Becker's ASC Review

15 EXECUTIVE BRIEFING EXECUTIVE BRIEFING Key metrics help to identify inefficiencies that can impact operating expenses Many of the same benchmarks used in hospital operating rooms can also be used in the ASC setting to uncover hidden costs. These benchmarks include metrics like block time utilization, staff and supply cost per case. "Reducing inefficiencies is all about asking the right questions," Ms. Schlossberg said. "Can you reduce those costs without lowering the quality of care?" Patient flow is also important to evaluate using metrics such as on- time starts and room turnaround time. "It can be helpful to look at typical reasons for room delays in your center. When a patient's procedure is complete, you may also want to consider whether you have enough recovery spaces for them to go," Ms. Schlossberg said. Navigators can reduce costly last-minute cancellations & improve the patient experience At ASCs that perform screening colonoscopies, it's a good idea to have a dedicated navigator who also handles scheduling. The navigator proactively calls patients and can even start some of the pre-op documentation in advance. "There is all sorts of literature about the importance of the navigator in colon cancer screening," Ms. Schlossberg said. "That goes back to scheduling. Once a patient is scheduled, is there someone they can talk to in the middle of the night if they have a bad prep? Without that, you run the risk of scheduling gaps resulting from same-day cancellations and no-shows." While the goal at ASCs should always be to compress the schedule, teams must also set expectations upfront with patients that their procedure times may change. At GI and endoscopy ASCs, maintaining an easily accessible patient waiting list is a best practice. If a colonoscopy patient can't come in on short notice, an upper endoscopy patient can be called since it does not involve a bowel prep. Well-trained ASC staff promote greater efficiency Both informal and formal training for employees is beneficial. Helping ancillary staff understand how procedures are performed, for example, can pay dividends. "You do everyone a great service if you invite them into a room and show them how a colonoscopy is performed," Ms. Schlossberg said. "Your biller might say, 'Wow, I heard you say colonoscopy with a snare polypectomy. Yet, when I look at the supplies for the case, there's no snare listed. Should there be?'" It can also be productive to regularly schedule "Skills Day" to provide quality assurance of endoscopy training and skill retention. At various stations, provide staff with the opportunity to demonstrate their skills through a return demonstration guided by a competency checklist. Stations might include new equipment and devices and equipment such as electrosurgical generators that can pose a very high risk to patient safety. When it comes to formal training, a competency-based approach is preferred. Staff certification among nurses and techs demonstrates proficiency, as well as a personal and professional commitment to patient care. GI and endoscopy nurses can get certified through the American Board of Certification for Gastroenterology Nurses (ABCGN). "Certification in endoscopy nursing means that a person has the equivalent of what a two-year nurse should know in GI and endoscopy," Ms. Schlossberg said. "That's very important. If you can say that your entire staff is certified, it shows patients that you really care about the quality of who is in the room assisting the physician." Certification for the technicians who reprocess the scopes used in GI and endoscopy procedures is also highly recommended. Avoiding transmission of infectious agents demands strict adherence to published reprocessing guidelines, particularly as endoscopic units become busier, and the number of procedures performed nationwide increases. Scopes are fragile and expensive. Endoscope reprocessing is a multi-step process demanding meticulous attention to detail, time, space, and training. GI and endoscopy techs can obtain certification from the Healthcare Sterile Processing Association (HSPA), as well as the Certification Board for Sterile Processing and Distribution (CBSPD). "Having people dedicated to that work is so key. The individuals reprocessing scopes must be up to date on the procedures. Every manufacturer provides a checklist because every scope model and manufacturer is a little bit different. Tech certification, especially for techs who reprocess scopes, gives everyone a much better feeling." The path forward to ensure ASC growth To survive and thrive in today's challenging, competitive environment, ASCs must take a multi-pronged approach to optimizing safety and efficiency. This includes taking a close look at the ways that the ASC schedules patients, deploys staff, utilizes space, and uses supplies. Ensuring staff are trained to utilize and maintain key equipment, like scopes in the GI and endoscopy space, is central to delivering high levels of safety and patient satisfaction, as well as achieving profitable operations. 2 At Olympus, we are committed to Our Purpose of making people's lives healthier, safer, and more fulfilling. As a global medical technology company, we partner with healthcare professionals to provide best-in-class solutions and services for early detection, diagnosis, and minimally invasive treatment, aiming to improve patient outcomes by elevating the standard of care in targeted disease states. For more than 100 years, Olympus has pursued a goal of contributing to society by producing products designed with the purpose of delivering optimal outcomes for its customers around the world. For more information, visit www.olympusamerica.com. LCR51220V01 This content represents the views and opinions of Nancy Schlossberg, BSN, RN, CGRN, CER and does not necessarily represent the views or opinions of Olympus.

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