do. Another reason for staffing appro- priately is ensuring efficiency, which results in cost effectiveness.”

Obstacles to Overcome Maintaining full coverage in an ASC is not always easy, notes Jill Thrasher, CASC, administrator for Precision Sur- gery Center of Dallas in Dallas, Texas. “ASCs must be prepared to respond

Running a Tight Ship

How to manage ASC staff to ensure full coverage BY ROBERT KURTZ


linical staffing requirements in an ASC are determined by sev-

eral factors, including the number of procedure or operating rooms (ORs) concurrently in use, the number of cases on the schedule, the type of surgery being done and the type of anesthesia, says Martha R. Colen, RN, CASC, administrator of Virginia Beach Ambulatory Surgery Center in Virginia Beach, Virginia.

“The staffing that is needed to ensure full coverage varies signifi- cantly between ASCs because surgery centers have different numbers of ORs and perform different cases with dif- ferent lengths and acuity,” she says. Despite these differences, an ASC’s

top priority when assigning and man- aging clinical staff is to meet the needs of patients, says Dianne (Wal- lace) Appleby, executive director of


quickly to changes in the schedule,” she says. “In addition, ASCs typically do not have a second shift to cover longer hours, so it is critical to ensure your staff are not overworked while covering cases.” Colen adds, “Keeping overtime to a minimum and staffing with the mini- mum required staff is a must to keep- ing compensation costs down and assuring profitability. However, while we want to maintain our profitability, it should never be at the expense of qual- ity or safety.” Variations

in the OR schedule,

You need to be prepared to staff to the demands of the schedule, not to a routine.”

— Martha R. Colen, RN, CASC Virginia Beach Ambulatory Surgery Center

Menomonee Falls Ambulatory Surgery Center in Menomonee Falls, Wisconsin. “You must have enough of the appro- priate people in the appropriate roles doing what they are clinically compe- tent and licensed to do,” she says. “We have clinical standards we must abide by, and staffing appropriately helps us meet those rules. Staffing appropri- ately also helps us meet the needs of our physicians, which, from a clinical standpoint, is paramount in what we

such as high volume, quick turnover cases versus longer, more complicated higher acuity cases, create fluctuations in demands for staffing, Colen says. “This causes variations in staff require- ments from day to day. You need to be prepared to staff to the demands of the schedule, not to a routine.”

Different Approaches to Achieve Objectives While every ASC must come up with its own ways to ensure full coverage based on the factors noted earlier, there are a number of approaches to consider to help achieve staffing objectives. Cross-training “We have man- dated cross-training between depart- ments as a condition of employment,” Appleby says. “This permits us to move staff during busy times and cover absences.” Thrasher says her ASC also requires cross-training. When employees are interviewed, they are informed upfront of the requirements to cross-train, not

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