How to use the 4 pillars of ASC lean staffing without sacrificing your A-team employees

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Salary, wages and benefits consistently top the list of ambulatory surgery center operations expenses. These costs are necessary to retain a high-quality staff, but this does not mean the expense can go unchecked. The tenets of lean staffing can be applied to manage staffing costs effectively, while keeping your A-team of employees motivated and satisfied.

Any ASC can apply a lean staffing strategy. The best place to start is by looking at your case load. How does it fluctuate? Hire and schedule based on those fluctuations. Utilize a high number of part-time and per diem staff members. Business office works can also be part-time, filling in for reception on late days and lending a hand with chart preparation and filing. While this will cut down on staff hours, work to ensure employees can also benefit from this model. "Set up an employee incentive program for controlling hours. Return to the employees a minor percentage of the savings realized," says Joyce (Deno) Thomas, RN, senior vice president of operations with Regent Surgical Health.

Though this lean model can effectively shave down labor costs, it is important to be aware of the potential pitfalls. Staff, particularly at center that has never used this model, may become concerned. Try to keep the staff calm and prevent the spread of rumors, says Ms. Thomas. Never cut hours to the point you are unsure if you could take an unexpected case. "Be wise and know your surgeons scheduling patterns," she says.

If done correctly, the lean staffing model will help create a tight knit team willing to take on extra duties and flexible hours. "It preserves the center's future," says Ms. Thomas. Here are the four pillars lean staffing that will engage and retain high-quality staff members.

1. Hire responsibly. "Hiring the right people with the right attitude is necessary to create the cohesive team mentality," says Ms. Thomas. "It is critical to the success of the center that high quality, multi-skilled and flexible staff are retained." When hiring ensure expectations are clear. Explain that work hours are dependent on case load, even for full-time staff members.

2. Share financial information. Explain why a lean staffing model is being used. "Show staff the profit/loss variables portion of the financials," says Ms. Thomas. "Don't assume they won't understand." This level of transparency will help to allay fears the staff may have about losing their jobs. A lean staffing model is put in place to ensure financial security, which ensures the staff's jobs will still be there.

3. Turn to your staff for solutions. Instead of unilaterally implementing a strategy, ask your staff for input. "When the team is a part of the solution, it is better accepted," says Ms. Thomas. Explain to them that staff hours need to be controlled and ask them for the best way to achieve that end with minimal damage to staff morale and motivation. This will foster a sense of ownership and minimize the chance of losing star team members.

4. Don't strip staff benefits. While it is important to save on salary, wages and benefits, excessive cuts will drive away high-performing employees. "It's enough to cut hours. Make sure not to cut their paid time off accrual or health benefits," says Ms. Thomas. Discuss your options with the center's human resources manager. Consider using worked hours plus low census hours to count towards PTO accrual and benefit eligibility, she says.

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