Becker's Spine Review

42 OUTPATIENT SURGERY Pandemic burnout: How 4 ASC leaders are managing staff fatigue By Carly Behm H ere's what four ASC leaders told Becker's ASC Review about how they are addressing potential staff and physician burnout during the COVID-19 pandemic. Note: Responses have been edited for style and length. Mark Spina, administrator at South Shore Surgery Center in Bay Shore, N.Y.: Every patient scheduled for outpatient surgery must get a COVID-19 test within five days of the scheduled surgery date. ose that test pos- itive are canceled for surgery until they ob- tain a negative test. So staff knows that any patients coming into the center are negative for COVID-19. We still take extra precautions, and because of this, staff is not exposed to COVID-19 pa- tients like hospital staff. None of my staff have gotten the virus. e only "fatigue" staff has is having to con- stantly remind scheduled surgical patients to go for their COVID-19 test within five days of their scheduled surgery. We rotate staff that communicates with patients prior to surgery, so that helps staff from getting burned out. Rishi Parikh, MD, of Cataract and Refrac- tive Surgery Center in Richmond, Va.: Hav- ing a supportive team around me during this pandemic is critical to avoid emotional fa- tigue. Each morning our team has a morning huddle where we remind each other of what matters the most, practicing excellent patient care together. Robert Carpenter, MD, Medical Director of Allegany Ambulatory Surgery Center in Cumberland, Md.: I feel that there are some strengths in having a small, tightly knit team during these periods of rapid change. Being agile has allowed us to review our local com- munities' transmission and incidence rates and react very quickly to accommodate local conditions on an almost weekly basis. Frequent communication among all team members is conducted to review current case rates, explaining changes in our procedures stimulated by our local community incidence, allowing staff input and questions about our reaction processes, and providing frequent encouragement and reassurance that this is a fluid situation that we will get through. Since I am the surgeon, medical director and boss, ensuring a unified, clear message and garnering cooperation of both physicians and staff has not been an issue. In short, I believe our surgicenter has benefited from our abili- ty to react quickly and communicate well to minimize the needless frustration that engen- ders burnout and fatigue. Moiz Carim, MD, of Carim Eye and Retina Center in Reading, Pa.: We are making sure that we are stocked up at all times, because this has been a significant challenge in the past. We are also doing a COVID-19 test on all patients undergoing general anesthesia. Of course [we are] doing social distancing in the waiting room. n 2 ASC administrators on the biggest threat to ASCs today By Eric Oliver A SCs continue to rise in national prominence as the COVID-19 pandemic has accelerated migration of procedures to the outpatient setting. Despite the prominent growth, ASCs still face threats from thin profit margins and payer reimbursement. Here, two ASC administrators shared insights into what they viewed as the biggest threat to ASCs today: Note: Responses were edited for style and content. Earl Anderson, CEO of Tennessee Orthopaedic Clinics in Knoxville: Without a doubt, the greatest threat to ASCs is the inability of leadership to change the culture to allow expansion of service lines and to flex with payer strategies. In orthopedics, ASCs must be nimble enough to accom- modate cases such as total joints and certain spine proce- dures. This involves making physical changes, like expand- ing operating room size, staffing adjustments, and working with physician partners and payers to initiate creative, value-based payment models that benefit the patient, pro- viders and payers. Physician groups such as ours are also developing methods by which we identify the appropriate ASC surgical candidates. So, in actuality, the greatest threat provides the greatest opportunities, and ASCs must pre- pare to take advantage of them. Kim Halladay, DPM, administrator at NorthPointe Surgi- cal Center in Tooele, Utah: Underpayment for the amount of money we are saving insurance companies. Medicare has documented that ASCs saved them $4.6 billion from 2016 to 2020, yet we have to run at such a thin margin that it threatens our future. n

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