In the last two years, the city of Hastings in Nebraska has experienced the brunt of the economic downturn: In one year, the community experienced a 10 percent decrease in its workforce. For ambulatory surgery centers in small communities, economic problems can take a significant toll. Tracy Hoeft-Hoffman, administrator of Hastings Surgical Center, managed by Nueterra Healthcare, shares 10 ways her ASC has succeeded despite damaging external factors.
1. Cross-train your nurses. Ms. Hoeft-Hoffman cross-trains her nurses so she can distribute them across the ASC without having to hire a new staff member. "All nurses are cross-trained in two areas," she says. "If we have a low case volume day, the OR would admit that patient in pre-op and follow them to the [OR]. She might even follow them to the PACU." Cross-training will also give your ASC greater flexibility if a certain staff member is unable to make it to work.
2. Ask the right interview questions. Hiring the right team is essential for ASC finances for a number of reasons. Physicians will be more likely to bring cases to your center if your staff is competent and friendly. You will likely spend less money keeping the same staff member than hiring a new one. Experienced employees are more likely to turn over cases quickly, opening up your schedule for more patients. For these reasons, ASC administrators must ask interview questions that identify the best candidates. Don't be afraid to ask candidates to come in for a second interview, Ms. Hoeft-Hoffman says; sometimes you'll catch problems the second time around that weren't apparent in your first meeting. "I ask them to give me an example of when they're being a team player," she says. "I recently had [a candidate] who said, 'I can't think of an answer for that.'" Ms. Hoeft-Hoffman knew the candidate would not be a good fit for her center based on that response.
3. Be flexible with surgeon scheduling. If your schedule is flexible, physicians will feel comfortable bringing cases to your center and you may open up room for more cases in other parts of the day. Ms. Hoeft-Hoffman says her center has some surgeons who prefer to start at 7:00 a.m. instead of 7:30 a.m. "If that time works, we'll do it," she says.
4. Don't guarantee hours. When Ms. Hoeft-Hoffman hires staff members, she never guarantees hours. If your surgery center sees fluctuations in case volume, you might consider telling staff members that their hours are subject to change. "We staff our clinical hours around our cases," she says. "Right now, when patient deductibles aren't met, [patients] are not that eager to come and see us. I have had Tuesdays when I don't have any patients." Drops in case volume will happen to every ASC at times; the key is to let clinical employees go home and save on staffing costs.
5. Take off early. Last year, case volume at Ms. Hoeft-Hoffman's facility took a hit when two of her surgeons left unexpectedly — one to the Army for three and a half months, one to a new home in another city. She noticed that on Friday, the ASC was always finished with cases by 2:00 p.m., and by 3:00 p.m., the phone had stopped ringing. The center started closing two hours early on Friday, thus saving on staff salaries and boosting morale by extending the weekend.
6. Say no to your vendor. Vendor negotiations can be tough for small ASCs that feel they lack leverage. Ms. Hoeft-Hoffman advises materials managers to walk away from the negotiation when the vendor offers an unreasonably high price. When one of the ASC's vendors introduced a 20 percent price jump, they simply asked the vendor to come back with a better offer. Eventually the price was lowered. "It's about being persistent, especially if they want our future business," she says. "We're hitting our five-year anniversary, and they know we have equipment needs coming up."
7. Market creatively. In a down economy, ASCs need to keep a steady case volume. Ms. Hoeft-Hoffman markets to physicians in the local area by distributing creative presents they may not receive from other facilities or vendors. "We've tried to be creative and not just give a coffee cup or the typical things that vendors bring around," she says. "This year we gave little LED flashlights. One of the doctors even sent a thank-you card for his flashlights. Last year we gave a mitten ice scraper, and by the time I got back to my office, people were already calling to thank me."
8. Network in unexpected places. Ms. Hoeft-Hoffman has been able to increase her advertising reach by developing a relationship with the local news station. When the local anchorwoman did a story on Hastings Surgical Center a few years ago, Ms. Hoeft-Hoffman kept in touch with her. She can now contact the anchorwoman if the ASC has a newsworthy story. Ms. Hoeft-Hoffman says ASC administrators should remember to be grateful for any support they receive from their community or local media: "Afterwards, thank them for doing your story," she says.
9. Share profits. Decrease staff turnaround and incentivize frugality by sharing the center's profits. Ms. Hoeft-Hoffman's staff receives a portion of the center's profits on a quarterly basis. The bonus helps boost staff morale and demonstrates a clear, tangible effect of efforts to reduce cost.
10. Train staff on utility costs. Many ASC administrators train and quiz staff on supply costs, but Ms. Hoeft-Hoffman goes the extra mile by including utility costs. "[Employees] typically have no idea how much it costs per month to have lights and heating and cooling," she says. "Keeping the staff and surgeons informed on cost helps tremendously." Giving staff information about lighting costs, for example, will remind them to turn off the light when they leave a room. These are simple costs but they can add up to significant savings over time.
Learn more about Nueterra Healthcare.
