West Bloomfield, Mich.-based Lakes Surgery Center Administrator Jennifer Butterfield, RN, discusses her centers most effective methods for cost containment.
Ms. Butterfield will speak on cost containment at the Becker's ASC 24th Annual Meeting: The Business and Operations of ASCs event on Oct. 25-28, 2017 in Chicago. Click here to learn more and register.
Q: What has been the most successful cost containment initiative you've implemented at your ASC?
Jennifer Butterfield: I made cost containment a high priority for everyone in my center. Cost containment cannot be something solely designated to a materials manager or an OR manager. Cost containment has to be a priority with everyone in the facility from the doctors and nurses to the receptionist. Each person needs to have set goals on how to reach cost containment initiatives and accountability towards reaching those goals.
For example, a sterile processing technician could have 'increasing reprocessing 3 percent over prior year' as a goal. A receptionist could have 'reduce office supplies per case by $0.03 over prior year' as a goal. Failure to reach set goals would affect their annual performance evaluation and potentially their annual merit increase or bonus.
Q: How do you ensure supply and staffing costs stay under control?
JB: It's easier to control supply costs when you have each person accountable to cost containment. But making them responsible goes two ways. You have to educate staff members on the cost of supplies so they can make educated decisions on usage. For example, if you educate OR staff, and your physicians, that the cost of skin adhesive is over three times the cost of a Monocryl suture for wound closure, they are more likely to take the few extra minutes to close the wound the old fashioned way.
If those same people know using a name brand k-wire out of an implant tray is 2.5 times more expensive than a generic k-wire, then they are more likely to take the extra step to open the generic k-wire package. All those little actions add up.
For staffing, the same premise applies. Each and every initiative being utilized will add dollars to the bottom line. Adjust staffing to match scheduled cases, avoid time clock rounding by having a policy in place, cross-training, watching for overtime and having managers send people home when cases are finished are just a few initiatives. We may utilize up to 20 different strategies on any given day. Managers have all been trained on around 50 different strategies they can use for productivity and containing staffing costs.
Q: Where do you see the biggest opportunity for your ASC, or ASCs in general, to improve productivity?
JB: The best way to improve productivity is to have consistent case volume. Nothing kills productivity more than having several rooms going at the same time but only a handful of cases. To improve productivity we try to consolidate ORs, which means having some tough conversations with physicians.
Overall, things to watch include:
• Block utilization
• Bouncing ORs inefficiently or with not enough cases to justify
• Significant gaps in scheduling
• Service line gaps that increase staffing (such as busy in endoscopy at certain times and OR at other times and having to keep two sets of staff available)
• Acuity of cases
If you find you have inconsistent volume, then the best thing an administrator can do is to launch a marketing/recruitment campaign to get more footsteps into your center. You will find your center has a magic number of staffing hours per patient hours or a similar ratio for productivity. If you can hit that number then you have leveraged productivity to its maximum and have become the most efficient and therefore most profitable.