7 Steps to Create a Culture of Adaptability at Surgery Centers

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Healthcare providers today are being thrown curve balls left and right from regulatory bodies, insurance companies and the overall poor state of the economy; however, the most resilient centers are able to meet those challenges head-on and still come out on top. Those surgery centers foster a culture of adaptability and are able to remain prosperous despite economic and regulatory changes.


"Healthcare providers are accustomed to consistently dealing with reimbursement challenges, staffing dilemmas and nursing shortages. We may see a reported 40 million uninsured healthcare consumers enter the market, and we will have to figure out how to get those folks into our centers cost-effectively to ensure they have access to care," says Rob Carrera, president and CEO of Pinnacle III. "There are always challenges, but there are also opportunities. We're not always sure what we're going to have to face next but we can choose how we are going to respond."  

Here are seven steps to create a culture of adaptability in your surgery center.

1. Promote flexibility in the board room. The surgery center's board of directors should be filled with nimble members who aren't opposed to thinking outside of the box. In order to solve the problems many surgery centers are facing today — and those they will face tomorrow — a flexible board of directors will set the stage for an adaptable facility.

"The physicians who make up the board should have flexibility and think on their feet," notes Mr. Carrera. "Members of the surgery center should continuously challenge their team and not view problems as problems, but as opportunities. The board can help foster that stance by ensuring they possess the same type of culture and expecting their administrator to model that attitude on a daily basis."

When administrators, physicians and other members of the ASC see a progressive attitude in the top leadership, they will likely follow suit.

2. Set problem-solving expectations for administrators.
Some surgery center administrators react to every issue as though it were a major problem, shutting down before finding a solution. If this is the case, your surgery center won't adapt quickly enough to succeed in a rapidly changing healthcare environment.

"The board can set the expectation early on that we are going to deal with small bumps in the road and keep moving," says Mr. Carrera. "Administrators should be expected to find ways to adapt and move on to solve problems as opposed to overreacting and shutting down because something has changed in the marketplace."

One of the biggest challenges facing administrators today is drug shortages; without the necessary drugs on-hand, surgeons can't perform their cases. Instead of allowing the flow of their surgery centers to be disrupted, administrators Mr. Carrera works with took action.

"Our administrators adapted by contacting everyone they knew in the market and industry to find the medications and make sure they had what they needed to perform cases in their surgery center," he says.

3. Promote a proactive approach to problem solving amongst the staff.
If the staff see every road block as a reason to stop doing their job, you need to change that culture quickly. Senior leadership should expect staff members to creatively problem solve and come to the administrator with solutions instead of problems.

For example, if there are often staff shortages on Fridays and a new surgeon wants to bring in a few cases that day, the administrator should figure out how to make it work instead of turning them down.

"I've walked into facilities where they've been courting a surgeon for a year and then when he wants to do a procedure at the center they say they don't have the necessary staff on that day," says Mr. Carrera. "Instead, they should be thinking about all of the ways they could make that happen. Sometimes it isn't possible, but you need to adopt a 'can do' attitude. If staff members know the senior leadership is going to challenge them and say 'why can't we do it,' they will work amongst themselves to find a way to make sure it's done before succumbing to the notion that it can't be done. It's important to set the expectation that you are going to be problem solvers."

Jill Sackman talks about surgery center culture4. Reward creative thinking.
If you are serious about creating a culture of adaptability, make sure you foster creative thinking among employees and reward those who exhibit adaptable behavior. "The culture of the center should reward innovation creatively and encourage staff members to think outside the box," says Dr. Jill Sackman, a senior consultant with Numerof & Associates. "You can incentivize them with a formal reward or informal recognition."

Rewards can include gift certificates, afternoons off or a preferred parking space; informal recognitions might be an e-mail thanking them for their suggestion or hand written note praising their skills.

"Recognize employees who are flexible and willing to take risks to solve problems on the job," says Dr. Sackman. "You need to think about fostering this collaborative thinking through how the organization works and hold employees accountable for their actions. Create structured brain storming sessions and spend time problem solving with them, which can be highly impactful."

Be sure to communicate the results of their suggestions with employees. Even if you aren't able to implement their plan, let them know you appreciate their suggestion but it isn't feasible for your center at that time.

5. Encourage dialogue and brainstorming.
The culture at your surgery center should be open to suggestions from employees at all levels and promote collaboration between different departments at the center.

"Ensure staff meetings at all levels foster an open and collaborative dialogue where employees feel comfortable addressing controversy," says Dr. Sackman. "It tends to be a hierarchical environment between the surgical and nursing staff, but really try to foster a comfortable atmosphere so employees can put an idea on the table and not be criticized."

You can also designate specific brainstorming sessions to overcome a new problem, or think about new ways to complete old processes. "Get people together and think out of the box," says Dr. Sackman. "Let employees know the results of the session so they know their time is well spent. Individuals in surgery centers are busy and the last thing people think about is whether they are communicating well; it's hard, but very important to communicate when everyone is stressed about what the future will look like."

6. Refresh a long-time employee's responsibilities.
Many surgery centers proudly boast high staff retention, but sometimes long time employees have a harder time adjusting to change. Surgery center leadership needs to make sure resistance from these employees doesn't hinder their flexibility while still recognizing them as an asset to the company.

"When you are faced with a mid- to late-career staff member, you should recognize the cultivated skill sets these individuals possess and if their role changes, to think of where these skills could be leveraged.," says Dr. Sackman. "But as a last resort, it may be time to part ways. You can't let it slip; that will have negative impact on the organization at large. But you can help them gain new skills or transition to new opportunities."

7. Anticipate change and prepare for it.
While not everything heading your way is predictable, there are certain changes within the healthcare system surgery center administrators can anticipate. Instead of waiting to see what others do or holding out until the surgery center has to close its doors, leadership should embrace these changes and use them to their advantage.

"There are a lot of things in the Patient Protection and Affordable Care Act that are somewhat nebulous, such as Accountable Care Organizations," says Mr. Carrera. "We are wondering how surgery enters are going to fit into ACOs and believe there are going to be a lot of positives for us in that type of system. There's the potential to bring more high acuity cases into the ASC as people look for a more cost-effective setting."

Some physician groups and surgery centers are already forming relationships with other providers and payors in the community to position themselves as a viable partner in future ACOs.

"Surgery centers have to have their eye on the external environment more than ever," says Dr. Sackman. "The leadership team at the surgery center should look at what is happening in the competitive market and where your center is in terms of cost and quality."

More Articles on Surgery Centers:

6 Qualities Anesthesiologists Look for in Ambulatory Surgery Centers

5 Steps to Maximize Utilization at Surgery Centers

5 Steps to Reduce Surgery Center Supply Cost Per Case

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