Read more advice from Nueterra facilities:
-3 Ways to Improve Relations With the Surgeon's Office
-3 Situations When Surgery Centers Might Send a Case to the Hospital
-7 Lax Habits of Otherwise Highly Effective Surgeons
1. Cross-train your nurses. Ms. Hoeft-Hoffman cross-trains her nurses so she can distribute them across the ASC without having to hire a new staff member. "All nurses are cross-trained in two areas," she says. "If we have a low case volume day, the OR would admit that patient in pre-op and follow them to the [OR]. She might even follow them to the PACU." Cross-training will also give your ASC greater flexibility if a certain staff member is unable to make it to work.
2. Ask the right interview questions. Hiring the right team is essential for ASC finances for a number of reasons. Physicians will be more likely to bring cases to your center if your staff is competent and friendly. You will likely spend less money keeping the same staff member than hiring a new one. Experienced employees are more likely to turn over cases quickly, opening up your schedule for more patients. For these reasons, ASC administrators must ask interview questions that identify the best candidates. Don't be afraid to ask candidates to come in for a second interview, Ms. Hoeft-Hoffman says; sometimes you'll catch problems the second time around that weren't apparent in your first meeting. "I ask them to give me an example of when they're being a team player," she says. "I recently had [a candidate] who said, 'I can't think of an answer for that.'" Ms. Hoeft-Hoffman knew the candidate would not be a good fit for her center based on that response.
3. Be flexible with surgeon scheduling. If your schedule is flexible, physicians will feel comfortable bringing cases to your center and you may open up room for more cases in other parts of the day. Ms. Hoeft-Hoffman says her center has some surgeons who prefer to start at 7:00 a.m. instead of 7:30 a.m. "If that time works, we'll do it," she says.
4. Don't guarantee hours. When Ms. Hoeft-Hoffman hires staff members, she never guarantees hours. If your surgery center sees fluctuations in case volume, you might consider telling staff members that their hours are subject to change. "We staff our clinical hours around our cases," she says. "Right now, when patient deductibles aren't met, [patients] are not that eager to come and see us. I have had Tuesdays when I don't have any patients." Drops in case volume will happen to every ASC at times; the key is to let clinical employees go home and save on staffing costs.
5. Take off early. Last year, case volume at Ms. Hoeft-Hoffman's facility took a hit when two of her surgeons left unexpectedly — one to the Army for three and a half months, one to a new home in another city. She noticed that on Friday, the ASC was always finished with cases by 2:00 p.m., and by 3:00 p.m., the phone had stopped ringing. The center started closing two hours early on Friday, thus saving on staff salaries and boosting morale by extending the weekend.
6. Say no to your vendor. Vendor negotiations can be tough for small ASCs that feel they lack leverage. Ms. Hoeft-Hoffman advises materials managers to walk away from the negotiation when the vendor offers an unreasonably high price. When one of the ASC's vendors introduced a 20 percent price jump, they simply asked the vendor to come back with a better offer. Eventually the price was lowered. "It's about being persistent, especially if they want our future business," she says. "We're hitting our five-year anniversary, and they know we have equipment needs coming up."
7. Market creatively. In a down economy, ASCs need to keep a steady case volume. Ms. Hoeft-Hoffman markets to physicians in the local area by distributing creative presents they may not receive from other facilities or vendors. "We've tried to be creative and not just give a coffee cup or the typical things that vendors bring around," she says. "This year we gave little LED flashlights. One of the doctors even sent a thank-you card for his flashlights. Last year we gave a mitten ice scraper, and by the time I got back to my office, people were already calling to thank me."
8. Network in unexpected places. Ms. Hoeft-Hoffman has been able to increase her advertising reach by developing a relationship with the local news station. When the local anchorwoman did a story on Hastings Surgical Center a few years ago, Ms. Hoeft-Hoffman kept in touch with her. She can now contact the anchorwoman if the ASC has a newsworthy story. Ms. Hoeft-Hoffman says ASC administrators should remember to be grateful for any support they receive from their community or local media: "Afterwards, thank them for doing your story," she says.
9. Share profits. Decrease staff turnaround and incentivize frugality by sharing the center's profits. Ms. Hoeft-Hoffman's staff receives a portion of the center's profits on a quarterly basis. The bonus helps boost staff morale and demonstrates a clear, tangible effect of efforts to reduce cost.
10. Train staff on utility costs. Many ASC administrators train and quiz staff on supply costs, but Ms. Hoeft-Hoffman goes the extra mile by including utility costs. "[Employees] typically have no idea how much it costs per month to have lights and heating and cooling," she says. "Keeping the staff and surgeons informed on cost helps tremendously." Giving staff information about lighting costs, for example, will remind them to turn off the light when they leave a room. These are simple costs but they can add up to significant savings over time.
Learn more about Nueterra Healthcare.
Read more advice from Nueterra facilities:
-3 Ways to Improve Relations With the Surgeon's Office
-3 Situations When Surgery Centers Might Send a Case to the Hospital
-7 Lax Habits of Otherwise Highly Effective Surgeons