Here are five ideas for better workflow at ambulatory surgery centers. 1. Streamline the admissions process. Surgeons, staff members and senior leadership must all be onboard with streamlining the admissions process to move patients through as quickly as possible. This means if there is a redundant form or test that really doesn't improve the quality of a patient care, consider eliminating that step and moving on to the next.
"For example, sometimes surgery centers have extra lab tests or an EKG that doesn't really impact the quality of patient care," says Mary Sturm, senior vice president of clinical operations at Surgical Management Professionals. "The decision to do these tests is driven by surgeon or anesthesiology preference. If those diagnostics are really going to be utilized to make decisions on the patient's plan of care, then they are important. However, sometimes they get ordered because they have always done those things and when people stop to think about it they don't use those results in the patient's care plan."
Audit your processes, either with internal personnel or hire an outside expert to look at workflow, and see where redundancies or unnecessary steps can be removed.
2. Make communication easier between departments. One of the biggest factors in long turnover times is a lack of communication between different departments and disciplines within the surgery center. The front desk should be in constant communication with the pre-op area, operating room and PACU to make sure there aren't any patient delays.
"You want to avoid confusion and make sure everyone is on the same page about each patient," says Ms. Sturm. "Another thing that can interfere with quick turnaround times is when the patient is not ready in the pre-op area, wasn't admitted in a timely fashion or arrived late and still hasn't seen the anesthesiologist."
This all begins with efficiency in the preoperative area to make sure patients are prepped and ready to go when the OR is prepared. There are several different communication devices staff members and providers can use, with one of the most efficient being in-house cell phones.
"You can call in real time and have a conversation with the operating room staff about a specific surgeon or patient," says Ms. Sturm. "You can find out whether a surgeon is ahead of schedule to prepare patients to be brought in early. Real time communication among the charge people in each department brings everyone up to speed about the flow and how things are going."
3. Automate functions when possible. Jeff Blankinship, president of Surgical Notes, said increased utilization of information technology can improve work flow processes. Using technology for responsibilities such as transcription, scheduling and satisfaction surveys can increase center efficiencies, according to Mr. Blankinship. He suggested ASCs utilize as much technology as possible, which may require the management team and staff to be retrained in the available tools.
4. Make sure employees are performing appropriate tasks. In many cases, higher-paid staff are doing tasks that could have been done by people paid a lot less. For example, operative nurses paid $30 an hour might be assigned to scanning documents or calling patients for satisfaction surveys. This work could easily be done by staff earning $10-$15 an hour. "With salaries making up [a significant portion] of a center's budget, this waste of high-paid staff can add up," Mr. Blankinship says. The solution? Ask employees to list each and every task he or she performs. Then closely review these detailed job descriptions to determine which tasks could be shifted to best reflect the skills of each person.
5. Use electronic scheduling. Using electronic scheduling can help an ASC get work done faster, and can increase patient satisfaction. Physician offices must run as efficiently as possible to create a positive experience for patients, said Oliver Kharraz, MD, COO and co-founder of ZocDoc. Many practices are concerned with implementing new technology and changing their processes because of the time and energy put into the change. However, more information technology companies are becoming savvy to these concerns and simplifying the integration process by using the Cloud.
"These systems should pull information on available times from the Cloud," he said. "We have tools on how the office manager can engage with these appointments. There is also a two-way messaging system to coordinate the times."
For practices that do not have electronic scheduling, there is a web-based gathering system that shows available times. "These platforms should be designed to have a minimum impact on workflow and provide all the information neatly written down in a copy/paste format that can be used easily," Dr. Kharraz said.
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