Surgery centers don't often incorporate clinical staff feedback into purchasing or strategy decisions that can help to reduce inefficiencies and cut costs for the center, says Robert Saenz, president of VIP Medical Consulting. Employees, in turn, may be hesitant to propose alternative solutions because their suggestions may be perceived as complaints — particularly if there is no established incentive or company goal for identifying sources of inefficiency, he says.
Surgery centers may also lack a unified sense of purpose within the organization, leaving employees to focus solely on their required tasks rather than encouraging them to think broadly about how to improve the center in a collaborative way. "When I go into a surgery center and interview staff for the first time, I find that an employee will say, 'This is what I do. I'm not sure about the others, but this is my job,'" says Mr. Saenz. "By asking your employees to point out sources of waste in the center, you're incentivizing them to save money."
Mr. Saenz discusses four steps to reducing waste and inefficiency in a surgery center.
1. Hold a staff-wide meeting to discuss the program's intent. The first step to creating a waste reduction program is holding a discussion-friendly meeting with the clinical and business staffs. "You simply want to plant the seed by saying, 'We're going to start to identify inefficiencies, reward you, factor the savings your idea brought to the table, and factor in a performance award for an employee who brings this to the attention of management," says Mr. Saenz.
Employees can be told to submit ideas in writing to the CEO or administrator so that there is a record of all suggestions. "The program should have no limits," he says. "Whether you're talking to receptionists, visiting physicians or nurses, everyone should have a stake in the game to feel like they can be part of the management team in saving dollars."
He says the program should focus on constructive criticism and rewards rather than on words that carry negative connotations, such as whistleblowing or abuse. "This is about team-building and trying to find positive ways to improve the center as a whole," says Mr. Saenz.
2. Emphasize that the program is a collaborative effort meant to improve the surgery center. Employees may initially think that reporting sources of waste will cause friction between staff members associated with the inefficiency. It is important to stress that the program is meant to improve the surgery center's financial outcomes, and that any recommendations made by staff should not be taken personally, says Mr. Saenz.
"This is about making employees feel that they're empowered and that it is an asset to speak up, not an inconvenience," he says. "They need to know that they won't be perceived as trying to be difficult.".
"In healthcare, we are notorious for accepting what the doctor says or the CEO or the purchasing agent says," says Mr. Saenz. "But this program should challenge everyone equally. If a physician is going to be adamant about using a piece of equipment or vendor, he or she now needs to justify it if another employee is able to come up with a [more cost-effective] idea."
3. Develop an incentive program to motivate employees. An incentive program should emphasize that vocal staff members will be valued, not reprimanded. "ASCs can save significant dollars by listening to the staff in the clinical areas and by rewarding employees with bonuses resulting from savings through the elimination of redundant steps or forms in the process," says Mr. Saenz.
Bonuses will likely make staff members feel more relaxed about reporting to superiors, he adds. "If you don't set up an incentive, then the one at the top may be making a decision that others are afraid to comment on," says Mr. Saenz. "But when you open it up and reward your staff for speaking up, it changes the whole dynamic."
An incentive program can also help employees to realize the tangible benefits of cutting costs. If an employee is able to spot an inefficiency that leads to a negotiation saving $50,000 per year, for example, the employee might be rewarded with a $500 bonus or some other percentage of those savings, he says. Incentives can also include extra time off, an employee parking space or an "employee of the month" designation, he says.
4. Provide examples of cost-cutting issues as guidance to staff members. Examples of ways to trim inefficiencies in the center will inspire staff members to think creatively about their own solutions.
For example, if a primary goal is to improve customer service by reducing inefficiency, staff members should be encouraged to think of better methods for following up with patients. "Think not only about communication with patients before they come into the center, but also after," says Mr. Saenz. "Maybe the center is wasting money on mail-outs and phone calls to confirm or follow up with appointments. It may cost too much money to have a staff member actually call patients as opposed to using an automated phone call."
Employees should also be encouraged to envision the time-saving benefits of more efficient business strategies. For example, staff members may be encouraged to trim down the time it takes to handle patient flow to 12 minutes from 15 minutes without sacrificing safety or necessary steps. "That's a lot of time that you save, and a lot of time that you can convert into overtime savings," says Mr. Saenz. "Encourage staff to think, by shaving off those minutes per patient, per day, what would that translate to over the course of a month, or a quarter, or a year?" Situational thinking will help staff members fully realize the purpose and benefits of saving time, he says.
