Becker's ASC Review

17 THOUGHT LEADERSHIP ASC leaders' secrets to success By Patsy Newitt Ten ASC leaders joined Becker's to discuss their secrets to success. Editor's note: ese responses were edited lightly for brevity and clarity. John Martin, MD. Gastroenterologist at Mayo Clinic (Rochester, Minn.): 1. Second-to-none workplace culture 2. Helping all staff feel valued, respected and appreciated — as individuals, and as a team 3. Everything for the patient, all for the team is our culture: "e needs of the patient come first" 4. Fair compensation for all physicians and staff and a meaningful benefits package for all 5. Emphasis on high-quality care from all angles, not just measured by technical success; best-in-class tech and highly qualified caregivers, but also patient- centered care that considers patient convenience, comfort, respect, dignity, efficiency and transparency Pankaj Vashi, MD. Chief of Gastroenterology/Nutrition Department and Vice Chief of Staff at Cancer Treatment Centers of America Chicago: I have been a gastroenterologist for over three decades. ere is really no secret for my success. I have done what every physician should do — that is to spend time listening to your patients; be thorough, honest, compassionate; and provide the best care in a timely manner to all your patients. e healthcare system today incentivizes the physician only on volume and relative value units. I personally feel the incentives should also include quality, safety and patient satisfaction. Value-based care is also important to cut down the cost of healthcare in our country. Julie Billingsley. Director of Patient Care Services for Orthopedics & Neurosciences at Sentara Northern Virginia Medical Center and Lake Ridge Ambulatory Surgery Center (Woodbridge, Va.): One word: flexibility. If we've learned nothing else in the last few years, it's that change will remain a constant in our field. It's our job to make sure we continue to quickly adjust to whatever new challenge of the day/ week/month we face. Our team has been exceptional at adjusting their sails with the shiing waves in healthcare. Amber Mitchell, MD. Neurologist at Nuvance Health (Kingston, N.Y.): If you pick a field that interests you and you love, then you will be successful, and then it won't feel like it is a job. You can see yourself there in the future and that motivates you to persevere. If you pick a field for other reasons like money, then you might be disappointed, because you can never have enough money! Christy Bray Ricks. Vice President of Provider Talent at Ardent Health (Nashville, Tenn.): Listening — seek first to understand the issue or concern, then collaborate with our stakeholders in order to best facilitate our desired outcome. Transparent and honest conversations about the difficulties facing not only our organization, but the country, as it relates to healthcare staffing shortages. Being an advocate for my team, our candidates and the communities we serve in order to save lives. Alopi Patel, MD. Assistant Professor of the Department of Anesthesiology at Icahn School of Medicine at Mount Sinai (New York City): My secret to success is to stay persistent. If something is worth working hard for and building, then keep on going. ere will be obstacles and it may take a long time, but persistence pays off. John Woodward Jr., MD, Orthopedic Surgeon at Orthopaedic Physicians of Colorado (Englewood): Always plan. Be prepared. Work hard. Work smart. Be kind. ank the people that help you to be successful. Mark Mattar, MD. Director of MedStar Georgetown University Hospital's IBD Center (Washington, D.C.): My secret to success stems from the framework of transformational servant leadership. Leading in a successful GI practice in a health system as we come out of a pandemic brings its own special challenges. At the end of the day, we focus on the people. We prioritize patient care without compromising associate wellness. We work as a team to evaluate each of the provider's needs and how we can help them work toward our common mission. is isn't easy, but when you pay attention to the needs of the team and act on them, we all succeed. Chris Blackburn, BSN. Administrator of South Kansas City SurgiCenter (Overland Park): I am an open book ... no secrets, but I hope my positive energy does help. Mark Mineo. Director of the Millard Fillmore Surgery Center (Williamsville, N.Y.): Nothing replaces teamwork and hard