Ambulatory surgery center operations are often complex and require a deep understanding of both administrative and clinical issues. Thus, effective nurse leaders, who have experience in both quality care delivery and work processes, are vital for continued ASC success.
"As patients are cared for throughout the day, nurse leaders, in many ways, are the hub of the wheel that keeps both operations and logistics moving 
smoothly," says Martie Moore, RN, MAOM, CPHQ, CNO at Medline.
The fast-paced environment of an ASC, where patients are treated and discharged within hours, places undue pressure on the leadership team, she adds. Lack of focus or direction can result in productivity loss, frustration and poor patient care.
"Having an effective nurse leader who is able to triage the issues, mitigate situations and keep a team atmosphere is the difference between a day and a really good day," says Ms. Moore. "An effective nurse leader is able to install a sense of resilience within the environment."
Additionally, nursing leadership directs the whole patient experience, says Gary Richberg, RN, BSN, administrator of Pacific Rim Outpatient Surgery Center in Bellingham, Wash. They help reduce risk, liability and promote the highest quality of patient care.
Thus, hiring the right people and helping them grow and evolve so that they can provide the kind of nurse leadership an ASC needs to thrive is essential. Here are 10 tips for hiring nurse leaders and encouraging their growth:
1. Understand the job before your hire for the position. "Watch a busy day at an ASC," says Ms. Moore, and note all of the issues and challenges that come up in a day that would require the nurse leader's deft hand. This exercise deepens the administrator's understanding of a nurse leader's role within the facility, and helps them hire the best possible candidate.
Also, administrators can write down moments where there was heightened tension or energy amongst the team, including the medical staff, and develop scenarios for hiring interviews.
2. "Dig" into a candidate's attitude. According to Sandy Berreth, administrator of Brainerd Lakes Surgery Center in Baxter, Minn., when interviewing a nurse leader, it's not just about asking the routine skill-and-experience questions. "You need to dig into the person's attitudes and insecurities," she says. "There are books written on the interviewing process; but finding the gem among the rocks is not about [following] the regular interview processes."
The usual questions are not the questions that will identify the best candidate, she adds. The typical questions will tell you who did the "homework," but the best nurse leaders have situational knowledge and a firm but pleasant style of sharing that knowledge with others.
3. Don't rush the hiring process. A common mistake ASC administrators make is hiring too quickly and ending up with the wrong person for the job, says Mr. Richberg. Being too quick to pull the trigger and hiring someone who isn't qualified or doesn't share the surgery center's goals is a mistake administrators cannot afford to make.
"Rushing to hire someone who isn't right for the role can be devastating to an ASC," says Mr. Richberg.
4. Look beyond the clinical. When it comes to nurse leadership, clinical knowledge is important, but it can't be the only thing to consider, says Ms. Moore. Good nurse leaders understand the business side of ASC operations. Also, nurse leaders must have strong skills in organization management, communication, managing diverse groups of people and patient experience as well as problem solving. "These skills are necessary in order for the nurse leader to lead the team and provide highly efficient and quality patient care," says Ms. Moore.
5. Offer attractive draws to find and keep great nurse leaders. According to Mr. Richberg, administrators need to provide nurse leaders with incentives, such as bonuses for meeting benchmarks and metrics, including patient, staff and physician satisfaction metrics. These incentives can help attract potential candidates and retain talented nurse leaders. "A nurse leader will try harder to reach the goals that are beneficial to the facility if it is also beneficial to them. So, incentivize them," he says.
6. Find the nurse leader that wants to take on new responsibilities. "Find the nurse that soaks up knowledge and wants to learn more," says Ms. Berreth. If the nurse leader actively wants to take on new projects, it will be easier for the administrator to identify the projects that can help them grow.
"Give nurse leaders the projects that have value for them," she says. "Infection control, safety, medication reconciliation for the organization, inventory management responsibilities and, of course, the big one — quality control and performance improvement."
7. Involve nurse leaders in every aspect of an ASC's operations. To engage nurse leadership, ASC administrators can involve nurse managers in discussions regarding the finances of the institution, cost of care as well as delivery of patient care, according to Mr. Richberg. Often nurse leaders aren't involved in the business or fiduciary side of an ASC. "Continuing business education and involvement in surgery center administration is key to training and retaining nurses," he says.
8. Mentor young nurse leaders. Young nurse leaders need to grow their humanity, humility, sincerity, accountability and willingness to succeed, says Ms. Berreth, and learn how to take constructive criticism and make improvements. ASC administrators can take young nurse leaders under wing and teach them about the highs and lows of leadership.
"I can't say enough about mentoring," says Ms. Berreth. "I know it is a top buzzword, but it is so important."
Encourage nurse leaders to think outside the box and flex their creativity for innovative solutions to a facility's problems.
9. Develop succession-planning programs. "With the aging of the workforce and impending retirements amongst nurses and nurse leaders, the market is going to be fiercely competitive," says Ms. Moore. Thus, ASC administrators need to develop and implement succession-planning programs, either within their own networks or by partnering with nursing leadership organizations.
"These programs help to identify the abilities of an emerging nurse leader and assist in fully developing their skills. Also, having programs such as leadership development creates retention strategies," she says.
10. Offer educational opportunities. Offering educational opportunities to nurse leaders enables their professional growth as well as adds to the success of the facility. "I offer a minimum of two educational seminars, both nurse-specific as well as general healthcare or administrative, for my nurse manager to attend, which is paid for by the facility," says Mr. Richberg.
"Ultimately, nursing leadership is key to the success of the institution," he adds. "A great nurse leader will make it great and a bad leader will definitely be problematic for the ASC's growth and success."
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