Ann Geier, MS, RN, CNOR, CASC, Chief Nursing Officer at SourceMed, discusses common ambulatory surgery center staffing issues and how the best centers address them.
1. Staffing levels change daily because they directly correlate to the surgical case volume. Efficient ASCs flex staff, but that can be hard on employees who need insurance or have trouble reaching 40 hours per week.
"Based on the flexing and lack of benefits, it can be difficult to find regular staff that will work under these conditions," says Ms. Geier. "ASCs often try to have a pool of per diem employees that they can call, but this can also be a challenge."
2. The biggest disciplinary issue at ASCs is attendance, as many employees have young children or elderly parents who have emergencies. Tardiness can also become an issue for ASCs that don't have time to spare. The best solution is to address the problem as quickly as possible and follow the ASC's protocol.
3. Staff members with difficult personalities can lead to disciplinary actions, especially if there are informal leaders who undermine managers. Passive-aggressive employees can keep the "pot stirred" unnecessarily.
"Mangers should act on issues quickly, fairly and consistently," says Ms. Geier. "Keeping a problem employee because of being short-staffed hurts everyone in the long run."
5. Managers are responsible for setting a good example for their staff and creating a positive culture. Following the ASC's policies and treating staff fairly is important to sustaining the right staff attitude. "Be friendly with staff but maintain a leadership role," says Ms. Geier. "Don't bring outside problems to work and weigh down the staff with issues that will distract them form doing their jobs."
6. Don't undermine the owners or shift the blame for an unpopular decision. "Be supportive of the owners and decisions that are made," says Ms. Geier. "Don't manage up by never accepting the blame. For example, don't say 'I wouldn't have made this decision to work until 7pm but the Board made me do it.'"
4. Don't involve owners in staffing issues; that's the administrator and manager's job. "If owners do get involved, it's usually because an employee got them involved through triangulation and it undermines the manager's authority to resolve the issues," says Ms. Geier.
7. Keep staff members informed when possible, but understand the value of confidential information. For example, if surgical volume is down because a busy group of surgeons left the center, staff raises are in jeopardy and they'll feel the pinch.
"Tell staff that raises may be held this year and tell them why," says Ms. Geier. "They deserve to know that you are aware, and they want to know that you have plans to address this when things change."
8. Build trust and commitment among the employees so they'll operate the center smoothly and consistently. "The staff are aware of issues that managers may not know about, and they truly care for each other," says Ms. Geier. "There is pride that results when there is low turnover; they are there because they want to be, and that's always good."