishing best practices based on the data should be done every month, Ms. Kizirian says. "This allows surgeons to see the efficiencies of each type of case they perform and what goes into these efficiencies," she says. Ingredients include supply utilization, incision time, overall OR time, implant selection and overhead costs. "The surgeon can pursue those efficiencies without any compromise to clinical outcomes," she says.

3. Understand big-picture efficiencies. ASC staff members need to make a concerted effort to educate surgeons on best use of the facility. They should strive to understand surgeons' specific needs, blending advocacy and inquiry to achieve maximum use of the ASC.

4. Communicate with your surgeons and their staffs. "The surgeon's scheduling staff are critical to maximizing the surgeon's production at the facility," Ms. Kizirian says. For key decisions like cancelling cases or starting late, communicate directly with the surgeon. Also, only surgeons should have the authority to cancel their own cases, not the ASC staff or the anesthesiologist. "When surgeons are directly involved, the issue can be quickly resolved, with excellent patient outcomes," she says. This approach also applies to start times, schedule compression and vertical scheduling. And when cases are going elsewhere that could be done in the ASC, "the quickest, most effective route to capturing lost cases is to involve the surgeon in the scheduling process," she says.

5. ASC staff and the surgeon should function as a team. "The most productive surgeons work with ASC staff in a team approach," Ms. Kizirian says. Having the surgeon and ASC staff in "lock step" allows maximal scheduling of eligible cases, maximal use of the surgeon's time and improves satisfaction of both surgeons and patients. It also minimizes rework and cancellations.


6. Perform a cost-benefit analysis of new procedures and services. The ASC manager should be constantly hunting for procedures and services to be added to the facility's repertoire. This means keeping on top of new procedures, technologies and services available in ASCs, rigorously analyzing implementation costs and presenting findings to surgeons on staff. The manager should also be looking to recruit area surgeons in markets that are not saturated.

Learn more about ASCOA.

Read more insight from Susan Kizirian:


- 3 Ways to Reduce Payroll Costs Without Impacting Care Quality


- 3 Critical ASC Benchmarks Not Routinely Tracked


- 3 Mistakes ASCs Make When Purchasing Supplies

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