Enhancements in the patient & surgeon experience

In a recent Becker's Healthcare Podcast episode, we were joined by Chris Bishop, CEO of Regent Surgical Health, to discuss innovations and enhancements in the patient and surgeon experience. Chris shares his insights on how to design surgery centers to streamline business operations and positively impact the patient or surgeon experience. how ESG (Environmental, Social, Governance) is becoming a stronger driver in business, and what Regent Surgical Health's strategy is for addressing this important company responsibility. A transcription of the podcast is available below, and the podcast episode can be listened to here.

Scott Becker: This is Scott Becker with the Becker's Healthcare Podcast. Thrilled today to get to visit with Chris Bishop. Chris is the remarkable Chief Executive officer of Regent Surgical Health. Regent Surgical Health is one of the fastest growing companies in the surgery center arena. They part mainly with hospitals and health systems and physicians. Chris is going to talk to us both about the history of surgery centers. Why is there such a big impact? Why there's growth again today? He's also going to talk about technology and surgery centers as well as ESG, sort of environmental social governance issues as it relates to surgery centers and the Regent Surgical Health. Chris, to tee up and ask you to take a moment, introduce yourself and tell us a little bit about Regent Surgical Health. Let me ask you for some background of why surgery centers have grown so much and why there's an important part of the ecosystem.

Chris Bishop: Sure, Scott, thanks for having me this morning. As you're well aware, Tom Mallon was the founder of this organization. Just an absolute gentleman thought leader in the space 22 years ago when he founded Regent. And he and I managed to work together to transition that about seven years ago. And Regent today sits at the intersection of three-way joint ventures. So we have the health system and the physicians combined with Regent to really create a special experience around the surgery center space.

SB: And talk a little bit about evolution of surgery centers. I know you've been a surgery center leader for a long time now, a couple of decades at least. And you've seen a lot of growth and evolution in the space. Again, surgery centers are at the forefront of sort of cost-efficient, high-quality care. What are some of the thing things you're seeing? And talk to us a little bit about that evolution.

CB: Yeah, Scott, it's interesting because surgery centers are sort of the undisputed ambulatory site for surgical care patient net promoter scores. Most of us are scoring in the nineties in that setting. We just have a unique advantage in that we're often these smaller focus factories. We don't have to worry about ERs, we don't have to worry about inpatient floors, cafeterias. We're able to focus and do one thing exceptionally well. And so because of that, although the surgery center industry is only about 50 years old, we have roughly 7,000 plus surgery center locations today. I think the area that's sort of intriguing and where we sit today is really around the experience, Scott. Patients have always rated us well, but one of the things that I think our industry is in a bit of a transition phase on is really starting to think through instead of sort of this sea of sameness or this all of us kind of leveraging what we have utilized successfully for the last 20 years, how do we really think about a more customized patient experience or a more customized physician experience? And I'll give you an example.

Recently, I had... I guess you could call it the privilege of an inpatient procedure in a hospital setting, had a high-quality clinical experience. I've had orthopedic procedures in surgery centers before. The difference here was I'd needed this particular procedure to stay overnight. So when I showed up that morning for that procedure, like most patients, I was quite anxious about what was about to happen. It was a multi-hour surgical procedure. I had to fill out about 25 to 30 minutes of paperwork that morning. The last thing I cared about that morning was the paperwork and the reimbursement associated with and the insurance. And so one of the things we've tried to do at Regent is to begin to shift the majority of that check-in experience in the morning at our facilities to really be around trying to assuage any fears that the patient may have, any anxiety and create a setting where that patient can come in, recognize we have high-quality care, superior anesthesia, and that we've got you well taken care of.

So trying to automate the intake experience before the day of surgery. So all they have to do is show up and focus on their health. That's a patient experience that we want to create and that we're working diligently to move forward. Another part of the experience is really around the surgeon. As we think about how those guys and ladies are running a hundred miles an hour, most of us historically in the industry, our primary communication with them from a business perspective has really been the once-a-month that we send them the monthly board packet, if you will.

Well, if I've got 20 surgeons, I really have 20 different communication styles. So an area that we're leaning into and investing heavily right now is really around technology-driven communication. Yes, we'll still have that monthly board packet because it's a great way to sort of close the month out. But some surgeons, they want little snippets of that information customized for them sent to their email. Others may want a text message that reminds them that we just uploaded something to their customized portal. So now we can communicate with 20 surgeons in a way that resonates with them and not just the prototypical sea of sameness where we provide one packet and expect everybody to glean the information they need out of that. So we have to continue to innovate in how we communicate with our partners and how we improve the patient experience.

SB: Thank you. And Chris, you're talking some about technology as well and surgery centers have both been a leader and a lagger in technology. Often they were behind in electronic health records and other kinds of things. Nurses sometimes couldn't buy the most expensive surgical robot or the most newest technology and so forth. Talk about as that's evolving and how technology's evolving with surgery centers. What are some of the things you're seeing and observing?

CB: Well, you're spot on, Scott because the innovation around technology in surgery has really been in the operating room. How do we drive robotics into the surgery center setting? I mean, if you'd asked me three or four years ago if Regent would have several dozen robots in our surgery centers, I wouldn't have believed it. Well, we do now. We're working with our supplier partners to... When it improves patient care and our physicians' request as owners in these facilities that they have access to that technology for their patients, we're able to secure that. Where I think the real innovation, that innovation has been there for 50-plus years, where I think the real innovation that our industry is beginning to turn to again kind of comes back to that experience. I've traveled most of my career, and it used to be every time you made a hotel reservation, you had to fill out your address, you had to provide your credit card.

