Here are five ways you can improve your ASC's staffing and scheduling processes.
1. Benchmark staff levels to ensure your numbers are optimal. According to Ross Alexander, MBA, the administrator of The Surgery Center of Fort Collins (Colo.), ASC administrators should benchmark staff numbers to make sure they aren't staffing too many or two few employees. "It's more important to know how many nurses you're using than what you're paying them," Mr. Alexander said. "Most surgery centers pay market rates. It's knowing how many nurses you need to provide care efficiently and safely."
He recommended ASC leaders look at data from similarly sized facilities or national benchmarking data that will gives averages based on facility size. For example, VMG Health's Multi-Specialty ASC Intellimarker 2010 reports that, on average:
• ASCs with 1-2 ORs staff 6.9 FTE nurses, 2.5 FTE techs and 5.0 FTE administrative staff members
• ASCs with 3-4 ORs staff 10.6 FTE nurses, 4.4 FTE techs and 7.0 FTE administrative staff members
• ASCs with more than four ORs staff 16.8 nurses, 8.0 FTE techs and 11.8 FTE administrative staff members
From: 5 Ways Surgery Centers Can Rein in Costs and Build Physician Relationships
2. Cutting staff hours indiscriminately can damage staff relationships. While financial cutbacks are understandable and necessary, Marc Jang, vice president of market development for Titan Health Corp., warns ASCs to be careful when cutting staff hours to save money. "It's not like you have 100 employees at one center like in a hospital," he says. "Cutting staff hours may be a strategy to safe money, but sometimes it can result in an unintended negative consequence."
He says centers looking to cut hours often adopt an "all for one and one for all" strategy in which the ASC cuts hours across the board to make the cost-cutting process fair. But if the ASC administrator fails to talk to staff members individually, he or she might not notice the individual financial situations that make pay cuts difficult for some employees. He says administrators should talk to staff members one-on-one about staffing decisions, as they may be reticent to object in front of their colleagues.
From: Critical ASC Mistake: Cutting Staff Hours Indiscriminately
3. Scheduling holes cost a lot of money. According to Jeff Leland, CEO of Blue Chip Surgical Center Partners, an ASC with holes in its schedule is wasting a great deal of money on staff and other operational expenses. One solution is to "compress" the schedule by closing down operations for a day.
Luke Lambert, CEO of ASCOA, says surgical schedule compression is the most important step a center can take to save money. "Whether you do 15 cases a day or 40 cases a day at the center, by and large it's going to cost you the same amount to staff the center," he said. "So obviously if you can have a higher throughput, in the tough reimbursement environment we're in, having a lot of cases going through your day is really essential be profitable."
Sandy Berreth says ASC administrators should be clear with staff during hiring that no cases means no work. It makes more sense to keep your ASC open three days a week and fill those days with cases than to staff your ASC every day and pay people to stand around, she says.
From: 5 Ways ASCs Unintentionally Waste Money
4. Call to check in with physicians whose case scheduling drops off. If you notice a particular physician has stopped or cut back scheduling cases at your ASC, Vicki Edelman, administrator of Blue Bell (Pa.) Surgery Center, says you should follow up and find out why his or her case load has decreased. "If he's on vacation, we can tell the other doctors, 'We need more cases that day, or we're going to have to move that day's scheduled cases to another day,'" she says.
If your physician is on vacation, your ASC will know to bump up cases from other physicians while he or she is away. If the physician has stopped scheduling cases because of a problem with a facility, it's absolutely essential you find out about it quickly. Ms. Edelman says it's much easier to deal with disgruntled physicians if you follow up and express concern than if you let them drop off the radar for weeks.
From: How to Tighten Your OR Schedule: Q&A With Vicki Edelman of Blue Bell Surgery Center
5. Control staff salaries and share profits. According to Lisa Austin of Pinnacle III, one way to involve staff members in ASC's operation is to allow them to financially benefit through a good profit-sharing program. If you're able to create cost savings in salaries and supplies, a portion of that profit can be distributed on a quarterly or monthly basis. This way, you're not cutting into the budget to raise staff salaries, but rather using your additional savings to reward your employees. Staff members will be happier because they receive a bonus based on their hard work and will be more likely to put in effort to save your center money.
