Michelle Steele of Eastside Endoscopy Shares Advice for GI ASC Administrators

Michelle Steele is the administrator of Eastside Endoscopy Center in Bellevue, Wash., a three-room GI ASC managed by Physicians Endoscopy. Ms. Steele has been with EEC for 15 years, starting as a charge nurse, before moving into her role as administrator in 1998. Prior to coming to EEC, she worked as an office RN for a gastroenterologist in the special procedures unit and on the surgical floor at Overlake Hospital in Bellevue.

Q: GI ASCs have faced a number of challenges recently, especially due to declining reimbursements and increased regulatory demands. What have been some of the best initiatives and programs you have undertaken at your center that have added to its success and profitability?  

Michelle Steele: The most recent and successful programs we have implemented here have been the implementation of our electronic medical record and anesthesia services.  

The EMR allows us to easily retrieve and review a patient's chart, and with subsequent visits to the center, the information is updated rather than re-written on a paper form. The EMR also allows us to track our times so that we can identify our areas of delays and target them for improvement. Another benefit of the EMR has been in-chart storage and retrieval. Due to our limited storage space, we would have our chart storage company come at the end of each year to catalog and transfer the charts to an off-site storage center. We have eliminated this cost with the EMR and are gradually seeing our chart storage and retrieval costs decline each year.

Another successful program has been the implementation of anesthesia services. This year, we contracted with a local anesthesia group to administer propofol in our facility.  Washington is an opt-out state, so we use CRNAs and are not required to have an anesthesiologist (MD) on site. The CRNAs are a wonderful addition to our team, and our patient satisfaction has increased. One of the reasons I believe the patient satisfaction is high is because our patients are now awake and alert after the procedure and are able to remember discussing their procedure results with the gastroenterologist. The added income from the anesthesia charges off-sets the cost increases and decreasing reimbursement we have been experiencing over the past few years.

Q: What do you enjoy most about EEC and serving as an administrator?

MS: My favorite part about my center has to be the people. I am lucky to work with a fantastic group of physicians, RNs, medical assistants, techs and our corporate partner, Physicians Endoscopy. Everyone works together as a team, and we are truly a family. As an administrator, I enjoy implementing new services, researching and drafting policies and continually trying to improve our processes to increase patient, physician and employee satisfaction.

Q: What is the best piece of advice you received that has helped you in your career? What advice do you have for other single-specialty ASC administrators?  

MS: I think the best piece of advice I received was to never stop learning. I enjoy attending conferences and networking with my colleagues. I belong to an online network of GI nurse managers and administrators who have a wealth of information to share. I am constantly learning something new from them.

My advice for single-specialty ASC administrators would be to always try to include your staff in decisions. If you allow them input and use their suggestions, you create a sense of ownership in the facility. Don't be afraid to let your staff lead; you might be surprised at how well they do and it will make your job a lot easier!

Learn more about Eastside Endoscopy Center.

Learn more about Physicians Endoscopy.