1. Invest in software that will streamline the work flow. In addition to training staff on use of various technologies for research and conducting QI studies, an ASC has to make sure the software and technologies are tailored to the needs of the facility.
“We bought various software for the staff to use on their desktops so they can produce meaningful information,” John Dooley, MD, an anesthesiologist and administrator at Mississippi Valley Surgery Center in Davenport, Iowa, says. “In some cases, we’ve had staff members save a document to a hard drive and then someone else accidentally deletes it. We’ve had to go to a new software system so that accidental deletion doesn’t happen. Also, sometimes the data gets too large and bulky to manipulate, particularly patient surveys, so spreadsheets don’t work. In that case, we’ve had to switch to a larger database like Microsoft Access.”
2. Rely on several core anesthesiologists to streamline OR processes. To save money on intra-operative processes, Thomas Wherry, MD, principal of Total Anesthesia Solutions and medical director for Health Inventures, says ASCs must focus on recruiting anesthesiologists who are willing to perfect their technique and make the OR more efficient. “The skill level of a provider can really impact the flow of the room, and if they’re doing eight or nine cases in a day and the anesthesia provider is really slow, that could add an hour to the day easily,” he says. “A provider that can get the patient prepared and under anesthesia more efficiently can be a huge cost-savings.”
In order to make the OR more efficient, Dr. Wherry says anesthesiologists must build relationships with nursing staff and help them address inefficiencies. This can only be accomplished if an anesthesiologist spends a good amount of time at the center, he says. “A lot of centers will insist that out of a group of 20 anesthesiologists, they use a few core providers and one provider that’s there on a regular basis,” he says. “Without that consistency, you don’t get any traction on some of these initiatives.” He says the facility should take responsibility for encouraging the core anesthesiologists to identify problems and work with nursing staff and surgeons to fix them.
3. Streamline supply or equipment costs. Mike Kintner, service contracts manager at TriMedx, says there are various strategies ASCs can adopt to streamline supply costs, including consolidating equipment purchases, working to negotiate a warranty tailored to your advantage, standardizing equipment and more.
Mr. Kintner adds that most organizations don’t look how much it costs over a piece of equipment’s life span to support it and only look at the capital acquisition. “They have to actively manage service costs to understand that maybe an investment in equipment with higher capital would be better because its service costs over its life span will be lower than cheaper equipment,” he says.
4. Streamline documentation through a short form for operation notes. David Ott, MD, founder of Gateway Surgery Center in Phoenix, says hiring a full-time nurse helped his surgery center overcome the challenge of maintaining complete and thorough clinical records. Hiring a point-person allows for greater accountability and also allows that individual to focus and brainstorm process improvement ideas around clinical documentation.
“That nurse floats between various parts of center to make sure all documentation is being filled out,” Mr. Ott says. “Fortunately, that administrator was also able to streamline the process of filling out operation notes and ensure those get done. What they have created is a short form for the operation notes, which takes less than 30 seconds to fill out. Often, nurses in the procedure room will ask us after the procedure to fill in the form and have us verify and sign it.”
5. Streamline scheduling by minimizing initial patient data. Streamline all aspects of the scheduling process to make scheduling cases at your practice or surgery center easy for surgeons and their staff personnel. “Minimize your initial data needs and engage the patient for more details,” says Tom Faith of The C/N Group in Merrillville, Ind. “That also allows you to initiate a relationship with the patient and enhance customer service.”
