Finding & maintaining staff to maximize your ASC's potential: 6 considerations

A surgery center's staff is integral to its success as a dedicated staff can bolster efficiency and deliver superior care. During Becker's ASC Review's 23rd Annual Meeting: The Business and Operations of ASCs on Oct. 29, experts seasoned in the ASC industry discussed key strategies for finding and maintaining staff members during a panel titled, "How to Recruit and Retain Great Staff."

Here are six considerations:

1. Using tools to find the best fit. Getting the right people through the door for an interview can be a challenge for many centers. However, some have found success through certain online platforms as well as networking.

Beverly Hills, Calif.-based Doctors Outpatient Center for Surgery needed to fill a surgery scheduler position and the center had limited qualified applicants. Michael Sengmanivong, the ASC's administrator, said he employed various tactics including cold calling other physician offices and surgery centers to see if they knew of someone looking for a job.  

A center's current staff may also know of viable candidates for a position. Robert Haen, executive director of CenterOne Surgery Center in Jacksonville, Fla., noted his surgery center provides employees a recruitment bonus if they recommended someone who stayed at the center passed the probationary period.

Headquartered in Boca Raton, Fla., Cancer Treatment Centers of America also relies heavily on staff referrals to fill positions. Nancy Hesse, MSN, RN, interim president and CEO of Cancer Treatment Centers of America, said 65 percent of their employees resulted from other employees referring them. She did note, however, social media is an avenue for filling positions, as well.

"The power of social media is upon us," she said. "Millennials want to talk to you in snip bits, or tweets, if you will."

2. Asking the right questions during an interview. The in-person interview is crucial, as this may be the last step before onboarding a new employee. Therefore, understanding who a potential employee is as a worker is a critical part of the interview process. During interviews, Mr. Haen seeks to primarily discover their relevant experience, flexibility with their hours and their attitude, which is of the utmost importance.

"We all have had employees with bad attitudes and you can't change attitudes," he said. "You can only work around it."

A potential employee's attitude should fall in line with your ASC's culture, as a contrasting mentality or conflict of values may detract from the center's overall mission. To ensure a person is a solid fit, Cancer Treatment Centers of America's candidates undergo a series of phone interviews. Ms. Hesse noted, "If they don't pass the culture tests, they don't get into the doors for an interview."

When seeking candidates from within the Bradenton, Fla., market, Jacqueline Gonzalez, director of business for Musculoskeletal Ambulatory Surgery Center at Coastal Orthopedics, said due to lack of numbers, relevant work experience may not be the primary deciding factor when hiring someone. Therefore, personality comes heavily into play as she seeks someone "that has that spark and grit."  
Diversity amongst staff memebrs is vital, so administrators should know what type of personality their center needs. Mr. Sengmanivong explained not every staff member can be a 'type A' personality, as someone has to be the organizer or the worker or the integrator.

3. Evaluating wages and benefits. When Doctors Outpatient Center for Surgery opened its doors, it did not offer its employees a benefits package. Coming from H&M, Mr. Sengmanivong molded the center's benefits around what he had learned from years in retail. Currently, the center gives its employees four weeks of vacation and staff members share in profits. Birthdays and Black Friday also constitute as holidays at the surgery center.

To remain a contender in the competitive Florida marketplace, CenterOne Surgery Center offers packages that are equal or surpass those of hospitals. Mr. Haen talks with the other 10 or so surgery centers' administrators in Jacksonville about what they offer to ensure CenterOne Surgery Center falls in line with those benefits and wages.

"Large health systems have strong benefit packages and you are fighting that battle [to offer similar packages]," Mr. Haen said. "Hospitals offer a competitive package so it is good to have relationships with other administrators. It doesn't have to be a dog eats dog relationship."

Cancer Treatment Center of America has employees spanning five hospitals across the United States. The health system spends a great chunk of time analyzing regional wages and has a corporate compensation committee dedicated to gauging these regional differences and determining the appropriate salary for staff members.

4. Giving out bonuses. Musculoskeletal Ambulatory Surgery Center at Coastal Orthopedics uses a bonus incentive program based on five criteria when determining how hefty a bonus to allot each staff member. The five criteria include:
•    Performance
•    Teamwork
•    Attitude
•    Communication
•    Customer satisfaction

"This model allows employees to strive for an increase compared to how they did last quarter," said Ms. Gonzalez. "They become more efficient."

At Cancer Treatment Centers of America, the system treats all their employees as stakeholders and the system holds each stakeholder to key performance indicators. Additionally, colleagues can nominate each other for a spot bonus.

CenterOne Surgery Center typically provides bonuses of 10 percent to 15 percent of their wages, if the center meets its profit goals for the year. Mr. Haen said, "There is a significant amount that comes out of our doctors' pockets. It is very effective and gets the attention of the staff. They are very appreciative of it."

5. Balancing full-time and part-time personnel. For many centers, success is due to both full-time and part-time staff members. The make-up of a workforce is contingent on a center's needs and capabilities.

CenterOne Surgery Center doesn't allow for overtime, so the center employs 22 full-time nurses and 20 part-time nurses to keep the operating room running. Part-time nurses get five dollars more an hour, on average, as they don't get benefits. If a part-time nurse commits a certain number of hours to the center, CenterOne offers an increased hourly salary of $7 or so.

It is essential to also treat part-time employees equal to that of full-time employees, to ensure everyone is dedicated to a center's success, Mr. Sengmanivong noted.  
6. Managing a disruptive employee. Sometimes, the vetting process doesn't always show an employee's true colors and you could have a toxic personality at your center. Ms. Hesse says Cancer Treatment Center of America has a zero-tolerance policy as "once you are disruptive, you are gone."

Mr. Haen's center gives employees a probationary period, modeled after a traditional disciplinary process. He said, "It is important to not let behavior fester because staff will pick it up."

Ms. Gonzalez added, "Whenever [you] have a toxic employee, they fire themselves. It shouldn't take more than two weeks to get them out of there if you document their behavior well."

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