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Surgery centers may also lack a unified sense of purpose within the organization, leaving employees to focus solely on their required tasks rather than encouraging them to think broadly about how to improve the center in a collaborative way. "When I go into a surgery center and interview staff for the first time, I find that an employee will say, 'This is what I do. I'm not sure about the others, but this is my job,'" says Mr. Saenz. "By asking your employees to point out sources of waste in the center, you're incentivizing them to save money."
Mr. Saenz discusses four steps to reducing waste and inefficiency in a surgery center.
1. Hold a staff-wide meeting to discuss the program's intent. The first step to creating a waste reduction program is holding a discussion-friendly meeting with the clinical and business staffs. "You simply want to plant the seed by saying, 'We're going to start to identify inefficiencies, reward you, factor the savings your idea brought to the table, and factor in a performance award for an employee who brings this to the attention of management," says Mr. Saenz.
Employees can be told to submit ideas in writing to the CEO or administrator so that there is a record of all suggestions. "The program should have no limits," he says. "Whether you're talking to receptionists, visiting physicians or nurses, everyone should have a stake in the game to feel like they can be part of the management team in saving dollars."
He says the program should focus on constructive criticism and rewards rather than on words that carry negative connotations, such as whistleblowing or abuse. "This is about team-building and trying to find positive ways to improve the center as a whole," says Mr. Saenz.
2. Emphasize that the program is a collaborative effort meant to improve the surgery center. Employees may initially think that reporting sources of waste will cause friction between staff members associated with the inefficiency. It is important to stress that the program is meant to improve the surgery center's financial outcomes, and that any recommendations made by staff should not be taken personally, says Mr. Saenz.
"This is about making employees feel that they're empowered and that it is an asset to speak up, not an inconvenience," he says. "They need to know that they won't be perceived as trying to be difficult.".
"In healthcare, we are notorious for accepting what the doctor says or the CEO or the purchasing agent says," says Mr. Saenz. "But this program should challenge everyone equally. If a physician is going to be adamant about using a piece of equipment or vendor, he or she now needs to justify it if another employee is able to come up with a [more cost-effective] idea."
3. Develop an incentive program to motivate employees. An incentive program should emphasize that vocal staff members will be valued, not reprimanded. "ASCs can save significant dollars by listening to the staff in the clinical areas and by rewarding employees with bonuses resulting from savings through the elimination of redundant steps or forms in the process," says Mr. Saenz.
Bonuses will likely make staff members feel more relaxed about reporting to superiors, he adds. "If you don't set up an incentive, then the one at the top may be making a decision that others are afraid to comment on," says Mr. Saenz. "But when you open it up and reward your staff for speaking up, it changes the whole dynamic."
An incentive program can also help employees to realize the tangible benefits of cutting costs. If an employee is able to spot an inefficiency that leads to a negotiation saving $50,000 per year, for example, the employee might be rewarded with a $500 bonus or some other percentage of those savings, he says. Incentives can also include extra time off, an employee parking space or an "employee of the month" designation, he says.
4. Provide examples of cost-cutting issues as guidance to staff members. Examples of ways to trim inefficiencies in the center will inspire staff members to think creatively about their own solutions.
For example, if a primary goal is to improve customer service by reducing inefficiency, staff members should be encouraged to think of better methods for following up with patients. "Think not only about communication with patients before they come into the center, but also after," says Mr. Saenz. "Maybe the center is wasting money on mail-outs and phone calls to confirm or follow up with appointments. It may cost too much money to have a staff member actually call patients as opposed to using an automated phone call."
Employees should also be encouraged to envision the time-saving benefits of more efficient business strategies. For example, staff members may be encouraged to trim down the time it takes to handle patient flow to 12 minutes from 15 minutes without sacrificing safety or necessary steps. "That's a lot of time that you save, and a lot of time that you can convert into overtime savings," says Mr. Saenz. "Encourage staff to think, by shaving off those minutes per patient, per day, what would that translate to over the course of a month, or a quarter, or a year?" Situational thinking will help staff members fully realize the purpose and benefits of saving time, he says.
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