7 Best Practices to Create Goals and Objectives for a Surgery Center

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Maggie Summerfelt, administrator of Advanced Surgery Center in Omaha, Neb., discusses seven ways she creates clear goals and objectives for her surgery center and motivates employees to meet them.

1. Assess progress monthly and quarterly. Ms. Summerfelt says her surgery center board of managers and medical executives meet on a quarterly basis to track progress on financial goals and larger quality improvement initiatives. These initiatives may span an entire year, so meeting once a quarter is enough to check in and determine necessary next steps. She says the smaller committees at her ASC also meet on a monthly basis to talk about successes and failures over the past month and discuss goals for the next four weeks. The ASC produces monthly reports on quality, infection control and patient satisfaction, and all physicians undergo peer review of their medical records on a monthly basis.

She says these monthly meetings are useful because some projects do not require an entire quarter to implement, and some goals need to be met more regularly. "It seems like we always need reminders to stay on time and communicate timeliness with families in the center," she says. "That seems to be an area where we don't always do the job we should do."

2. Tailor benchmarks to fit your surgery center. In some cases, the recommended benchmark for surgery centers will not fit the needs of your facility, Ms. Summerfelt says. Be careful about adopting benchmarks directly from surveys in case the numbers are unrealistic for your size, number of physicians or specialty.

For example, Ms. Summerfelt says Medicare recommends that surgery center recovery times last approximately two hours. When Advanced Surgery Center attempted to shorten recovery times to two hours, it started receiving complaints from patients who felt they had not recovered adequately. "We did a long-term study on shoulder patients, and we learned it wasn't appropriate to discharge them at two hours and they needed closer to four hours," she says. The center now uses a four-hour benchmark to account for the time needed for patients to cover from the anesthesia blocks.

3. Create a visual target for your goals. Creating a visual target can keep employees excited about a surgery center objective and remind them of your progress, Ms. Summerfelt says. Her surgery center created a "thermometer of cash" to keep track of the ASC's cash goals. "We color the thermometer in on a daily basis so that office staff can see where we are in relationship to our goals," she says. "It gets everybody involved because all the nursing staff know where the thermometer is kept."

4. Ask staff to take ownership of their complaints. When a staff member brings up a problem that needs to be addressed, Ms. Summerfelt asks the employee to fill out a single sheet that lists the problem, the ideal solution and the steps to get there. The problem is then shared with the staff to gather input and brought to a committee to solve. From there, the staff monitors the center's progress toward a solution and meets on a regular basis to discuss any changes that need to be made.  

5. Don't forget about projects once they've ended. Surgery center employees may forget to follow improved processes once a particular project is no longer discussed on a daily basis. For example, a surgery center may find that handwashing compliance increases dramatically during a two-week push for compliance — and then drops again once the push ends and employees start focusing on other projects. Ms. Summerfelt says surgery centers should keep an eye on quality indicators even after special projects have ended by reviewing them along with other indicators on a quarterly basis.

"When a project ends, it goes into the quality indicator bucket, and it's reviewed regularly so we can tell if we've slipped out of favor," Ms. Summerfelt says. If you notice that compliance has dropped dramatically since the special project ended, meet with staff to remind them of your prior success and talk about ways to promote compliance even when the project is out of the spotlight.

6. Make a note of goals for part-time staff.
Ms. Summerfelt says goals and objectives are posted on the employee bulletin board at Advanced Surgery Center to keep staff up-to-date on progress and recent initiatives. The center's three managers — the OR manager, the pre-op/PACU manager and Ms. Summerfelt, the administrator — also take responsibility for sharing each project with their subordinates. For part-time staff that may not be around when the projects are discussed, Ms. Summerfelt has created a notebook that lists recent changes to center processes. "The notebook is kept on the nurse's desk, so a casual person who just works a few hours a week will know to look in the book first thing," Ms. Summerfelt says. "This assures that everybody is on the same level."

7. Plan one month, one year and five years into the future.
Your surgery center should always be thinking about the future, whether that means next month, next year or five years from now, Ms. Summerfelt says. For example, the administrator might work to increase patient collections by five percent by the end of the month and plan to recruit one new orthopedic surgeon by the end of the year. Five-year plans will probably focus on long-term trends, such as the state of the healthcare industry, the local market and the movement of physicians within the center.

Ms. Summerfelt's board of managers has regular discussions about physician ownership and the future of the center's physicians. "It's very difficult to get new physicians at this time, so part of the five-year plan involves what physicians [approaching retirement] will be doing in five years and whether they have younger members in their group that will come in to take their place," she says.

Related Articles on ASC Operations:
6 Best Specialties for Surgery Centers
6 Creative Ways to Engage Surgery Center Physicians
6 Ways to Provide Robust Benefits to Surgery Center Employees

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