1. Implement an effective patient satisfaction survey. Many legacy surveys that exist for multi and single-specialty ASCs have not evolved with organization and industry change, says Paul G. Faraclas, MBA, president and CEO of CTQ Solutions. A critical success factor is to ensure the final survey deployed reflects facility uniqueness. Each evaluation statement must provide some magnitude of value when responded to. Over time the questionnaire needs to evolve to remove statements providing little or no value. To maintain optimal effectiveness, statements are added to reflect new processes, facility specialty or quality assurance oversight. The survey must contain enough statements to evaluate the entire experience. The facility needs to be able to discern whether individual components of the care continuum are effective and reflect excellence.
Even-scale survey models create a forced response. The patient either agrees, disagrees or has no opinion (not applicable). A middle response of neutral provides no evaluation value and skews both individual and overall scoring. Verbs and adjectives must be consistent. A statement should not attempt to evaluate two different measures. The category responses need to be limited to four options, plus the not applicable choice. Finally, the language needs to be easy to understand and statement with unmistakable clarity.
Two indicators encompass all measures, but do not supersede them. The two patient loyalty indicators measure: (1) if the patient will recommend the facility to others; and (2) if the patient is confident in the care provided. From a clinical standpoint the encounter may have been successful, yet patient loyalty is based on how immediate patient needs were attended to. One negative experience may negate 10 or more positive experiences.
From “4 Critical Components to Implementing an Effective Patient Survey Model.”
2. Offer online billing, payment and assistance to improve patient collections. A 2008 Pew Internet Study found that 39 percent of Americans pay their bills online, says Michael Storch, national client representative for Mnet Financial Collection Agency. Providing patients with an online bill pay option can improve your patient collections. Your Web site can also offer assistance with understanding EOBs and common insurance and medical billing terminology.
From “5 Inexpensive Ways to Improve ASC Patient Collections.”
3. Benchmark infection control measures. Hand-washing may seem like a relatively simple practice, but many ASC administrators agree that their staff members are often unaware of how — and how long — to wash their hands. According to Jane Kirk MSN, RN, CIC, clinical specialist and adviser for GOJO Industries, staff should wash their hands with soap and water for 15 seconds — about the amount of time it takes to sing “Happy Birthday.” Ms. Berreth says she uses her patient care coordinator for the pre/post-operative area to document hand-washing. “If [as an administrator], I went out and just hung around the nurse’s station, it would be really odd,” she says. “So I have my patient care coordinator take data sheets on every one of the staff and mark down whether they’re washing their hands appropriately.”
From “15 Processes Your ASC Should Benchmark.”
4. Don’t rely on staff members to wear “too many hats.” A mistake we’ve witnessed is relying on internal staff to be experts in too many critical areas of need within the ASC, says Tom Jacobs, CEO and founder of MedHQ. Business needs are too vast and the legal environment too complicated (and growing more complicated with each passing legislative session) for a staff of 15 to 45 or so employees to have all the expertise needed to manage an ASC.
Who, if anyone, within your center, is best manage a particularly difficult employment issue? To do your accounting? To maintain your credentialing files in a constant audit-ready condition? Or even establish your billing and collecting to optimize reimbursement? Handling many non-core functions internally can often be an expensive distraction to providing great, efficient patient care to two to five hundred patients each month.
The answer? Hire outside advisors and services providers to handle these important areas that are critical, do not require full-time attention, and are not related to patient care. In fact, one of the best resources are firms that outsource business processes; in these arrangements, you can often realize significant cost savings, compared to internal staff or consultants, while improving the level of service you receive and reducing the number of vendors you need to manage.
From “Critical ASC Mistake: Staff Wearing ‘Too Many Hats.'”
5. Focus on staffing and supply costs. Staffing and supply costs are the two biggest expenses to an ASC, so any struggling ASC should take time to evaluate expenses and determine whether costs can be reduced. Graham Cherrington executive vice president of operations for NovaMed recommends matching labor to case volume, meaning employees should be staffed more when case volume increases and less when it decreases.
By flexing your staff to match projected volumes, he says “you can really align better the one cost item you control most in your ASC, and that’s labor.” He adds, “We ask our managers, our ASC directors, to take their budgeted labor balance early in the month or before the month starts and get a projected number of cases. Net revenue per case is a good proxy for how much revenue you’ll generate, and then [you can] figure out how many dollars you have to play with on the staffing side.”
From “5 Essential Steps to Turning Around a Struggling ASC.”
6. Collect the right patient information to avoid denied claims. Have procedures in place to ensure the right patient information is entered, says Kelly D. Webb, CEO of ASC Billing Specialists in Glendale, Ariz. Everyone is focused on mistakes in the billing office, but it could be the front office has entered incorrect information. Staff should copy the front and back of the patients’ insurance identification and copy the front of the driver’s license.
Then, make a record of the prior authorization call. To verify the call, you can often obtain a call reference number, linked to the insurer’s recording of your particular call. If not, ask for the first name and last initial of the person you talked to. Always record the date and time you placed the call.
