The staggering of patients, cases


and staff will need to be the new norm for ASCs, Norman says. “Many things will have to come into play that we have never thought of before. We are looking at how to best recon- figure our existing surgeon blocks to make the best use of the time when employees can be at the center.” Recognizing that her ASC is oper- ating at reduced capacity during the pandemic, Norman is seeking new ways to reduce costs. “We are looking at those goods we use on a daily basis and are investigating other options that may be less expensive.” This includes consideration of reusable rather than disposable goods but only in instances when making such a change would not harm safety or quality. When ASCs are not busy support- ing patients, Kaczor recommends using available time to review staffing, physician preferences and infection control protocols to identify poten- tially worthwhile changes. “ASCs should also fully vet recent changes to patient screening and treatment pro- tocols to ensure the seamless imple- mentation of any new processes.” If your ASC has invested in tech-


nology, this is the time to leverage it as much as possible, Beauvais says. “You want to limit person-to-person contact whenever possible. Use your electronic solutions to interact with patients for COVID-19 screening pre- arrival, registration, mobile check-in and online payment processes.” ASCs


still relying on paper


records might want to consider con- verting to electronic records. Using an electronic medical record (EMR) system can help streamline processes and ensure more optimal management of supplies and equipment, Norman says, assuming the EMR includes an electronic inventory system. Beauvais recommends that ASC administrators continually work with their medical staff and clinical leadership to review and revise their


It is challenging to make decisions about operations and finances with so much fear and change happening. ASC leaders must work to avoid basing their decisions on emotions.”


— Cindy Beauvais, RN Ambulatory Surgery Consulting Partners


operational plan as procedures ramp up. This should include ongoing evaluation of operating room utiliza- tion and block scheduling, contracts with payers and vendors, staffing plans and the supply chain. “By eval- uating these high-revenue or high- cost areas on a regular basis, ASCs can make timely changes to improve their operations,” she says. As valuable as it is to focus on opti- mizing efficiency, ASCs should also work to ensure actions do not have the opposite effect. “The pandemic forced administrators, medical direc- tors and clinical directors to make dif- ficult choices, such as who to furlough or layoff,” Beauvais says. “Now they must determine which staff to bring back and when, which is


just one


among a host of tough decisions.” Further complicating matters is


that ASCs are receiving ongoing and rapidly evolving information from the Centers for Disease Control and Prevention, the Centers for Medi- care & Medicaid Services, the medi- cal societies, professional academies and local public health agencies. “It is challenging to make decisions about operations and finances with so much fear and change happen- ing. ASC leaders must work to avoid basing their decisions on emotions,” Beauvais says. Rather, they need to focus on what is best for patient and


staff safety and ensuring consistent, positive surgical outcomes. With reduced operations comes tightened available block time. A desire to maximize that availability should not come at the expense of staff well-being, Norman says. “Avoid try- ing to squeeze as many cases as possi- ble into short amounts of block time. This can lead to staff burnout. We, administrators and managers, must remember to make our staff a priority at all times. If we do not have the staff we need in our ASC, we cannot take care of our patients.”


Identifying and Addressing Inefficiencies


Judiciously monitoring operational efficiency can help ASCs spot areas in need of change faster, Kaczor says. She suggests ASCs identify key per- formance indicators (KPIs) that are applicable to their current operations, including surgical volume, turnover time, prep and recovery times, staff training and inventory management. These KPIs should be reevaluated at consistent intervals to determine any inefficiencies and allow for imple- mentation of lean solutions.” Monitoring those indicators and benchmarks that provide windows into an ASC’s operational efficiency will indicate where to target quality improvement efforts, Beauvais says. Norman says there is great value in listening and following up on patient and staff concerns. “I am a believer in using patient and staff satisfaction surveys to their fullest extent.” When you identify areas of inef-


ficiency, approach correcting the root cause of the problem with care, Kaczor adds. “Too often, organiza- tions tend to throw additional staff or extended protocol at a process break- down. This more often than not leads to increased inefficiency and loss of valuable time and resources at the facility.”


ASC FOCUS AUGUST 2020| ascfocus.org 11


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