Ten ambulatory surgery center administrators discuss effective leadership strategies for boosting staff morale, organization, efficiency and profitability.
Steve Corl, Mackinaw Surgery Center (Saginaw, Mich.): We implemented a rounding protocol for managers. Once a month, they will round on each employee for five to 10 minutes to see how things are going. Rounding must be done privately and at a time convenient for the employee. This program helps identify employees that are doing an outstanding job — not from just the management's point of view, but from their peers. Recognition of those employees can be given in the form of a thank-you card mailed to their home, an "employee of the month" parking spot up front in the parking lot, or a gift card. We also will have potlucks that can be sponsored by all employees bringing something or by the organization if they meet certain patient satisfaction or quality initiative goals.
Chris Doyle, Riddle Surgical Center (Media, Pa.): We conducted an employee satisfaction survey, and I was anxious to present the excellent staff scores at our monthly team meeting. To kick off the summer, my leadership team and I served water ice and pretzels, Philadelphia-style, to our team members. At the end of the meeting, we provided Riddle Surgical Center T-shirts. As a follow-up to that meeting, I formed an employee satisfaction committee to further improve team morale. This committee includes five team members from each area of our facility. The steering committee is meeting monthly and will present their results to the entire team at the end of the year. A second initiative to improve morale is my monthly "lunch with the administrator," where I provide lunch for four team members. I deliver a facility report to the group and ask them for feedback about their experiences.
Sandy Berreth, Brainerd Lakes Surgical Center (Baxter, Minn.): Staff morale is based on perceptions. I believe by recognizing, by encouraging, by being "present" and finally by rewarding, the staff will appreciate the efforts of the leadership team, and therefore staff morale will increase. I participate daily in the managing of the surgery center, and I know the work schedule and the workload of each employee. In recognition of jobs well done, we give gift certificates to Target and the local movie theater, as well as having lunches and breakfasts as rewards.
Tim Luckett, Advanced Diagnostic and Surgical Center (Alhambra, Calif.): I meet with the medical director and the president of the board to go over a detailed report showing what the center's expenses are. You can't know what you're making unless you know how much you're putting out, and a lot of people don't do those cost studies. From the time patients hit the door until the time they leave, include costs associated with labor, the admitting clerk, time spent in pre-op, what supplies were used, any premedication, the amount of labor and how much each room costs per hour in an eight-hour day. When you factor in all of those things, you come out with a fairly accurate report. It shows which cases you make the most money on and the importance of volume, and it gives them a sense of the importance of being on time.
Anita Roper, Viewmont Surgery Center (Hickory, N.C.): One of a leader's most important resources is their staff. Invest in your staff; listen to them; engage with them; ask them what is working and what is not working. During our staff meetings, I always go around the room and give each employee at the meeting time to ask any questions, voice any concerns, or mention any topics they believe need to be discussed. If you as a leader decide to implement this opportunity for employees, you can plan on a long first meeting. But the staff members will get accustomed to the process, and they will learn how to bring up important conversations. If they bring up a topic that you plan to discuss in your agenda, thank the employee for bringing that up and let them know you will address it.
Traci Albers, North Memorial Ambulatory Surgery Center (Maple Grove, Minn.): During our facility expansion, we consistently talked to staff a lot about the process and how the facility will look when it's done. We also talked about creating a very calm, quiet environment, and how we don't want clutter in the hallways. The team jumped on board with it, even though change is hard and requires a lot of meetings. We had weekly updates that went out to physicians and staff — we would send out an email saying what is coming next week. We also had weekly construction meetings. Any time changes came up, they would be communicated out.
Arvind Movva, MD, CEO, Regional Surgicenter (Moline, Ill): The most important factor in improving non-provider productivity is boosting employee efficiency.
This is accomplished through increased morale and personal buy-in. Recently, we began disseminating information via intranet postings and e-mail, replacing our previous methods of paper postings, mailings and word of mouth. We also launched several new service lines, which include interventional pain and ENT. Because we were a GI predominant multi-specialty center, our staff was very well educated on all things GI, but they were less familiar with these newer specialties. An educated staff is a productive staff. So, how can we improve the knowledge level of our staff while at the same time giving them a feeling of ownership and improving morale? Answer: Trivia game with prizes via e-mail and intranet that revolve around new service line offerings. We tied these to sports tickets, but anything fun can work. This created significant interaction among the staff and physicians regarding their procedures and also fostered some healthy competition about knowing more than others.
Toni Rambeau, SurgCenter (Glen Burnie, Md.): If a day is short, we'll send staff members home to try to save money on staffing. The first thing out of my mouth in the interview process is that staff members have to be flexible and that we can't guarantee 40 hours. There may be a couple of slow days here and there. I'll also cross-train my whole staff — from nursing to business — so that everybody can do everyone else's job.
Brooke Day, Hastings Surgical Center (Hastings, Neb.): There is a difference between hearing what an employee is telling you and actually listening to what an employee is telling you. It is important to approach each individual conversation with openness to their feelings, opinions and perceptions. Listening involves paying attention to the non-verbal cues, being aware of their feelings and in return being sensitive. Leaders always have to consider the business, surgeons, employees and patients and although the appropriate decision may not be the preferred choice by staff, you can always approach the staff with an honesty and awareness of their feelings.
Mary Ellen Rider, Maryville Surgical Center (Maryville, Tenn.): It is my belief that an administrator in an ambulatory surgery center has to be a hands-on person and lead by example. She needs to be willing to do anything she asks of her staff. This includes turning OR rooms, mopping floors, taking care of patients and staying late. My staff members know they can call on me for anything and I will help them. If we are short staffed, I work an area as much as needed.
