Jim Stilley, CEO of Northwest Michigan Surgery Center in Traverse City, Mich., has enjoyed a great relationship with his center's hospital partner for the last six years, benefiting from strategic input, cheaper supplies and help from the hospital's many available experts. He discusses five ways his ASC has worked with Munson Medical Center to build a strong relationship and reap the benefits of partnership.
1. Maintain the difference between hospital and ASC culture. In the beginning, Mr. Stilley says the transition to a hospital-ASC joint venture was difficult. Neither the hospital nor the surgeons fully understood the structure of a hospital-ASC joint venture, and the two parties had different goals. "I believe we created a structure where the partners better understand the joint nature of the relationship," he says. "The partners rely on ASC leadership to navigate the path between what each entity may 'need', such as freedom from undue administrative burden and due care given in respect toward the heavily regulated hospital structure." This middle path is one of great compromise and education, as both partners will have to work to see the other's point of view. "Some emerging hospital/ASC joint ventures are having problems because they struggle to identify the physician-centric nature of the center," he says. "My hospital partner has done a very good job understanding that this is a physician-led and directed surgery center." He says the hospital does not impose an "administrative culture of no" on the ASC and instead collaborates with the center to produce policies that fit with the ASC's culture.
2. Install a completely separate leadership structure. If possible, separate hospital and ASC leadership to give the ASC more control over its culture. Mr. Stilley is the CEO of Northwest Michigan Surgery Center, and the board membership is comprised of some the center's physicians and hospital leadership. If the board cannot come to a majority decision on an issue, they must go to arbitration, but agreement and collaboration is such that the board members have never reached that point. Mr. Stilley says the ASC has also installed a completely separate employee system, whereby staff members are employed by the surgery center and not the hospital. "At the start-up, many were employees of the hospital, so we created this bridge structure to allow them to come into the surgery center for five years to try it out," he says.
3. Alter hospital policies to fit the ASC's needs. Many hospital/ASC joint ventures struggle to succeed at first because the ASC simply adopts hospital policies without tweaking them to fit ASC needs or different regulations. Various factors, including physical location, layout, staffing structure, culture and regulatory requirements, can mean that hospital policies won't fit without some adjustments. "At first, we adopted a lot of things directly from the hospital, and over time, we found that a lot of them were asking the wrong things of a surgery center," Mr. Stilley says. When hospital policies are moved over to the ASC now, both parties consult federal and state guidelines to determine what must be done and what can be altered. For example, the ASC altered policies for pre-op screening of anesthesia delivery because the hospital inpatient setting required a different method of screening than the ASC.
4. Don't encourage competition. A hospital and an ASC that enter a joint venture may be historical rivals, and staff members might find it difficult to let go of that competition and the idea that one facility is better than the other. Mr. Stilley says it's acceptable to allow that competitive nature at first, as it lets employees establish their own identity and take pride in the care they provide, rather than feeling subservient to the hospital. But once that pride and self-reliance has been established, the ASC administrator should encourage employees to let go of that competition. "You're not really competing on the same playing field as the hospital, and we had to back off on that competition," he says. "We found after a little while that it wasn't beneficial to have one or the other entity saying they provide better surgical care." ASCs are fundamentally different from hospitals, and while ASCs may be more efficient, they also benefit from being able to select their cases and patients.
5. Ask for help when you need it. The whole point of a hospital/ASC joint venture is the positive changes it brings for both facilities, so don't be afraid to take advantage of them. When Mr. Stilley's center needs a radiology or pharmacy consultant, the center uses a hospital consultant. When the center was nominated for a national award, the hospital helped the ASC by creating a poster presentation through its marketing department. It is important to highlight each investor's complex contributions to the partnership to avoid feeling that one party is not carrying their weight.
Read more on hospital/ASC joint ventures:
-6 Ways a Hospital/Surgery Center Joint Venture Benefits Both Parties
-5 Steps Surgery Centers Should Take Before Selling to a Hospital
1. Maintain the difference between hospital and ASC culture. In the beginning, Mr. Stilley says the transition to a hospital-ASC joint venture was difficult. Neither the hospital nor the surgeons fully understood the structure of a hospital-ASC joint venture, and the two parties had different goals. "I believe we created a structure where the partners better understand the joint nature of the relationship," he says. "The partners rely on ASC leadership to navigate the path between what each entity may 'need', such as freedom from undue administrative burden and due care given in respect toward the heavily regulated hospital structure." This middle path is one of great compromise and education, as both partners will have to work to see the other's point of view. "Some emerging hospital/ASC joint ventures are having problems because they struggle to identify the physician-centric nature of the center," he says. "My hospital partner has done a very good job understanding that this is a physician-led and directed surgery center." He says the hospital does not impose an "administrative culture of no" on the ASC and instead collaborates with the center to produce policies that fit with the ASC's culture.
2. Install a completely separate leadership structure. If possible, separate hospital and ASC leadership to give the ASC more control over its culture. Mr. Stilley is the CEO of Northwest Michigan Surgery Center, and the board membership is comprised of some the center's physicians and hospital leadership. If the board cannot come to a majority decision on an issue, they must go to arbitration, but agreement and collaboration is such that the board members have never reached that point. Mr. Stilley says the ASC has also installed a completely separate employee system, whereby staff members are employed by the surgery center and not the hospital. "At the start-up, many were employees of the hospital, so we created this bridge structure to allow them to come into the surgery center for five years to try it out," he says.
3. Alter hospital policies to fit the ASC's needs. Many hospital/ASC joint ventures struggle to succeed at first because the ASC simply adopts hospital policies without tweaking them to fit ASC needs or different regulations. Various factors, including physical location, layout, staffing structure, culture and regulatory requirements, can mean that hospital policies won't fit without some adjustments. "At first, we adopted a lot of things directly from the hospital, and over time, we found that a lot of them were asking the wrong things of a surgery center," Mr. Stilley says. When hospital policies are moved over to the ASC now, both parties consult federal and state guidelines to determine what must be done and what can be altered. For example, the ASC altered policies for pre-op screening of anesthesia delivery because the hospital inpatient setting required a different method of screening than the ASC.
4. Don't encourage competition. A hospital and an ASC that enter a joint venture may be historical rivals, and staff members might find it difficult to let go of that competition and the idea that one facility is better than the other. Mr. Stilley says it's acceptable to allow that competitive nature at first, as it lets employees establish their own identity and take pride in the care they provide, rather than feeling subservient to the hospital. But once that pride and self-reliance has been established, the ASC administrator should encourage employees to let go of that competition. "You're not really competing on the same playing field as the hospital, and we had to back off on that competition," he says. "We found after a little while that it wasn't beneficial to have one or the other entity saying they provide better surgical care." ASCs are fundamentally different from hospitals, and while ASCs may be more efficient, they also benefit from being able to select their cases and patients.
5. Ask for help when you need it. The whole point of a hospital/ASC joint venture is the positive changes it brings for both facilities, so don't be afraid to take advantage of them. When Mr. Stilley's center needs a radiology or pharmacy consultant, the center uses a hospital consultant. When the center was nominated for a national award, the hospital helped the ASC by creating a poster presentation through its marketing department. It is important to highlight each investor's complex contributions to the partnership to avoid feeling that one party is not carrying their weight.
Read more on hospital/ASC joint ventures:
-6 Ways a Hospital/Surgery Center Joint Venture Benefits Both Parties
-5 Steps Surgery Centers Should Take Before Selling to a Hospital