Retaining, recruiting, keeping staff healthy: ASC leaders vent on new year's biggest challenges

Staffing shortages are the biggest concern of many ASC leaders in the new year as COVID-19 surges nationwide. 

Editor's note: These responses were edited lightly for clarity and brevity. 

Question: What are you most worried about in 2022? 

Phillips Kirk Labor, MD. President, owner of LoneStar Ambulatory Surgery Center (Grapevine, Texas): Our biggest concern in 2022 is overcoming the healthcare worker shortage. We have started to plan ahead by cross-training our employees so that we can continue to provide quality patient care when an employee is absent or leaves their position. Our top priority is to retain the staff we currently have by demonstrating our appreciation for our employees and by continuing to foster a positive work environment.

Debra Fin. Administrator of Great Lakes Bay Surgery & Endoscopy Center (Midland, Mich.): In our market, my challenges concern managing the intersection of staffing, culture and patient safety. With COVID-19, we have had significant staff change across the organization due to intense competition for replacement staff by all healthcare providers in mid-Michigan. The new nurses and techs bring new skills and insights, but also require integration with our long-standing employees. We have been spending a great deal of time sourcing and onboarding new staff, and that now requires us to take a step back and help patient care areas integrate new team members and build relationships and trust. Getting the new staff to feel welcomed and part of the team is just as important as supporting existing staff to address change in their team members and the loss of those relationships.

Crystal Aigner, RN. Administrator of Surgical Suites of Coastal Virginia (Williamsburg): Staffing! The inability to compete with the local health system's bonuses and frequent salary adjustments in 2021 has impacted both facilities I manage. Recruitment is more difficult at the newly opening facility, and retention has become an issue at the established ASC due to the financial incentives being offered by the community hospitals. Additionally, there appears to be an increasing shift in the clinical workforce to part-time or pro re nata status in lieu of full-time employment. 

Bobbi Freeman, RN. Administrator of Harbin Clinic GI Lab Rome (Ga.) and Cartersville (Ga.): Right now, I am terribly concerned about staffing and sustainability of my practice. This new variant is rampant. I currently have five employees out that are positive and three with close-contact exposures, all within the last 72 hours. Trying to keep my two ASCs and a physician office practice running business-as-usual amid all of this chaos is the biggest challenge I have ever faced. It is very difficult to keep a positive attitude and feel like I am setting a good example for my staff when I feel like I am drowning every single day! I think the mental health of our providers, administrators, managers, leaders, etc., is a big concern. I have been working 12, 13-hour days Monday through Friday since March of 2020, plus coming in on the weekends, and still can’t stay on top of the workload. #burnedout

Alfonso del Granado. Administrator of Covenant High Plains Surgery Center (Lubbock, Texas): My biggest worry in 2022 is that the ongoing COVID-19 crisis will continue to play a role in preventing a portion of the population from availing themselves of elective surgical treatment options. Conversations with my surgeon always touch on one similar topic  —  some of those who can safely delay surgery are continuing to do so. In some cases, they forthrightly express their concerns about COVID-19, but in other cases, as so often happens, they say “thank you very much, let me think about it and discuss it with my family,” and that’s the last anyone hears from them. This is not the lion’s share of the elective surgery population, but it’s enough to make a significant difference.

Helen Lowenwirth. Administrator of East Side Endoscopy (New York City): Staffing and the health and well-being of our employees is and continues to be the biggest concern as we enter 2022. Everyone is simply exhausted, and the holidays did not offer the usual respite for the second year in a row. We continue to recruit aggressively with an eye toward cross training across departments and using per diem staff to supplement to relieve the stress on full-time employees. Our commitment to quality care begins with providing staff an environment where they are safe, valued and appreciated. 

Raghu Reddy. Chief Administrative Officer of SurgCenter of Western Maryland (Cumberland): I'm worried about the continued impact of COVID-19 on staff shortages and physician recruitment. We are working to improve our PRN pool of nurses to cover quarantines. We also had physicians retire, and it is proving difficult to replace their case volume. Our hospital partner is helping by shifting specialties and cases that they are unable to accommodate due to their full capacity during the pandemic, and the service lines that are not being delivered with high efficiencies. Thankfully, we have not seen major payer changes in our area, and the reimbursement challenges are on the back burner for now.

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