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Steve Corl, Mackinaw Surgery Center (Saginaw, Mich.): We implemented a rounding protocol for managers. Once a month, they will round on each employee for five to 10 minutes to see how things are going. Rounding must be done privately and at a time convenient for the employee. This program helps identify employees that are doing an outstanding job — not from just the management's point of view, but from their peers. Recognition of those employees can be given in the form of a thank-you card mailed to their home, an "employee of the month" parking spot up front in the parking lot, or a gift card. We also will have potlucks that can be sponsored by all employees bringing something or by the organization if they meet certain patient satisfaction or quality initiative goals.Chris Doyle, Riddle Surgical Center (Media, Pa.): We conducted an employee satisfaction survey, and I was anxious to present the excellent staff scores at our monthly team meeting. To kick off the summer, my leadership team and I served water ice and pretzels, Philadelphia-style, to our team members. At the end of the meeting, we provided Riddle Surgical Center T-shirts. As a follow-up to that meeting, I formed an employee satisfaction committee to further improve team morale. This committee includes five team members from each area of our facility. The steering committee is meeting monthly and will present their results to the entire team at the end of the year. A second initiative to improve morale is my monthly "lunch with the administrator," where I provide lunch for four team members. I deliver a facility report to the group and ask them for feedback about their experiences.
Sandy Berreth, Brainerd Lakes Surgical Center (Baxter, Minn.): Staff morale is based on perceptions. I believe by recognizing, by encouraging, by being "present" and finally by rewarding, the staff will appreciate the efforts of the leadership team, and therefore staff morale will increase. I participate daily in the managing of the surgery center, and I know the work schedule and the workload of each employee. In recognition of jobs well done, we give gift certificates to Target and the local movie theater, as well as having lunches and breakfasts as rewards. Tim Luckett, Advanced Diagnostic and Surgical Center (Alhambra, Calif.): I meet with the medical director and the president of the board to go over a detailed report showing what the center's expenses are. You can't know what you're making unless you know how much you're putting out, and a lot of people don't do those cost studies. From the time patients hit the door until the time they leave, include costs associated with labor, the admitting clerk, time spent in pre-op, what supplies were used, any premedication, the amount of labor and how much each room costs per hour in an eight-hour day. When you factor in all of those things, you come out with a fairly accurate report. It shows which cases you make the most money on and the importance of volume, and it gives them a sense of the importance of being on time.
Anita Roper, Viewmont Surgery Center (Hickory, N.C.): One of a leader's most important resources is their staff. Invest in your staff; listen to them; engage with them; ask them what is working and what is not working. During our staff meetings, I always go around the room and give each employee at the meeting time to ask any questions, voice any concerns, or mention any topics they believe need to be discussed. If you as a leader decide to implement this opportunity for employees, you can plan on a long first meeting. But the staff members will get accustomed to the process, and they will learn how to bring up important conversations. If they bring up a topic that you plan to discuss in your agenda, thank the employee for bringing that up and let them know you will address it.Traci Albers, North Memorial Ambulatory Surgery Center (Maple Grove, Minn.): During our facility expansion, we consistently talked to staff a lot about the process and how the facility will look when it's done. We also talked about creating a very calm, quiet environment, and how we don't want clutter in the hallways. The team jumped on board with it, even though change is hard and requires a lot of meetings. We had weekly updates that went out to physicians and staff — we would send out an email saying what is coming next week. We also had weekly construction meetings. Any time changes came up, they would be communicated out.
Arvind Movva, MD, CEO, Regional Surgicenter (Moline, Ill): The most important factor in improving non-provider productivity is boosting employee efficiency.
This is accomplished through increased morale and personal buy-in. Recently, we began disseminating information via intranet postings and e-mail, replacing our previous methods of paper postings, mailings and word of mouth. We also launched several new service lines, which include interventional pain and ENT. Because we were a GI predominant multi-specialty center, our staff was very well educated on all things GI, but they were less familiar with these newer specialties. An educated staff is a productive staff. So, how can we improve the knowledge level of our staff while at the same time giving them a feeling of ownership and improving morale? Answer: Trivia game with prizes via e-mail and intranet that revolve around new service line offerings. We tied these to sports tickets, but anything fun can work. This created significant interaction among the staff and physicians regarding their procedures and also fostered some healthy competition about knowing more than others.Toni Rambeau, SurgCenter (Glen Burnie, Md.): If a day is short, we'll send staff members home to try to save money on staffing. The first thing out of my mouth in the interview process is that staff members have to be flexible and that we can't guarantee 40 hours. There may be a couple of slow days here and there. I'll also cross-train my whole staff — from nursing to business — so that everybody can do everyone else's job.
Brooke Day, Hastings Surgical Center (Hastings, Neb.): There is a difference between hearing what an employee is telling you and actually listening to what an employee is telling you. It is important to approach each individual conversation with openness to their feelings, opinions and perceptions. Listening involves paying attention to the non-verbal cues, being aware of their feelings and in return being sensitive. Leaders always have to consider the business, surgeons, employees and patients and although the appropriate decision may not be the preferred choice by staff, you can always approach the staff with an honesty and awareness of their feelings.Mary Ellen Rider, Maryville Surgical Center (Maryville, Tenn.): It is my belief that an administrator in an ambulatory surgery center has to be a hands-on person and lead by example. She needs to be willing to do anything she asks of her staff. This includes turning OR rooms, mopping floors, taking care of patients and staying late. My staff members know they can call on me for anything and I will help them. If we are short staffed, I work an area as much as needed.
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How a Turnaround Saved $225K for a Distressed Surgery Center: Q&A With Michelle Gigowski