Case volume is easy to measure, and while culture is harder, ASC leaders say it may matter more.
Seven administrators and physicians told Becker’s how they define a high-performing ASC culture — from on-time starts to patient satisfaction — and what they look for to know it’s actually working.
Question: How do you define a high-performing ASC culture, and how do you measure it?
Editor’s note: Responses have been edited lightly for clarity and length.
Elisa Auguste. Administrator of Precision Care Surgery Center and Vice President of New York State Association of ASCs (East Setauket): A high-performing ASC culture isn’t defined by case volume alone, but by the quality, safety and efficiency of care delivered. It prioritizes patient safety, low infection rates, strong outcomes and high patient satisfaction while maintaining steady volume. Performance is measured by these quality metrics, ensuring that as volume increases, standards of care never decline.
Bruce Feldman. Former Administrator of Eastern Orange Ambulatory Surgery Center and Current Founder of an ASC Consulting Firm (Cornwall, N.Y.): A high-performing ASC culture is defined by a team environment where everybody works well with one another. The way you measure it comes down to outcomes — patient satisfaction scores, OR turnaround time, physician satisfaction and staff satisfaction. Those are the key indicators of whether you’ve truly built that kind of culture.
Megan Friedman, DO. Chair and Medical Director at Pacific Coast Anesthesia Consultants (Los Angeles): A high-performing ASC culture is one where the facility, surgeons and anesthesia providers operate as true operational partners. The centers that run well tend to have predictable scheduling, strong communication and a shared focus on efficiency. You see it in the operational metrics such as on time starts, turnover times and consistent case completion without excessive overtime. But it also shows up in staff stability and the ability to adapt when schedules change. When the culture is right, the whole center is working toward the same goal of moving patients safely and efficiently through surgery.
Michael Gross, MD. Orthopedic Director of Union Middlesex Orthopedics (Woodbridge, N.J.): In my view, a high-performing ASC culture is built upon three fundamental missions. First and foremost is the commitment to patient safety and comfort, which must always remain at the core of everything we do. Next comes efficiency and cost-effectiveness, ensuring that resources are used wisely without compromising quality. Finally, ease of access and use for surgeons and their staff is essential; when the workflow is smooth and the environment is supportive, it empowers everyone to deliver their best.
If an ASC can consistently achieve these three goals — prioritizing patient wellbeing, operating efficiently and making things easier for providers and staff — success naturally follows. These pillars provide a solid foundation for measuring performance and fostering a thriving culture.
Carrie Marut. Administrator (Ohio) Mentor Surgery Center: A high-performing culture in a surgery center is an environment where clinical excellence, patient safety and operational efficiency are consistently prioritized and achieved through strong leadership amongst leaders and peers, accountability and teamwork. It is characterized by clear communication, evidence-based practices and a shared commitment of staff to deliver high-quality patient-centered care. In this culture continuous improvement is embedded in daily operations with decision making, ongoing education and openness to feedback guiding practice changes. Staff feel empowered, supported and engaged which promotes collaboration reduces errors and enhances patient outcomes while maintaining compliance and sustainability.
Neil Parikh, MD. Chief Innovation Officer of Connecticut GI (Farmington): It starts with prioritizing patient safety by creating an environment of transparent standardization and shared accountability. I am fortunate that I work mostly at ambulatory procedure centers rather than ASCs because everyone in our building is focused on gastroenterology procedures. It is a team sport and we all have the same playbook as opposed to having to cross train our nurses and technicians. In an AEC, we are all aligned. This allows for high quality and consistency. And while there are numerous operational metrics to evaluate an ASC, there’s only one that, to me, defines culture: whether the nurses would confidently send their own loved ones there for a colonoscopy.
Lauren Phillips. Administrator of The Cardiac & Vascular Institute Ambulatory Surgery Center (Gainesville, Fla.): Defining ASC culture can be measured in a variety of ways, but one of the most important indicators is patient satisfaction. When patients are satisfied and happy with the care they receive at a facility, it often reflects a team that is engaged, supported and proud of the work they do.
Creating a culture that supports not only the patients but also the staff and performing physicians is essential to maintaining a positive and high-performing ASC environment. When leadership prioritizes collaboration and open communication, it fosters a workplace where team members feel valued and involved in the success of the organization.
An environment where staff feel heard and empowered to contribute ideas can significantly impact morale, teamwork and overall performance. Ultimately, high patient satisfaction is difficult to achieve without a strong, positive ASC culture that supports both the people providing care and those receiving it.
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