From: Critical ASC Mistake: Failure to Control Staff Salaries
1. Benchmark staff levels to ensure your numbers are optimal. According to Ross Alexander, MBA, the administrator of The Surgery Center of Fort Collins (Colo.), ASC administrators should benchmark staff numbers to make sure they aren't staffing too many or two few employees. "It's more important to know how many nurses you're using than what you're paying them," Mr. Alexander said. "Most surgery centers pay market rates. It's knowing how many nurses you need to provide care efficiently and safely."
He recommended ASC leaders look at data from similarly sized facilities or national benchmarking data that will gives averages based on facility size. For example, VMG Health's Multi-Specialty ASC Intellimarker 2010 reports that, on average:
• ASCs with 1-2 ORs staff 6.9 FTE nurses, 2.5 FTE techs and 5.0 FTE administrative staff members
• ASCs with 3-4 ORs staff 10.6 FTE nurses, 4.4 FTE techs and 7.0 FTE administrative staff members
• ASCs with more than four ORs staff 16.8 nurses, 8.0 FTE techs and 11.8 FTE administrative staff members
From: 5 Ways Surgery Centers Can Rein in Costs and Build Physician Relationships
2. Cutting staff hours indiscriminately can damage staff relationships. While financial cutbacks are understandable and necessary, Marc Jang, vice president of market development for Titan Health Corp., warns ASCs to be careful when cutting staff hours to save money. "It's not like you have 100 employees at one center like in a hospital," he says. "Cutting staff hours may be a strategy to safe money, but sometimes it can result in an unintended negative consequence."
He says centers looking to cut hours often adopt an "all for one and one for all" strategy in which the ASC cuts hours across the board to make the cost-cutting process fair. But if the ASC administrator fails to talk to staff members individually, he or she might not notice the individual financial situations that make pay cuts difficult for some employees. He says administrators should talk to staff members one-on-one about staffing decisions, as they may be reticent to object in front of their colleagues.
From: Critical ASC Mistake: Cutting Staff Hours Indiscriminately
3. Scheduling holes cost a lot of money. According to Jeff Leland, CEO of Blue Chip Surgical Center Partners, an ASC with holes in its schedule is wasting a great deal of money on staff and other operational expenses. One solution is to "compress" the schedule by closing down operations for a day.
Luke Lambert, CEO of ASCOA, says surgical schedule compression is the most important step a center can take to save money. "Whether you do 15 cases a day or 40 cases a day at the center, by and large it's going to cost you the same amount to staff the center," he said. "So obviously if you can have a higher throughput, in the tough reimbursement environment we're in, having a lot of cases going through your day is really essential be profitable."
Sandy Berreth says ASC administrators should be clear with staff during hiring that no cases means no work. It makes more sense to keep your ASC open three days a week and fill those days with cases than to staff your ASC every day and pay people to stand around, she says.
From: 5 Ways ASCs Unintentionally Waste Money
4. Call to check in with physicians whose case scheduling drops off. If you notice a particular physician has stopped or cut back scheduling cases at your ASC, Vicki Edelman, administrator of Blue Bell (Pa.) Surgery Center, says you should follow up and find out why his or her case load has decreased. "If he's on vacation, we can tell the other doctors, 'We need more cases that day, or we're going to have to move that day's scheduled cases to another day,'" she says.
If your physician is on vacation, your ASC will know to bump up cases from other physicians while he or she is away. If the physician has stopped scheduling cases because of a problem with a facility, it's absolutely essential you find out about it quickly. Ms. Edelman says it's much easier to deal with disgruntled physicians if you follow up and express concern than if you let them drop off the radar for weeks.
From: How to Tighten Your OR Schedule: Q&A With Vicki Edelman of Blue Bell Surgery Center
5. Control staff salaries and share profits. According to Lisa Austin of Pinnacle III, one way to involve staff members in ASC's operation is to allow them to financially benefit through a good profit-sharing program. If you're able to create cost savings in salaries and supplies, a portion of that profit can be distributed on a quarterly or monthly basis. This way, you're not cutting into the budget to raise staff salaries, but rather using your additional savings to reward your employees. Staff members will be happier because they receive a bonus based on their hard work and will be more likely to put in effort to save your center money.
From: Critical ASC Mistake: Failure to Control Staff Salaries