Experienced OR nurses at one New York ASC now earn about $11 more an hour than they did four to five years ago. To keep labor costs from climbing further, the center’s administrator is cross-training staff instead of turning to agencies.
Elisa Auguste, administrator of East Setauket, N.Y.-based Precision Care Surgery Center, said experienced OR nurses earned about $50 an hour a few years ago. Today they average $61, a 22% increase. The center focuses on orthopedics, spine and pain management.
Ms. Auguste, who is also vice president of the New York State Association of Ambulatory Surgery Centers, shared the figures during a panel at Becker’s 32nd Annual Business and Operations of ASCs conference, held Oct. 29-31 in Chicago.
Labor, overhead and supply costs are all rising, and none of them are easing, Ms. Auguste said.
“We are challenged every single day on how to get creative,” she said. “Because they’re not going back down.”
Cross-training is her main defense against high agency costs.
“So my nurses now are scrubbing,” she said.
When she can’t find a per diem scrub tech, she has a nurse circulate in the OR for half a shift and scrub for the other half rather than pay agency rates. The setup also gets the nurse a full eight-hour day. She also trains OR nurses to work in pre-op and PACU, and trains pre-op and PACU nurses to work in the OR. Per diem staff take turns making pre-admission testing calls, so she doesn’t have to add a full-time employee.
The goal is to rely less on higher-cost agencies and use her existing team as fully as possible, Ms. Auguste said.
On the same panel, Terry Bohlke, CEO of Keystone Surgical Partners and a past board president of the Ambulatory Surgery Center Association, said many ASCs have too many staff in the afternoon, when two ORs are running, and too few in the morning, when eight are. He said the common productivity measure, hours per case, “just rewards inefficiency.”
Mr. Bohlke recommended a mix of per diem and part-time staff on fixed schedules. Experienced nurses who don’t want eight-hour days may still need benefits, he said, so ASCs should consider offering benefits to part-time staff. He also called cross-training critical: a nurse who covers the morning pre-op rush can move to PACU in the afternoon.
Gregory DeConciliis, administrator of Boston Out-Patient Surgical Suites, said his center added 12-hour shifts so full-time staff can work three days a week. He also uses short midday shifts to cover breaks and lunches during peak hours.
Nirav Shah, MD, medical director of three GI ASCs at U.S. Digestive Health, said health systems in his market compete for the same nurses. His group can’t always pay the most, Dr. Shah said, so it relies on a culture that makes staff want to work with its physicians.
At the Becker’s 32nd Annual Meeting: The Business and Operations of ASCs, taking place October 29-31 in Chicago, ASC leaders, surgeons and healthcare executives will explore strategies to drive growth, enhance operational performance, navigate reimbursement challenges and prepare for the future of ambulatory surgery. Apply for complimentary registration now.