work. n • In patients undergoing hemorrhoidectomy, a total of 266 mg (20 mL ) of EXPAREL was diluted with 10 mL of saline, for a total of 30 mL, divided into six 5 mL aliquots, injected by visualizing the anal sphincter as a clock face and slowly infiltrating one aliquot to each of the even numbers to produce a field block. Local Analgesia via Infiltration Dosing in Pediatric Patients The recommended dose of EXPAREL for single-dose infiltration in pediatric patients, aged 6 to less than 17 years, is 4 mg/kg (up to a maximum of 266 mg), and is based upon two studies of pediatric patients undergoing either spine surgery or cardiac surgery. Regional Analgesia via Interscalene Brachial Plexus Nerve Block Dosing in Adults The recommended dose of EXPAREL for interscalene brachial plexus nerve block in adults is 133 mg (10 mL), and is based upon one study of patients undergoing either total shoulder arthroplasty or rotator cuff repair. Compatibility Considerations Admixing EXPAREL with drugs other than bupivacaine HCl prior to administration is not recommended. • Non-bupivacaine based local anesthetics, including lidocaine, may cause an immediate release of bupivacaine from EXPAREL if administered together locally. The administration of EXPAREL may follow the administration of lidocaine after a delay of 20 minutes or more. • Bupivacaine HCl administered together with EXPAREL may impact the pharmacokinetic and/or physicochemical properties of EXPAREL, and this effect is concentration dependent. Therefore, bupivacaine HCl and EXPAREL may be administered simultaneously in the same syringe, and bupivacaine HCl may be injected immediately before EXPAREL as long as the ratio of the milligram dose of bupivacaine HCl solution to EXPAREL does not exceed 1:2. The toxic effects of these drugs are additive and their administration should be used with caution including monitoring for neurologic and cardiovascular effects related to local anesthetic systemic toxicity. • When a topical antiseptic such as povidone iodine (e.g., Betadine ® ) is applied, the site should be allowed to dry before EXPAREL is administered into the surgical site. EXPAREL should not be allowed to come into contact with antiseptics such as povidone iodine in solution. Studies conducted with EXPAREL demonstrated that the most common implantable materials (polypropylene, PTFE, silicone, stainless steel, and titanium) are not affected by the presence of EXPAREL any more than they are by saline. None of the materials studied had an adverse effect on EXPAREL. Non-Interchangeability with Other Formulations of Bupivacaine Different formulations of bupivacaine are not bioequivalent even if the milligram dosage is the same. Therefore, it is not possible to convert dosing from any other formulations of bupivacaine to EXPAREL and vice versa. Liposomal encapsulation or incorporation in a lipid complex can substantially affect a drug's functional properties relative to those of the unencapsulated or nonlipid-associated drug. In addition, different liposomal or lipid-complexed products with a common active ingredient may vary from one another in the chemical composition and physical form of the lipid component. Such differences may affect functional properties of these drug products. Do not substitute. CLINICAL PHARMACOLOGY Pharmacokinetics Administration of EXPAREL results in significant systemic plasma levels of bupivacaine which can persist for 96 hours after local infiltration and 120 hours after interscalene brachial plexus nerve block. In general, peripheral nerve blocks have shown systemic plasma levels of bupivacaine for extended duration when compared to local infiltration. Systemic plasma levels of bupivacaine following administration of EXPAREL are not correlated with local efficacy. PATIENT COUNSELING Inform patients that use of local anesthetics may cause methemoglobinemia, a serious condition that must be treated promptly. Advise patients or caregivers to seek immediate medical attention if they or someone in their care experience the following signs or symptoms: pale, gray, or blue colored skin (cyanosis); headache; rapid heart rate; shortness of breath; lightheadedness; or fatigue. Pacira Pharmaceuticals, Inc. San Diego, CA 92121 USA Patent Numbers: 6,132,766 5,891,467 5,766,627 8,182,835 Trademark of Pacira Pharmaceuticals, Inc. For additional information call 1-855-RX-EXPAREL (1-855-793-9727) Rx only March 2021

• Cover