Jesseye Arrambide, RN, BSN, CNOR, executive director of Oregon Outpatient Surgery Center in Tigard and vice president and program chair of the Oregon Ambulatory Surgery Center Association, discusses six ways to cut staffing costs in an ASC.
1. Use a mix of full-time and per diem staff. Ms. Arrambide recommends supplementing a core group of staff members with a list of per diem staff who can come to the center when case volumes are higher. "If you staff with per diem staff on a regular basis, they can be the first ones to go home when you only have a few cases for the day," she says. "I know that if you have to call full-time staff off frequently, you will lose them."
2. Give staff projects when the schedule is light. If you send your core staff members home when the schedule is light, they may become frustrated with the surgery center and seek employment elsewhere. Instead, find projects for staff members to complete on slower days, so that your ASC remains productive while maintaining staff loyalty. Ms. Arrambide says her OR staff members will work on preference cards or complete an assigned monthly chore, such as cleaning out cabinets, wiping down stretchers or cleaning out refrigerators.
"Sometimes we'll have focused studies in our charting for quality improvement, and I'll say, 'You guys need to review this many charts and this is what we're looking for,'" Ms. Arrambide says. She takes staff suggestions for improvement projects, touting a relatively 'flat' management structure that allows for contribution at all levels. "I really like getting suggestions from the staff," she says. "I like to say that collectively, we have hundreds of years of experience."
3. Track productivity. At Ms. Arrambide's center, the staff member in charge of payroll tracks staff productivity on a regular basis. "She has all that information right at her fingertips, and on a two-week basis, when our payroll ends, she looks at the number of hours each staff member has worked," she says. "We then track that across each quarter and set goals for pre- and post-op and the OR." She likes to see the number of FTEs used for base staff decrease as volumes fluctuate. Tracking productivity lets the surgery center leadership compare historical case volumes with staffing levels.
4. Hire staff with expertise in multiple areas. Many surgery center administrators recommend cross-training staff members so employees can move back and forth between areas of the ASC without difficulty. Ms. Arrambide takes this advice one step further and tries to hire staff members who are cross-trained in several areas already. "I like to hire people who have worked in multiple areas of the surgery center," she says. "For example, they might have worked post-op but they also like the OR."
She says this experience is helpful when a surgery center staff member calls in sick or gets delayed. "If it's 6 a.m. and traffic is bad and someone can't get in, what do you do?" she says. "People have to be able to step in when they're needed." She says cross-training also increases employee satisfaction because staff members are not performing the same tasks all the time.
5. Offer strong benefits and competitive wages. Offering a strong benefit package and competitive wages may not seem like a cost-cutting tip at first glance, but Ms. Arrambide points out that replacing an OR nurse can run anywhere from $5,000-$10,000. "Turnover is expensive," she says. "If an OR nurse leaves, you've got to bring someone else in and cross-train them." She says a good benefits package will attract quality employees who would otherwise seek employment at another surgery center or the local hospital.
6. Hire the right employees the first time around. Your surgery center will save money on turnover and new hire orientation if you hire the right employees the first time around, Ms. Arrambide says. She says she uses references and job history to determine whether someone will be a good fit for the surgery center. "I look at their employment history to find out how long they've been in a job and where they've been," she says. The ideal employee will have cross-trained in another surgery center and will understand the "surgery center mentality." She says it can be more difficult to train a staff member who only has experience working in the hospital OR.
Related Articles on Surgery Center Operations:
What Surgery Centers Can Learn From a Cash Flow Statement
14 Achievable Goals for Surgery Centers Before Year's End
6 Ways to Integrate Outsourced Surgical Staff Members Into an ASC
1. Use a mix of full-time and per diem staff. Ms. Arrambide recommends supplementing a core group of staff members with a list of per diem staff who can come to the center when case volumes are higher. "If you staff with per diem staff on a regular basis, they can be the first ones to go home when you only have a few cases for the day," she says. "I know that if you have to call full-time staff off frequently, you will lose them."
2. Give staff projects when the schedule is light. If you send your core staff members home when the schedule is light, they may become frustrated with the surgery center and seek employment elsewhere. Instead, find projects for staff members to complete on slower days, so that your ASC remains productive while maintaining staff loyalty. Ms. Arrambide says her OR staff members will work on preference cards or complete an assigned monthly chore, such as cleaning out cabinets, wiping down stretchers or cleaning out refrigerators.
"Sometimes we'll have focused studies in our charting for quality improvement, and I'll say, 'You guys need to review this many charts and this is what we're looking for,'" Ms. Arrambide says. She takes staff suggestions for improvement projects, touting a relatively 'flat' management structure that allows for contribution at all levels. "I really like getting suggestions from the staff," she says. "I like to say that collectively, we have hundreds of years of experience."
3. Track productivity. At Ms. Arrambide's center, the staff member in charge of payroll tracks staff productivity on a regular basis. "She has all that information right at her fingertips, and on a two-week basis, when our payroll ends, she looks at the number of hours each staff member has worked," she says. "We then track that across each quarter and set goals for pre- and post-op and the OR." She likes to see the number of FTEs used for base staff decrease as volumes fluctuate. Tracking productivity lets the surgery center leadership compare historical case volumes with staffing levels.
4. Hire staff with expertise in multiple areas. Many surgery center administrators recommend cross-training staff members so employees can move back and forth between areas of the ASC without difficulty. Ms. Arrambide takes this advice one step further and tries to hire staff members who are cross-trained in several areas already. "I like to hire people who have worked in multiple areas of the surgery center," she says. "For example, they might have worked post-op but they also like the OR."
She says this experience is helpful when a surgery center staff member calls in sick or gets delayed. "If it's 6 a.m. and traffic is bad and someone can't get in, what do you do?" she says. "People have to be able to step in when they're needed." She says cross-training also increases employee satisfaction because staff members are not performing the same tasks all the time.
5. Offer strong benefits and competitive wages. Offering a strong benefit package and competitive wages may not seem like a cost-cutting tip at first glance, but Ms. Arrambide points out that replacing an OR nurse can run anywhere from $5,000-$10,000. "Turnover is expensive," she says. "If an OR nurse leaves, you've got to bring someone else in and cross-train them." She says a good benefits package will attract quality employees who would otherwise seek employment at another surgery center or the local hospital.
6. Hire the right employees the first time around. Your surgery center will save money on turnover and new hire orientation if you hire the right employees the first time around, Ms. Arrambide says. She says she uses references and job history to determine whether someone will be a good fit for the surgery center. "I look at their employment history to find out how long they've been in a job and where they've been," she says. The ideal employee will have cross-trained in another surgery center and will understand the "surgery center mentality." She says it can be more difficult to train a staff member who only has experience working in the hospital OR.
Related Articles on Surgery Center Operations:
What Surgery Centers Can Learn From a Cash Flow Statement
14 Achievable Goals for Surgery Centers Before Year's End
6 Ways to Integrate Outsourced Surgical Staff Members Into an ASC