A stabilized workforce is an important yet often overlooked component of a thriving and profitable surgery center, says Tom Jacobs, president and CEO of MedHQ, a medical human resources, accounting and credentialing company based in Westchester, Ill.
"Surgery centers operate well if they have great doctors, a good revenue cycle management function to collect what you bill, a really good set of clinical practices and engaged personnel," says Mr. Jacobs. "If you can handle all four of those things and do them well, you're going to be successful."
It is also important to equip an organization with the ability to handle change effectively. "Change brings conflict, and conflict can be disruptive," he says. "Your HR service needs to understand that and know how to deal with it."
Mr. Jacobs discusses five key surgery center HR practices that will contribute to an organized, fluid and ultimately profitable organization.
1. Develop a strong peer-based hiring process. New employees should be hired based on core values as well as professional qualifications, Mr. Jacobs says. The most effective way to accomplish this is to establish a peer-based interviewing process, in which the surgery center trains current employees to interview and evaluate prospective staff members.
Employees chosen for peer-based interviewing should possess values important to the surgery center because they will be able to identify those same values in prospective employees, Mr. Jacobs says. The peer-based review system is particularly important if the center is deciding between several professionally qualified candidates. Employees may sense that a candidate is particularly caring and help to narrow down the selection.
To facilitate the peer review process, employees should be given a written interview guide that consists of pre-written questions that concentrate on professional experience. "Have the candidate talk about what they've done in the past," says Mr. Jacobs. "If you're interviewing for a receptionist, you want that person to be friendly, have a smile on their face and readily greet people when they come in. So, in a question, you may ask them to about a time when they've been in a customer service role, having them elaborate on how they approached customers and made them feel welcome."
Asking prospective employees to speak about real experience and past performance is the best predictor of future results, Mr. Jacobs says. Particularly in the peer-based interview process, it will help current employees determine if the candidate demonstrates a desired skill or value.
2. Consult a human resources mentor for mediation of internal conflicts. There are many professional issues that surgery center administrators may encounter, including discipline issues, poor attendance, tardiness and attitude. An effective HR service can mentor or couch front-line managers and supervisors during changes and conflicts within the surgery center, Mr. Jacobs says.
If a surgery center uses an outsourced HR service, the administrator should consult a human resources representative remotely. "It really helps for a supervisor to have an HR professional who is just a phone call or Skype conference [call] away," says Mr. Jacobs. "This person has seen hundreds of similar situations, and they can give practical advice on how to approach the conflict. The administrator, on the other hand, may only encounter the conflict several times per year and have less experience to draw on."
An HR professional may also visit the center in person for a discipline conference, which serves as a step between intermediate disciplinary action and final termination. He or she can serve as a third-party, independent arbitrator between the employee and supervisor, creating an environment where both voices can be heard. "It involves confronting the employee with a respectful but direct conversation," says Mr. Jacobs. "An HR professional has done this many times and can really help that supervisor cut to the chase."
For example, an employee with a track record of poor attendance and tardiness may now be suffering from an illness or personal issue, and the surgery center supervisor may want to ensure that the additional time off is accommodated correctly. "There are a lot of things to consider, including the American Disabilities Act and Medical Leave Act, and when you can refer the employee to a physician for evaluation," says Mr. Jacobs. Discipline conferences moderated by an HR representative will help administrators safely and tactfully address these issues.
3. Establish an employee wellness plan in the benefits program. Wellness plans promote behavior that will help employees become or stay healthy. "Wellness plans have been effective in avoiding upward spiraling healthcare costs for companies," says Mr. Jacobs. "They put the decision-making into the hands of the employee."
One basic component of a wellness plan is a health risk assessment, a widely-used and confidential screening tool to assess an employee's health status and target behaviors that minimize risk, such as frequent exercise. Employees who agree to take the HRA may receive discounts to their health insurance plans, such as a $10 per month reduction on their monthly premium or a deductible reduced to $1,000 from $1,500, says Mr. Jacobs.
An effective benefits plan should also consist of a consumer-directed health plan, which includes two components: a high-deductible plan funded partially by the employer that is intended to cover emergency medical care, and a health savings account to cover routine medical costs. These plans are beneficial because they give employees a choice about where and how they receive care. "Employees can practice due diligence in deciding where the best treatment is, and they will be incentivized to take better care of themselves," says Mr. Jacobs.
4. Draw on multiple data sources to put together a competitive compensation plan. Surgery centers can consult two key sources when determining appropriate employee compensation: salary and benefits estimates compiled by healthcare associations and a point factor analysis. These tools are excellent starting points for building a fair compensation plan, Mr. Jacobs says. "You need to strike a balance between paying people what they're worth, but not overpaying," he says. "If you're underpaying, you're threatened by turnover. If you're paying too much, the consequences are self-evident. You want to pay people fairly in accordance with the market."
While association surveys can also be useful in determining compensation, surgery centers should be hesitant to take them at face value without evaluating the specific responsibilities of the positions in their organizations, Mr. Jacobs says. If a position requires additional responsibilities that are not typical of the positions for which salary averages are given, for example, the center should consider the full scope of tasks when determining compensation.
The point factor analysis is a more systematic job evaluation tool that aids surgery centers in understanding the total scope of a given position. The areas of evaluation include educational requirements, years of experience required, supervisors needed, the complexity of the position, the physical effort required, the physical work environment involved and the impact of employee's decision-making or actions. "These are all areas that you can analyze the job based upon — each of these things can be assigned a point," says Mr. Jacobs. "This represents a fuller approach to the definition of a position, and there tends to be a lot of commonality among surgery centers."
