Keeping an ambulatory surgery center running smoothly during the holiday season is a challenge for most facility managers. As we approach the end of the year many employees will utilize their "use it or lose it" vacation hours to spend extended time with family and friends over the holiday season. As a result, maintaining the necessary staff to ensure operations run smoothly can be a difficult task for a busy ASC. To avoid disruptions during the holiday season early planning is essential. To help you get started, consider the following tips for stretching staff during the holidays.
1. Ask about surgeons' schedules. It is important to remember that doctors take vacations over the holidays too. Inquire with surgeons' offices early on to identify any planned vacation time over the holiday season, this will help you better allocate staff. If a surgeon is off they will not be scheduling cases. With their vacation schedule on hand, it is easier to identify instances where operating rooms will likely sit idle. Working with surgeons who have cases scheduled to see if they can move them to another day to fill rooms will minimize the amount of staff required. For example, the ability to reduce three half rooms to two full rooms can save significant staff hours.
2. Know your employees' vacation time. Inquire with staff about vacation plans early on so you can plan accordingly. In "use it or lose it" situations, it is important to know how much vacation time your employees have remaining well in advance of the end of the year. Inquire with staff about the possibility of taking a few days off each week rather than waiting to use their remaining vacation time consecutively at the end of the year. This will allow you to better manage cases around staff availability throughout the week(s). Furthermore, surgical volumes are typically lower the days before and after a holiday, encourage staff to take advantage of this down time.
3. Don't underestimate the value of per diem staff. While not always needed, it is a good idea to sporadically work per diem staff into the rotation to ensure they are familiar with the operations of your facility. In addition to a much more economical alternative to temporary staff which can easily double in rates, doctors and other employees will find it easier to work with per diem staff if they are familiar with them. Because per diems often work part time at other facilities, it is important to schedule them as early as possible during the holiday season. Knowing vacation schedules well in advance will help you plan accordingly. If per diem staff are only able to commit to a few hours each day, utilize them during your busiest hours.
4. Allocate paperwork to non-licensed staff. For paper-based facilities in particular, significant time can be freed up when you evaluate the paperwork your staff is doing and identify areas that can be allocated to non-licensed staff. Freeing registered nurses from busy work such as making sure paperwork is in order and charts are prepared for the next day will free RNs and allow you to allocate them to patient-focused tasks. Staffers from other areas such as billing can be utilized to assist the postoperative staff with assembling completed charts in correct order.
5. Consider technology. If a facility has a dedicated pre-admission nurse and that person is on vacation then the pre-op, recovery and even OR nurses have to step in and make calls. If staffing is tight, overtime may be required if staff have to complete their regular work before they conduct pre-admission calls. Even if an ASC has several staff members cross-trained to complete the pre-admission process, they may still be stretched thin during the holidays. Fortunately technology can help streamline the pre-admission process, enabling patients to input their medical histories online.
Utilizing the online pre-admission system One Medical Passport, Short Hills Surgery Center has significantly reduced the amount of time nurses spend playing phone tag with patients and conducting lengthy pre-admission screenings. The online questionnaire guides our patients to create a health history, nurses quickly verify this information then, once approved, clinical forms are generated by the system and made available to staff. In addition to significant time savings for nursing staff, our patients truly prefer to go online which improves our patient satisfaction.
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