“I highly recommend you find an architect, engineer and construction company that have built ASCs before,” Donithan says. “They should be familiar with state ASC rules, fire marshal regu- lations, Life Safety Codes and all other regulations. Do not simply trust someone who says they know the requirements. Verify this to the best of your ability. This can help you avoid a lot of delays.” (For more information, read “Design Considerations for an ASC” in the Sep- tember 2019 issue of ASC Focus). Even after Prime Surgical Suites opened, Burwell was surprised by the obstacles that remained. “To secure payer contracts, our ASC needed to be accredited. To be accredited, however, we needed to first complete a certain number of cases and have cases occur- ring during our survey. We could not see Medicare patients because we were not certified to do so yet. Our options for the types of cases we could perform were limited, and we thought it would be easier to find them. We needed a bet- ter strategy for those first cases.”


The Fine Line for Staffing


One of the most significant changes in how Donithan approached developing her first and second ASCs concerned staffing. For the Roanoke ASC, she had a full team ready to go in advance of its opening. “Then we experienced a three- month delay and were faced with decid- ing what to do with all of that staff,” she says. “It was a frustrating experience and an expensive one as well. For Mar- tinsville, I went extremely tight with my staff. It was all hands on deck for our skeleton crew until we hired and trained the rest of the team.” Burwell, too, would change how she approached staffing were she to build another ASC. “You need to budget for staff earlier than you think,” she says. “It can take a long time to find and then train the people you need. You want at least some of these people in a month before you plan to do your first case. Someone needs to stock shelves, put preference


Choose people knowledgeable in healthcare who are current with the latest regulations and ensure you have solid contracts to fall back on to recoup expenses if there are errors.”


—Laurri Wallace, Surgery Center of Roswell


cards together, assemble instrument sets, move furniture around. You do not real- ize how many little things need to get done, and one person cannot do it all.” While all hires are important, Wal- lace says, there is at least one opening deserving of increased attention and care: the charge nurse. “Filling this posi- tion with the right person can make a sig- nificant difference in the initial success of your ASC. Finding someone with strong clinical experience, management experience, surgery center experience and knowledge in your specialties is dif- ficult. That is kind of a unicorn. If you need to prioritize a skill, choose some- one with a good clinical foundation, then mentor them in leadership.”


Bring your clinical director on early, Burwell advises. “The sooner, the bet- ter, even before construction starts. You will want that person for input on clinical and workflow decisions. Other initial hires should be whoever over- sees supplies and instrumentation and a business manager to get the accounts payable process started.”


Filling In the Blanks The faster you accept that you are not likely to know everything that must hap-


pen to open a new ASC, the more time you have to address knowledge gaps, Burwell says. “Go out and find resources in the industry that can help you. Attend conferences. Ask questions on the ASCA Connect discussion board. Read every- thing you can get your hands on.” Tap into local resources available to you, Donithan adds. “I proactively con- tacted people in my state health depart- ment’s office of licensure and certifi- cation. I introduced myself, explained our project and our plan for develop- ment. While they could not provide any advice, they were able to help me better understand how they expected us to complete work for inspections.” If your budget permits, consider a temporary addition to your team. “Hire a good consultant who can help you get the job done right,” Wallace says. “This is a person who knows the players: contractor, architect, suppli- ers, linen company, biomedical waste disposal company and all the other partners you will need. If you are the administrator, your hands are going to be fuller than you expect. Working with someone who has those contacts and provides another level of support is very helpful.”


ASC FOCUS MAY 2020 | ascfocus.org 17


Page 1  |  Page 2  |  Page 3  |  Page 4  |  Page 5  |  Page 6  |  Page 7  |  Page 8  |  Page 9  |  Page 10  |  Page 11  |  Page 12  |  Page 13  |  Page 14  |  Page 15  |  Page 16  |  Page 17  |  Page 18  |  Page 19  |  Page 20  |  Page 21  |  Page 22  |  Page 23  |  Page 24  |  Page 25  |  Page 26  |  Page 27  |  Page 28  |  Page 29  |  Page 30  |  Page 31  |  Page 32  |  Page 33  |  Page 34