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"Surgery centers operate well if they have great doctors, a good revenue cycle management function to collect what you bill, a really good set of clinical practices and engaged personnel," says Mr. Jacobs. "If you can handle all four of those things and do them well, you're going to be successful."
It is also important to equip an organization with the ability to handle change effectively. "Change brings conflict, and conflict can be disruptive," he says. "Your HR service needs to understand that and know how to deal with it."
Mr. Jacobs discusses five key surgery center HR practices that will contribute to an organized, fluid and ultimately profitable organization.
1. Develop a strong peer-based hiring process. New employees should be hired based on core values as well as professional qualifications, Mr. Jacobs says. The most effective way to accomplish this is to establish a peer-based interviewing process, in which the surgery center trains current employees to interview and evaluate prospective staff members.
Employees chosen for peer-based interviewing should possess values important to the surgery center because they will be able to identify those same values in prospective employees, Mr. Jacobs says. The peer-based review system is particularly important if the center is deciding between several professionally qualified candidates. Employees may sense that a candidate is particularly caring and help to narrow down the selection.
To facilitate the peer review process, employees should be given a written interview guide that consists of pre-written questions that concentrate on professional experience. "Have the candidate talk about what they've done in the past," says Mr. Jacobs. "If you're interviewing for a receptionist, you want that person to be friendly, have a smile on their face and readily greet people when they come in. So, in a question, you may ask them to about a time when they've been in a customer service role, having them elaborate on how they approached customers and made them feel welcome."
Asking prospective employees to speak about real experience and past performance is the best predictor of future results, Mr. Jacobs says. Particularly in the peer-based interview process, it will help current employees determine if the candidate demonstrates a desired skill or value.
2. Consult a human resources mentor for mediation of internal conflicts. There are many professional issues that surgery center administrators may encounter, including discipline issues, poor attendance, tardiness and attitude. An effective HR service can mentor or couch front-line managers and supervisors during changes and conflicts within the surgery center, Mr. Jacobs says.
If a surgery center uses an outsourced HR service, the administrator should consult a human resources representative remotely. "It really helps for a supervisor to have an HR professional who is just a phone call or Skype conference [call] away," says Mr. Jacobs. "This person has seen hundreds of similar situations, and they can give practical advice on how to approach the conflict. The administrator, on the other hand, may only encounter the conflict several times per year and have less experience to draw on."
An HR professional may also visit the center in person for a discipline conference, which serves as a step between intermediate disciplinary action and final termination. He or she can serve as a third-party, independent arbitrator between the employee and supervisor, creating an environment where both voices can be heard. "It involves confronting the employee with a respectful but direct conversation," says Mr. Jacobs. "An HR professional has done this many times and can really help that supervisor cut to the chase."
For example, an employee with a track record of poor attendance and tardiness may now be suffering from an illness or personal issue, and the surgery center supervisor may want to ensure that the additional time off is accommodated correctly. "There are a lot of things to consider, including the American Disabilities Act and Medical Leave Act, and when you can refer the employee to a physician for evaluation," says Mr. Jacobs. Discipline conferences moderated by an HR representative will help administrators safely and tactfully address these issues.
3. Establish an employee wellness plan in the benefits program. Wellness plans promote behavior that will help employees become or stay healthy. "Wellness plans have been effective in avoiding upward spiraling healthcare costs for companies," says Mr. Jacobs. "They put the decision-making into the hands of the employee."
One basic component of a wellness plan is a health risk assessment, a widely-used and confidential screening tool to assess an employee's health status and target behaviors that minimize risk, such as frequent exercise. Employees who agree to take the HRA may receive discounts to their health insurance plans, such as a $10 per month reduction on their monthly premium or a deductible reduced to $1,000 from $1,500, says Mr. Jacobs.
An effective benefits plan should also consist of a consumer-directed health plan, which includes two components: a high-deductible plan funded partially by the employer that is intended to cover emergency medical care, and a health savings account to cover routine medical costs. These plans are beneficial because they give employees a choice about where and how they receive care. "Employees can practice due diligence in deciding where the best treatment is, and they will be incentivized to take better care of themselves," says Mr. Jacobs.
4. Draw on multiple data sources to put together a competitive compensation plan. Surgery centers can consult two key sources when determining appropriate employee compensation: salary and benefits estimates compiled by healthcare associations and a point factor analysis. These tools are excellent starting points for building a fair compensation plan, Mr. Jacobs says. "You need to strike a balance between paying people what they're worth, but not overpaying," he says. "If you're underpaying, you're threatened by turnover. If you're paying too much, the consequences are self-evident. You want to pay people fairly in accordance with the market."
While association surveys can also be useful in determining compensation, surgery centers should be hesitant to take them at face value without evaluating the specific responsibilities of the positions in their organizations, Mr. Jacobs says. If a position requires additional responsibilities that are not typical of the positions for which salary averages are given, for example, the center should consider the full scope of tasks when determining compensation.
The point factor analysis is a more systematic job evaluation tool that aids surgery centers in understanding the total scope of a given position. The areas of evaluation include educational requirements, years of experience required, supervisors needed, the complexity of the position, the physical effort required, the physical work environment involved and the impact of employee's decision-making or actions. "These are all areas that you can analyze the job based upon — each of these things can be assigned a point," says Mr. Jacobs. "This represents a fuller approach to the definition of a position, and there tends to be a lot of commonality among surgery centers."
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