8 Steps to Promote Growth & Innovation at Surgery Centers

Here are eight steps for surgery center administrators to create a culture of growth and innovation at their facilities.

1. Be proactive with your decisions. Many surgery centers boast high efficiency and some profitability now, but you have to look to the future to make sure growth and development is always happening at the ASC. Don't be content with where you are now, because as the healthcare landscape evolves you'll be forced to change.

"The first thing is you need to be proactive," says John McConnell, MD, an orthopedic surgeon in Greenville, Texas. "The facility always has to be accommodating to bring in new blocks and more people who are involved in the growth and development at the ASC. They should be driving the change as opposed to reacting to it."

For example, a surgeon's retirement could have a big impact on your center if you haven't been actively recruiting new surgeons in. An economic downturn in your community could also spell disaster if you don't have a strategic plan to accommodate for lower case volume.

2. Understand the surgeon dynamic at your ASC and constantly recruit.
Administrators must be keenly aware of the macro and micro elements of the healthcare market as they relate to their physicians and the daily activities at the ASC. "There is no shortcut for honest discussion with surgeons about how things are going and what they need to make the surgery center a better experience," says Joseph Zasa, co-founder and managing partner of ASD Management. "When the surgeons stop talking to you, you have a problem."

Surgery centers should always be in the development mode, which means identifying new surgeon recruitment opportunities. Current physicians may be retiring or becoming employed by hospitals, so it's good strategy to continuously recruit new surgeons.

Charles Dailey"We appreciate surgeons that are doing cases at our center, but we always need to bring more surgeons in," says Charles Dailey, vice president of development at ASD Management. "We are constantly looking to refill that funnel. We are constantly out there looking for new partners to join our centers."

3. Control costs for future growth.
Surgery centers must operate at a high level in their current state before seriously considering change for the future. The first step might be focusing on materials management to control cases and make room for growth.

"We are actively educating our centers to stay with their group purchasing contracts because the more compliant they are and the more they adhere to them, the more money we save," says Mr. Dailey. "When we buy within the contracts, we save money. We are also focusing on volume buying because the power of volume allows us to get better deals."

ASD is focusing on how they can save on medication and supplies through alternative programs and resources to drive better pricing for their surgery centers and physician offices.

4. Grow internally with new procedures in emerging medical markets.
Administrators can also look for opportunities to grow internally by adding new procedures that benefit a larger patient population than in the past. When considering a new procedure, investigate whether it can be done safely in an outpatient setting and ask our surgeons whether there is clinical benefit and economic justification to move forward.

"Doing more procedures in our surgery center allows the physician to grow his practice base and ultimately the patient is being offered another surgical option that could make a difference in their lives," says Mr. Dailey. "If the surgeons are interested, we are trying to partner with industry members to certify us to perform new procedures."

For example, in the orthopedic and spine realm surgery centers can bring in compression fracture patients for kyphoplasty or interventional pain patients for neurostimulators. Gastroenterologists can bring in colon screenings as well as other procedures. However, due diligence is important to make sure this strategic move will be beneficial.

"When new procedures arrive, sometimes they are more or less efficient for the center," says Dr. McConnell. "Adding new procedures doesn't always translate to the surgery center moving forward in a typical fashion."

5. Adapt to practice pattern changes.
Surgery centers must be adaptable to changes in practice patterns and trends, which includes bringing in new technology. New technology can be expensive, but smart purchases will have a high return on investment.

"The surgery center has to be committed intellectually and financially so that equipment will have the improved upgrade as better equipment rises on the scene," says Dr. McConnell. "This is a competitive edge the surgery centers have over the hospital. Bureaucratic hospitals push outpatient elective cases to the back of the queue for procurement. Commitment to staying on top of continually improving and upgrading equipment is key."

When new technology or procedures are added, surgery centers can help market their physicians to bring new cases into the center. "We're constantly trying to market our physicians on a regular basis," says Mr. Zasa. "We try to find them patients and help them. One of the things we focus on is looking at new technology and new procedures down the pipe and promote them so they'll have a competitive edge in the market."

6. Make cost-effective decisions.
Projecting efficiency and cost effectiveness is very important because surgery centers don't have the resources to waste on a failed venture. Negotiate the best contracts possible for a new piece of equipment and make sure the case volume will be there once it is in place.

"Independent surgery centers don't have the large support basis of the hospital," says Dr. McConnell. "They have to be more cost effective and generate cases that will make money. They have to be adaptable, cost effective and customer friendly. Maintaining this commitment is important for continued growth."

7. Recognize the team culture.
Surgery centers are different from hospitals because all the medical professionals work as a team, which means not all surgeons have the right personality for the surgery center. Administrators should promote working in a team environment and atmosphere, especially in a community where they are one of few surgery centers.

"Oftentimes, if the surgery center is fairly new to a community that has not be served by surgery centers in the past, patients and physicians are used to the culture of the hospital so you need to inform them and educate them about the advantage of the ASC," says Dr. McConnell. "In a hospital setting there is, to some extent, a management/labor type relationship between administration and physicians. IN the hospital setting, it's almost slightly adversarial in many circumstances. In the surgery center, the administrator is collegiate, accommodating, friendly and part of the team."

In some cases, hospitals may apply pressure on surgeons and their staff to continue bringing cases to the hospital instead of an ASC. The administrator should make sure surgeons know they have the right to bring their patients to the ASC if it’s the most accommodating space for treating their patient.

"You are working toward a goal of better service and working with the needs of surgeons' and patients' schedule," says Dr. McConnell. "Adapting to things that are more innate to the culture of the surgery center than the hospital fosters growth."

8. Stay open to new ideas from every source.
Surgery center administrators should be open to ideas from various sources, whether they are networking with other administrators or listening to suggestions from staff members and patients. Management companies can provide some fresh perspectives as well, and surgeons can bring home new suggestions from annual meetings.

"The important thing is to look for good ideas," says Dr. McConnell. "Sometimes surgeons or staff members have ideas from their previous facilities. Other times, ask vendor representatives their opinion because they have interchanges with staff members and physicians at all of their surgery centers. There should be openness to new ideas, whatever the source, and that has to be a hallmark of the facility."

You should also solicit feedback from patients about their experience. Sometimes the idea isn't doable, but other times it is. "It's being open to innovation and advantageous ideas, whatever the source, that is the mark of an evolving surgery center," says Dr. McConnell.

More Articles on Surgery Centers:

10 Steps to Attract Orthopedic & Spine Surgeons During Recruitment

6 Stesp to Optimize OR Efficiency & Cut Costs With Minimally Invasive Spine Surgery

How ASCs Can Become a Disruptive Force in the Healthcare Market: Q&A With Adam Powell

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