1. Know your top five CPT codes by physician. In all patient accounting/billing systems, Brian Brown, regional vice president of operations of Meridian Surgical Partners, says you should be able to track CPT codes by physician. What this information will allow you to do is analyze the subspecialty mix of your physicians. “For example, does your ASC have an orthopedic physician who focuses on shoulders or a physician who is doing heavy cases like ACL repairs,” Mr. Brown says. “[That data] will let you be able to prepare for that physician’s patients in a unique fashion, whether it be scheduling time, looking to see if that physician needs more block time, the cost of doing those cases and it will let you be able to examine your physician base at the ASC and identify what could be a nice compliment through recruiting a new physician.”
For example, if you have several orthopedic surgeons but none focusing on hand surgery, that’s a very efficient orthopedic subspecialty you can work to add to your ASC, he says.
2. Track employee satisfaction. Another key to continuing success at newer surgery centers is ensuring the staff members it hires are in it for the long run, as high staff turnover eventually leads to decreased quality care and decreased profits. Angie Laux, administrator of Bellin Orthopedic Surgery Center in Green Bay, Wis., routinely measures employee satisfaction to make sure the entire staff is happy working there and that they are invested in the mission of the facility.
“As soon as I started working here, I decided I would do employee satisfaction surveys with employees every six months and track certain metrics on a scale of one to five,” she says. “I track things like how happy employees are with their work hours, their benefit packages, whether they feel they’re being treated with respect and courtesy and how they feel about the overall teamwork of the OR team.”
Administering employee satisfaction surveys also gives Ms. Laux a better idea of what employees are unhappy with so that proper changes can take place, such as employee vacation time which Ms. Laux says many employees expressed concern over.
“A lot of them might have had as much as 4-5 weeks of vacation time at their old workplace, so they were worried about that,” she says. “I did a market analysis of what other organizations were offering their employees, compared that to what a new employee gets here, and took the data to our governing board. They agreed we needed to increase our vacation time, so now our employees have 22 days of vacation time instead of 17 days.”
3. Pay attention to OR time. Block time and scheduling of ORs should be managed to allow for the most contiguous use of case times, Ross Alexander, MBA, the administrator of The Surgery Center of Fort Collins (Colo.), a multi-specialty ASC owned and managed by a group of surgeons, Poudre Valley Health System and Surgical Care Affiliates, says. “The more contiguous your schedule, the better.” In the course of preparing for and receiving AAAHC accreditation, Mr. Alexander’s surgery center did extensive benchmarking of its OR use. While the center ultimately increased OR use rate and block utilization rate, it had to balance efficiency against physicians’ desire to have operating room time available when they wanted it, which Mr. Alexander concedes can be a delicate balancing act.
Measuring utilization rates is necessary to improve efficiency. “It is something we now track on a quarterly basis,” Mr. Alexander says. Measurement, however, is only the starting point. The goal is maintaining and continually improving upon what has been measured.
4. Share data with physicians as news briefs. When including physicians in the decision-making process, administrators should share practice data, such as financial statistics or patient evaluations, with physicians using a “Presidential” brief form. “Physicians like and enjoy data but they don’t want to be overwhelmed by it,” says Patrick Hinton, executive director of the Jacksonville (Fla.) Orthopaedic Institute. “If you give physicians the facts in a brief and concise way and then give them a recommendation as to what course of action they should take, they will be supportive of your decision making as an administrator.”
Additionally, when the administrator provides a synthesized report about a potential change in the practice, it shows that the administrator is able to competently research the topic and is coming to them with a realistic and valid request.
