Mary Sturm, RN, MBA, senior vice president of clinical operations at Surgical Management Professionals, discusses seven steps to kick-start a positive culture in ambulatory surgery centers.
1. Start the positive culture at the top. Surgery center leaders must be invested in a positive culture and set the tone for every other employee in the center. This means owners, board members and other appointed leaders must strive for excellence in their behavior as well as clinical practice.
"The owners and board of governors at the surgery center set the expectation for managers, leaders and staff members," says Ms. Sturm. "They want to own and work at a center of excellence and the only way to provide that is with a positive culture. It does really start with the leaders of the organization and their commitment to doing whatever it takes to create a surgery center that everyone is passionate about."
One way to impact the surgery center's culture is by greeting individual staff members by name and really listening when they have suggestions. You should also be an advocate for quality at the center.
"Are you as focused on quality and patient care as you expect the worker bees to be?" says Ms. Sturm. "You need to 'walk-the-walk' and really treat people well. Focus on safety and quality because that's what you expect from employees to create a positive culture."
2. Spend time in the break room. As surgery centers become larger and more staff members are brought on, it becomes increasingly difficult for upper leadership and physician partners to form a relationship with other staff members at the ASC. However, knowing each employee's name, successes and concerns are still important. One way to become more familiar with the employees and what goes on at the ground-level of the surgery center is by interacting with them in the employee break room.
"Physicians and administrators can sit in the employee lunch room and have their breaks with the employees," says Ms. Sturm. "They can rub shoulders and get to know a little bit about the non-clinical aspects of what goes on at the surgery center. The break room is where you really get your finger on the pulse of what is going on in the center."
3. Be selective in the hiring process. As you hire new employees, be selective about who you bring onto the team. Make sure they will fit into the positive culture you are trying to create at the center and add to the team as a whole.
"For the most part, surgery centers have a schedule that is very attractive to individuals and I think ASCs can be very selective about the employees they hire," says Ms. Sturm. "There is a tendency, especially among surgeons, to equate a good employee to having a great deal of experience and competence in what they do. You definitely want a good clinician, but the mandate needs to go a step further to be very passionate about the employees they hire."
Surgery centers must promote an expectation of excellence among their employees; employees must be competent and have good behavior. "It falls on the leaders of the organization to screen and hire employees who are good citizens and bring that professionalism and citizenship to the surgery center beyond just the clinical concepts," says Ms. Sturm.
4. Work on performance improvement for employees who don't fit. If you notice an employee who doesn't fit this culture of excellence — or someone who has been lagging more recently — introduce a strategy for performance improvement to help them get on track. Calling the program "Performance Improvement" suggests that you are giving them a chance to become better at what they do, not just saying they are unsalvageable.
"Identify where they need to be better, share the expectations with them very clearly and definitively and give them every opportunity to succeed, and help them succeed," says Ms. Sturm. "There can be great success stories when employees take their behavior to heart, reflect on that and really improve. Sometimes they do not improve and when they show you they are not able to change their behavior and act in a manner that isn't appropriate, they aren't a good fit for the center."
5. Let bad apples go. When employees refuse to change their behavior even after going through a performance improvement program, you must be willing to let them go. "Sometimes you will get a bad apple in the bunch and when you dwell on the expectations for someone and they still aren't a good fit, I am very passionate about letting them go," says Ms. Sturm. "The saying 'one bad apple can spoil the bunch' sounds trite, but it really can affect the well being of your department and surgery center."
Bad behavior can come from any employee, but is particularly prevalent among employees who were previously working in a hospital setting. "When they work in a hospital setting for a long time where there isn't the same expectation for good behavior, they can come into the surgery center and think it's business as usual," says Ms. Sturm. "They will have passive aggressive behavior that is really toxic in the ASC."
If you allow employees to continue their bad behavior without consequences, you risk other employees following suit. "When you let bad behaviors continue, you are sending a message to the other employees that it's okay," says Ms. Sturm. "The leaders aren't acting on the bad behavior and therefore they find it acceptable and it can become more of a norm than it should be."
6. Align leader and employee goals with reward. Aligning leadership and employee interest goes a long way to promoting a positive environment in the surgery center, and when the goals of both are met you can reward employees. The incentives can be minimal — such as a pizza party if patient satisfaction goals are met — but it really does make a difference.
"We are very fortunate that our SMP centers have boards of directors that are very much in line with the fact that when the centers are successful, employees are providing great patient care," says Ms. Sturm. "Our physician owners know that low infection rates and high patient satisfaction has a lot to do with employees doing the right thing. Providing rewards for reaching these goals demonstrates that the employees' hard work is recognized and valued."
7. Make sure there is a sense of "fun." Providing good healthcare to patients is serious and must be treated that way. However, the surgery center doesn't always have to be a serious place; inject a sense of "fun" into the center by making sure employees enjoy coming to work and take pride in what they do.
"While the business of surgery is very serious, the really successful surgery centers also create an environment where there is a sense of fun," says Ms. Sturm. "By that I mean an atmosphere where everyone enjoys themselves in the workplace."
One of the reasons why surgery centers are attractive to healthcare professionals, and often have high employee retention, is because employees are given the resources they need to do their jobs well. "They are given the appropriate equipment, supplies and nurse-to-staff and patient ratio that allows them to take pride in the care they provide," says Ms. Sturm. "They become very good at their craft."
