Tom Jacobs, CEO of MedHQ, a healthcare human resources, accounting and credentialing firm in Westchester, Ill., lists eight key challenges for an ambulatory surgery center.
1. Resolving employee disputes. When disputes between employees heat up, "managers can't walk away from their responsibilities," Mr. Jacobs says. "It's important to get the facts from each side and consider the situation dispassionately." Disputes can include bullying and sexual harassment charges. Sometimes it helps to bring in a neutral third party. When ASC clients need help in this arena, a MedHQ representative interviews both parties, usually remotely over a Skype connection. Being one step removed from the situation can help. The MedHQ representative "can play the role of Judge Judy," Mr. Jacobs says. "He is getting down the facts." The MedHQ representative then writes up a report with recommendations and sends it to the administrator for review.
2. Hiring. Hiring is one of the biggest decisions a manager makes, so it is important to do it right. The ASC needs to produce an appealing job description, conduct a useful job interview and undertake thorough background checks. "The employer should be developing effective questions, getting behind the job-seeker's presentation and revealing how they would work out as an employee," Mr. Jacobs says. MedHQ and others provide training in good interviewing techniques.
3. Welcoming new employees. When a new employee arrives, the employer needs to go through an extensive process that HR professionals call "on-boarding." It covers everything from setting the newcomer up for insurance coverage to learning a new computer system and understanding all the details of the job. Employees might not be familiar with the whole process and might leave some parts of the process out, especially if they don't do a lot of hiring. "If you hire someone just once a year, you might not remember all that needs to be done," Mr. Jacobs says. It's important to have a checklist of all the steps involved in on-boarding. When an employee leaves, it's called off-boarding, and again the center needs to go through a set of processes, such as arranging for COBRA health insurance coverage and, when applicable, unemployment payments.
4. Understanding employment laws. There is a plethora of federal and state laws and regulations that impact employment and they are very detailed. Some of the major laws are the Americans with Disabilities Act; Title 7 of Civil Rights Act, which covers discrimination at the workplace; the Family Medical Leave Act; the Fair Labor Standards Act; and wage and hours laws in each state. Many companies, including MedHQ, offer training courses on these laws for administrators and can help the ASC handle issues pertaining to these laws when they come up.
5. Employees' questions. Employees may have a lot of questions about benefits, workers comp coverage, needlestick policies and other issues. Often, the administrator cannot answer them without doing a little research, which takes time away from other duties. To address employee needs and free up the administrator's time, the ASC has the option of providing employees with computer software that can answer these questions. For example, MedHQ provides an online system that each employee can access. Each employee has his own secure site where they can update content.
6. Dealing with high turnover. A turnover rate of 30 percent a year is relatively high for an employer and raises questions. In a facility with 50 employees, that means 15 are leaving each year. When this happens, the center might want to study the matter to determine if there is a problem. "Don't let turnover get out of hand," Mr. Jacobs says.
7. Risk management. Surgery centers should strive to prevent payments from getting out of hand in such areas as workers comp, unemployment claims and harassment. Sometimes a facility pays these costs without seriously considering whether they are necessary. For example, MedHQ was able to reduce a small hospital's exposure by $850,000 by reviewing its current obligations and recommending steps to take.
8. Developing an effective culture. Perhaps the biggest challenge for any employer is creating a positive culture in which employees can grow. "This starts at the top of the organization," Mr. Jacobs says. "What are the core values?" The ASC should develop a mission statement and other documents that enshrine values such as respect, integrity, efficiency and stewardship.
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