1. Hire an inventory manager. The key to inventory control is an inventory manager who has complete responsibility for tracking your inventory, according to Ms. Berreth. “You don’t have to hire a medical person, though it doesn’t hurt to have an experienced OR nurse because they just know what you need and what you’re using,” she says. “The key is to have a single person who’s completely engaged in the process of inventory control.”
If you leave inventory duties up to your administrator or other staff members, they may neglect inventory tasks when your ASC is busy and they have other things on their plate. An inventory manager will let you know which supplies you aren’t using, which you could be saving money on and which cases cost you the most in terms of supplies — information you may overlook if you’re handling the responsibility on top of everything else.
2. Share your end-of-year profit among your staff. Many ASC administrators agree the best way to involve your staff in cost-cutting measures is to incentivize them. Ms. Burnett says she decreases waste by dividing 3-5 percent of net profit equally among her staff members. “That’s paid directly back to the employees equally, whether you’re an OR manager or a front desk receptionist,” she says. “That way, when you get into a room, and your press sheet calls for five packs of suture, you’re not going to open five packs of sutures all at once. You’re going to open them one at a time as the surgeon uses to them to make sure you don’t waste any.”
She says the expectation of this bonus means her staff members are very diligent about preventing product waste. Their number one priority is still quality, but they know that if they can save the center money by switching to a new supply or not using an existing one, they will benefit personally.
Ms. Burnett says her staff members sometimes see a cheaper, better product at conference and bring it back to the center. “If a staff member brings something in that’s going to save us fifty cents on every case we do, we’ll give them $100 certificate to their favorite restaurant or buy them a little TV,” she says. “The rewards mean they’re 100 percent invested in what we do.”
3. Quiz your staff on supply costs. Ms. Burnett likes to promote knowledge of supply costs by holding regular game show days, when her staff tries to guess the price of various supplies. “The staff knows what everything here costs,” she says. “We also post prices on the press sheets, and they’re always looking for alternatives.”
If your staff is very knowledgeable about your supply costs, they won’t be easily swayed by vendors, and they’ll know a good deal when they see one. They’ll also be sure to handle products carefully. As many administrators point out, a staff member is far less likely to drop a product if they know it costs $250 to replace.
4. Post side-by-side comparisons of physician case costs. Your ASC should always promote quality first, Ms. Burnett says, but it doesn’t hurt to make your physicians aware of how much their cases are costing. She posts physician case costs side-by-side on press sheets to let her physicians know how they compare to their colleagues. “If one doctor sees that another doctor did the same case for $200 less, he’s going to want to know how it was done,” she says. “It might be a question of quality, but you want to encourage those discussions so you know where you could be saving money.”
5. Be upfront about ASC salaries. An ASC will most likely pay staff members less than a hospital, and your staff members should know that up-front, Ms. Burnett says. When she hires staff members, she makes it clear that the ASC will pay a lower salary but offer a more familial atmosphere and more flexible scheduling. “You can’t compete with what hospitals are paying, so we tell our employees right away that it’s a trade-off,” she says. If you make salary expectations clear up-front, you won’t have to deal with dissatisfied employees requesting more money.
6. Tell your staff: “If there are no patients, expect to stay home.” When your first hire your staff, give them clear expectations about your center’s scheduling policies. Many ASCs use a flexible scheduling model that means if there are no patients, staff members don’t come in. Ms. Berreth says your staff has to understand that patient and staff volumes may fluctuate from week to week based on acuity levels and scheduled cases. “If all of a sudden we recognize the next day we have four patients that need a lot of help because they have high pain needs, we have the kind of staff who will accept that and come in,” she says. Your center can also use PRN staff to cover those shifts that might not require a full-time employee.
7. Schedule your cases three days ahead of time. If you schedule a case at 4:00 p.m. the day before, you won’t have much time to talk to the patient, verify insurance information and go over how much the patient is expected to pay up front. Many administrators emphasize the importance of collecting money on the front end so you don’t run into problems after the patient has surgery. “We tell our physicians to give us three days to verify insurance. With economic issues, most people have very high deductibles — sometimes two, three or four thousand dollars,” she says. “If you give the patient time to get the finances together, you can do 99 percent of billing on the front end and you won’t be trying to collect on the back end.”
By scheduling your cases ahead of time and talking to the patient, you can avoid doing a procedure and finding out afterwards that the patient doesn’t have insurance. “People don’t like owing money,” she says. “Your patients will appreciate the fact that somebody is going the extra mile to check that they won’t be in debt.”
Learn more about The Plastic Surgical Center and Brainerd Lakes Surgery Center.