More Articles on Surgery Centers:
Are Bundled Payments Near for Surgery Centers? Q&A With Dr. Jason Hwang of Innosight Institute
7 Ways for Surgery Centers to Make More Money Now
Attracting New Talent in Small Markets: Q&A With Saint Luke's Surgicenter Administrator Janet Gordon
1. Start the positive culture at the top. Surgery center leaders must be invested in a positive culture and set the tone for every other employee in the center. This means owners, board members and other appointed leaders must strive for excellence in their behavior as well as clinical practice.
"The owners and board of governors at the surgery center set the expectation for managers, leaders and staff members," says Ms. Sturm. "They want to own and work at a center of excellence and the only way to provide that is with a positive culture. It does really start with the leaders of the organization and their commitment to doing whatever it takes to create a surgery center that everyone is passionate about."
One way to impact the surgery center's culture is by greeting individual staff members by name and really listening when they have suggestions. You should also be an advocate for quality at the center.
"Are you as focused on quality and patient care as you expect the worker bees to be?" says Ms. Sturm. "You need to 'walk-the-walk' and really treat people well. Focus on safety and quality because that's what you expect from employees to create a positive culture."
2. Spend time in the break room. As surgery centers become larger and more staff members are brought on, it becomes increasingly difficult for upper leadership and physician partners to form a relationship with other staff members at the ASC. However, knowing each employee's name, successes and concerns are still important. One way to become more familiar with the employees and what goes on at the ground-level of the surgery center is by interacting with them in the employee break room.
"Physicians and administrators can sit in the employee lunch room and have their breaks with the employees," says Ms. Sturm. "They can rub shoulders and get to know a little bit about the non-clinical aspects of what goes on at the surgery center. The break room is where you really get your finger on the pulse of what is going on in the center."
3. Be selective in the hiring process. As you hire new employees, be selective about who you bring onto the team. Make sure they will fit into the positive culture you are trying to create at the center and add to the team as a whole.
"For the most part, surgery centers have a schedule that is very attractive to individuals and I think ASCs can be very selective about the employees they hire," says Ms. Sturm. "There is a tendency, especially among surgeons, to equate a good employee to having a great deal of experience and competence in what they do. You definitely want a good clinician, but the mandate needs to go a step further to be very passionate about the employees they hire."
Surgery centers must promote an expectation of excellence among their employees; employees must be competent and have good behavior. "It falls on the leaders of the organization to screen and hire employees who are good citizens and bring that professionalism and citizenship to the surgery center beyond just the clinical concepts," says Ms. Sturm.
4. Work on performance improvement for employees who don't fit. If you notice an employee who doesn't fit this culture of excellence — or someone who has been lagging more recently — introduce a strategy for performance improvement to help them get on track. Calling the program "Performance Improvement" suggests that you are giving them a chance to become better at what they do, not just saying they are unsalvageable.
"Identify where they need to be better, share the expectations with them very clearly and definitively and give them every opportunity to succeed, and help them succeed," says Ms. Sturm. "There can be great success stories when employees take their behavior to heart, reflect on that and really improve. Sometimes they do not improve and when they show you they are not able to change their behavior and act in a manner that isn't appropriate, they aren't a good fit for the center."
5. Let bad apples go. When employees refuse to change their behavior even after going through a performance improvement program, you must be willing to let them go. "Sometimes you will get a bad apple in the bunch and when you dwell on the expectations for someone and they still aren't a good fit, I am very passionate about letting them go," says Ms. Sturm. "The saying 'one bad apple can spoil the bunch' sounds trite, but it really can affect the well being of your department and surgery center."
Bad behavior can come from any employee, but is particularly prevalent among employees who were previously working in a hospital setting. "When they work in a hospital setting for a long time where there isn't the same expectation for good behavior, they can come into the surgery center and think it's business as usual," says Ms. Sturm. "They will have passive aggressive behavior that is really toxic in the ASC."
If you allow employees to continue their bad behavior without consequences, you risk other employees following suit. "When you let bad behaviors continue, you are sending a message to the other employees that it's okay," says Ms. Sturm. "The leaders aren't acting on the bad behavior and therefore they find it acceptable and it can become more of a norm than it should be."
6. Align leader and employee goals with reward. Aligning leadership and employee interest goes a long way to promoting a positive environment in the surgery center, and when the goals of both are met you can reward employees. The incentives can be minimal — such as a pizza party if patient satisfaction goals are met — but it really does make a difference.
"We are very fortunate that our SMP centers have boards of directors that are very much in line with the fact that when the centers are successful, employees are providing great patient care," says Ms. Sturm. "Our physician owners know that low infection rates and high patient satisfaction has a lot to do with employees doing the right thing. Providing rewards for reaching these goals demonstrates that the employees' hard work is recognized and valued."
7. Make sure there is a sense of "fun." Providing good healthcare to patients is serious and must be treated that way. However, the surgery center doesn't always have to be a serious place; inject a sense of "fun" into the center by making sure employees enjoy coming to work and take pride in what they do.
"While the business of surgery is very serious, the really successful surgery centers also create an environment where there is a sense of fun," says Ms. Sturm. "By that I mean an atmosphere where everyone enjoys themselves in the workplace."
One of the reasons why surgery centers are attractive to healthcare professionals, and often have high employee retention, is because employees are given the resources they need to do their jobs well. "They are given the appropriate equipment, supplies and nurse-to-staff and patient ratio that allows them to take pride in the care they provide," says Ms. Sturm. "They become very good at their craft."
More Articles on Surgery Centers:
Are Bundled Payments Near for Surgery Centers? Q&A With Dr. Jason Hwang of Innosight Institute
7 Ways for Surgery Centers to Make More Money Now
Attracting New Talent in Small Markets: Q&A With Saint Luke's Surgicenter Administrator Janet Gordon