And it was sort of starting over despite the fact that I slept in Marriott's a hundred to 120 nights a year. Well, now I go onto my phone into the app and essentially enable in about 30 seconds to select and reserve. And when I show up at the hotel, I show my ID and collect my card, or I might even have an automated room entry with my cell phone. So these are the sort of tools and experiences that we experience in our personal lives that we want to begin to design and implement into the surgery centers. Physical plant design. How can we create employing lean principles to reduce the number of steps that staff or physicians or even patients have to undertake to move from an OR to the PACU and to discharge the caregiver? Yes, we're focused on patient care, but if you're really serious about an experience, you need to be thoughtful about the caregiver that's responsible for driving mom back and forth.

Are we providing them with directions to the nearest Starbucks or do we have the right coffee machine in the waiting room? Do we have a texting technology that allows us to guide the caregiver through the process so that they know every step that mom makes through the surgical procedure and they know they need to be back at the surgery center around two o'clock for discharge and that Dr. Bishop will come out and speak to them at that point. It's so much easier than how we've historically done it where it was phone calls and we would miss them. They would call back and then couldn't get the circulator or the physician back on the phone because they were into the next case. So how do we leverage the technology for that? The other thing I would add is, and this is something that we also have a great opportunity for improvement, is really around the clinical staff. Are we creating a setting for them that allows them to feel more comfortable in the surgery center versus maybe the other settings that they've worked in historically? We're already a sort of boutique segment of the healthcare industry and surgery centers because we don't work weekends, we're off on July, we're closed on July 4th.

Staff actually chooses our locations because of that quality of life. How can we better design the facilities to continue to improve that setting? And then the only other thing I would add as it pertains to technology is around our physician partners. Our industry historically has not taken the day of surgery data and grafted that in or done a cloud-to-cloud interaction with the physician practice. But the day of surgery is a critical part of that, managing that patient's clinical pathway over years. So how do we download that information from the surgery center software systems from our cloud and get that into the practice cloud, thereby allowing them to better design their own clinical pathways based on the information they have from the surgery center? So I think you're going to see technology really leveraged over the next five years to improve staff, physician, patient, and even our health system partners' experiences.

SB: Thank you very, very much. And take a moment. We've got a few moments left. Chris, talk to us about ESG, environmental social governments, sort of what you're seeing out there in the surgery center industry, and more specifically what you're trying to do at Regent Surgical Health in this area.

CB: Got it. Yeah. No, it's a good question. And of course, if you're a publicly traded company, you're now getting scored for how well you're performing from an ESG perspective. It's a buzzword that I probably couldn't even defined for you 18 months ago. But the good news is most of our organizations because they are quality organizations in healthcare, already have a lot of elements of ESG. And I'll give you an example. Four years ago, we launched Regent Cares here. And this was really an opportunity for us to formalize our giving budget as we an organization were blessed. As we grew in profitability and our revenues and people, we were able to start carving out a percentage of our profitability to start giving back. We've done pre-COVID multiple trips to the Dominican Republic to do pediatric spine surgery mission trips, and we use Regent Cares for that.

Recently, we had 31 teammates affected by Hurricane Ian that went through Fort Myers, Florida. We were able to organize tarps and bottled water, which were the most important thing for those folks with the challenges they were facing after the hurricane. But now Regent Cares is providing groceries for those families for the next month. That's the sort of thing that ESG, as you think through how you can care for your team, plays a role in. But beyond that, as we think about diversity, how are we driving that in our workforce? What education are we providing to our hiring managers to aid them in becoming more thoughtful around maybe non-traditional sources for finding talent? When we use recruitment firms, are we requiring them to line up diverse panels, that's not something that a lot of our companies were necessarily requiring five years ago, 10 years ago.

So ESG is a way to really help I think corporate America become more thoughtful and compassionate about how they're serving their communities, how they're serving and building their teams. One other area and this was an interesting statistic for me, but I read recently that 30% of the United States' greenhouse gases are generated by the healthcare industry, that's almost a third, that just boggles my mind. And yet they were using examples of how some health systems have started to lead in this particular space and that the one example they used was Cleveland Clinic, how something as simple as in their operating rooms where they have these massive air filtration systems. They were running those things 24/7, although their operating rooms may only be operating for 10 or 12 hours, something as simple as shutting that off has an impact on energy consumption waste that's associated with running that system and how they think through that.

So if we as a surgery center industry and our 7,000 locations are just one small segment of healthcare, if we can organize our industry to be more thoughtful here and really lead, we're all building new surgery centers. If we can employ a lot of the leads certified standards to use more recycled and more energy efficient materials, this is the sort of thing that we can do that will create a stronger experience for all of our stakeholders besides the fact that it's just the right thing to do.

SB: Chris, as always, fantastic. I've had a chance to watch you through your leadership career, truly magnificent leadership. Thank you for joining us on the Becker's Healthcare Podcast today. And thank you for the leadership at Regent Surgical Health. Remarkable. Thank you very much.

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