How ASCs Can Thrive Through Teamwork: Q&A With Administrator Joseph DeMarco


Joseph DeMarco is the administrator at Jefferson Surgical Center at the Navy Yard in Philadelphia. The ASC was developed by Thomas Jefferson University Hospitals, Rothman Institute, and Nueterra. It includes four operating rooms and one procedure room, with specialties such as hand surgery, orthopedic surgery, pain management, and general surgery.

Joseph DeMarco, administrator of Jefferson Surgical CenterThrough many years of experience, Mr. DeMarco has developed strategies for building a strong team of surgery center personnel.


Here Mr. DeMarco describes his managerial style, as well as how ASC administrators should work to develop a team-oriented operation.

Question: How would you describe your leadership style?

Joseph DeMarco: I encourage over communication with empowerment. Over communication will help solve a problem before it becomes necessary for management to become involved. Problems sometimes come to managers when someone had an issue and didn't ask for help. While it is important for managers to be well-informed, good personnel keep managers from having to handle every issue. The golden rule is no surprises.

My management style is a coaching style. I strive to know the strengths and weaknesses of each employee and encourage them at whatever level they are to be engaged in the decision-making process. I also step in whenever the decision-making process breaks down so they are not taking the proverbial hit from the physician or whoever was affected.

Any ASC breakdowns need to be analyzed individually. Does the employee have the right tools or are they in the right position? My goal is to keep people from repeating the same mistakes. I encourage staff members to speak up and troubleshoot issues when they perceive something isn't correct.

The old management style was a triangle. Managers at the top made decisions and communicated them down to all levels. The newer style is an upside down pyramid. The employees on the front lines are making decisions and the information flows down to the managers. In addition to coaching employees, mangers need to let the people at the top of the new pyramid make decisions and handle opportunities appropriately. If not, how do we help them be successful? It's never about pointing fingers. It's about looking at concerns, issues and opportunities to improve personal and facility growth.

Q: What is the ASC administrator's main role as a team builder?

JD: Team building requires open communication and consistency in dealing with daily challenges. In addition to building trust among the staff, it is also very important to understand the needs of the employees and address those needs to improve overall employee satisfaction.  

Q: How can distinct areas of a surgery center function cohesively as a team?

JD: Each department has an important role to play in the success of the surgery center. All departments must work together to assure the best possible outcome. Cross training wherever possible is an effective tool in helping employees better understand how each role contributes to the whole. There has to be trust, honesty and mutual respect among the employees within individual department and throughout the facility.

That's where managers need to step in. We are basically running a hospital on a smaller scale where employees wear multiple hats. My management style allows for accountability, the empowerment of employees to make decisions freely and for all employees to be open to change.

Q: When hiring employees, what do you look for to find a good fit for your team?

JD: I look for people who are motivated and who can work independently with little supervision. Much success lies in surrounding yourself with people you can trust. You rely on those people to give you good information, and you develop strategic plans based on that information. Finding honest people who are problem solvers is key. They need to be open to what they hear from other staff members, and they need to be able to develop plans and actions based on that feedback.

Q: How do you deal with conflicts that arise among team members?

JD: As the administrator, my responsibility is to coordinate a meeting and to set ground rules when addressing issues between team members. The main rule is that they respect one another and listen openly. It is essential that even during disagreements everyone remains professional. If team members cannot come to an agreement, as the administrator you need to set clear expectations for future behavior.

Q: What suggestions do you have for new administrators?

JD: Selecting your core leadership team is an important responsibility for a new administrator who is tasked with overseeing the entire facility. The administrator relies heavily of the director of nursing, business office manager and materials manager, making it important that they function well as a team. It is important to have frequent meetings with the management team to define the direction of the facility.

Another suggestion for new administrators is to understand the ownership structure of the facility, and when reporting to the Board, pointing out areas of concern, no matter who will be affected.

More Articles on Turnarounds:
6 Steps to Structuring ASC Administrator & Staff Bonus Programs
Cost Cutting Methods Most Physicians Support
10 Articles on Performing Total Joint Replacements at Surgery Centers


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