Lanson Hyde, COO of Surgical Development Partners in Franklin, Tenn., offers five best practices to enhance productivity in an ambulatory surgery center.
1. Grow volume with existing surgeons. Growing volume is the most effective way to gain efficiencies and increase productivity. The easiest way to do so is to get more cases from existing surgeons. "It is infinitely easier to get additional cases from existing surgeons than to convince a new surgeon to try your facility," Mr. Hyde says.
Run monthly volume reports on surgeons to identify the "splitters": those who are splitting their cases between your ASC and other facilities. Start a conversation with these surgeons to find out why they are not bringing all their cases to the center. Do they have objections that can be addressed?
2. Focus on recruiting. Make recruiting new surgeons a top priority and follow up on progress every month. "All too often, facilities get complacent, thinking they've already hit all the likely candidates," Mr. Hyde says. "They tend to put those surgeons in a box." Without verifying their assumptions, they'll say, "This one is loyal to the hospital" or "That one is already using another ASC and doesn't want to switch." Even if all this is true, circumstances rarely stay the same. People change their minds.
Stay in regular contact with potential candidates. "This shows you have initiative and you care," Mr. Hyde says. Persistence and attention over time can be enough to win over a doctor. "Timing is everything," he says. "You may catch that doctor after they've had a bad experience somewhere else and is more willing to try your facility."
3. Adjust staffing. Continuously monitor staff hours worked per case. "A lot of the time ASCs don't flex staff well enough," Mr. Hyde says. Look at staffing reports daily. When the caseload falls but overall hours remain constant, staff has not been flexed well that day. "There are a million excuses," he says. "Some administrators see themselves as nurse advocates and not managers of multimillion-dollar businesses, with investors who have taken risk and expect — and deserve — returns." Quality is not a good excuse, either, because overstaffing does not improve clinical outcomes.
"It's easy to let overstaffing happen and hard when you see the results," Mr. Hyde says. Administrators who haven't made monitoring a priority will be in for a shock when they look at end-of-year reports. "They'll realize they have spent hundreds of thousands of dollars on additional staffing and have nothing to show for it," he says.
4. Manage the schedule. "Actively manage and consolidate the schedule where possible," Mr. Hyde says. Get the word out about unused blocks as soon as they open up. Talk to surgeons who are hanging on to blocks they never use. Fill in holes in schedules by moving up surgeries and closing earlier.
5. Limit OR-flipping. Allowing surgeons to flip cases between two ORs can raise their productivity, but it ties up two rooms. Therefore, this approach should be limited to high-volume surgeons. "Treat flipping rooms as a privilege earned by hitting certain volume thresholds," Mr. Hyde says. For example, a block of four cataracts shouldn't warrant tying up two rooms, but anything over 10 cataracts probably does.
Learn more about Surgical Development Partners.
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