The new staffing challenge for growing ASCs

As ASCs begin to resume more normal operations and case volumes in 2021, owners and operators are ready for growth. But that can't happen without the right staffing model.

"Right now I'm in a growth mode and looking at any possibility of growing staff," said Brian Bizub, CEO of Raleigh (N.C.) Orthopaedic. "I think staff is very challenging in an ASC. There is not a lot of upward mobility for nurses, so it's really difficult to attract newer nurses. We tend to get more tenured nurses, which is great, but keeping them can be a little difficult because of the salary requirements of a nurse that has been in nursing for 10 to 12 years."

COVID-19 exacerbated the existing nursing shortage and placed additional stressors on medical staff in the past year.

"There is a limited pool of surgical techs and RNs in our area as we compete with the larger systems," said Becky Ziegler-Otis, administrator of Ambulatory Surgical Center of Stevens Point (Wis.). "I think we have a great staff and a great working environment, but I also know we have to keep it that way. Satisfied staff drives positive patient satisfaction."

She said the center had to find creative ways to keep staff motivated, especially through a busy fourth quarter when COVID-19 cases across the U.S. surged. But there is hope. Some nurses have become disenchanted with hospital employment over the last year after they experienced long hours, flex time and layoffs, said Mr. Bizub.

"We're hoping they switch over from the hospital and come to the ASC," he said. Mr. Bizub plans to over-staff his ASCs in anticipation of further growth to avoid overworking the staff and maintain high-quality care. With more experienced nurses now onboard, he sees opportunities for early career nurses to fit on the team.

"In the past, we were concerned about having the right staff as we opened the ASCs. We really looked primarily at hospital nurses who worked in the operating room, post-anesthesia care unit, or telemetry unit because we were concerned with the risks," he said. "Now since we have our base, we have the opportunity to bring newer nurses in and train them a little differently."

One of the big differences is room turnover times. At hospitals, nurses and staff typically have 45 to 60 minutes for room turnover; the turnaround time at ASCs is often 10 minutes. Mr. Bizub said the experienced nurses at his center know they're valued and the group needs them to train others coming in.

"They are excellent in the operating room. They know the cases, they anticipate the needs of the surgeon," he said. "It's a nice place to be."


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