Becker's ASC Review

8 THOUGHT LEADERSHIP Why ASC leaders are losing sleep over staffing By Patsy Newitt Burnout and staff turnover are becoming quiet but costly threats to ASCs. Staff retention and turnover is becoming a "silent" force undermining ASCs' financial performance, Benjamin Stein, MD, president and CEO of Capital Orthopaedic Surgery Center (Germantown, Md.), told Becker's. To find out what's really happening on the ground, Becker's asked six ASC leaders to share the biggest staffing challenge they're facing right now. Editor's note: ese responses were edited lightly for clarity and length. Christopher Merhan. Administrator of Memorial Hermann Surgery Center Woodforest (Montgomery, Texas): As an administrator, the most difficult challenge is balancing the clinical staffing needs of the facility and managing personnel costs while ensuring adequate hours are provided to retain your core staff. Case volumes in the ambulatory surgery setting are prone to ebb and flow. Some days may be extremely busy, and cases may go well into the evening while other days may have one or two cases scheduled. erefore, influenced by demand, staffing must remain fluid and teammates must accept the implications of working in an ASC setting. Alicia Perrine. Administrator at Riverwalk Ambulatory Surgery Center (Bradenton, Fla.): e biggest staffing challenge at the moment is finding the optimal staffing mix. Finding the ideal mix of all levels of experience in our nurses plays a critical part in diversifying staffing. Our facility sometimes experiences a high influx of novice or experienced nurses. We always aim to achieve a staffing mix that spans across all competencies and strengths, which can be challenging to attain at times. Lori Sylvester. Administrator of Riverside Outpatient Surgery Center (Columbus, Ohio): Although we employ enough staff, we are encountering unexpected time off issues as it relates to surgery, care of elders, sick children, and as associates get older, they are requesting less workdays. Rebecca Anne Vitillo, RN. Administrator at Meadows Surgery Center (Nutley, N.J.): At this time, the most challenging issue that I am experiencing related to staffing is to find qualified, experienced operating room nurses. It is both interesting and frustrating to have so many individuals respond to an ad for someone who has experience in a specific nursing specialty yet has no previous experience in that specialty. In an ASC milieu, it is not a learning ground to be able to teach or precept someone who does not have OR experience. It is much too diversified a specialty to be able to think that we are able to teach someone with no experience to be able to function independently in less than 9-12 months. is is not cost efficient, at least for me. Michael Warne. CEO at Associated Gastroenterologists of Central New York (Camillus, N.Y.): In our area, pay for GI nurses has gone up significantly with demand, and even front desk and admin wages keep climbing as we try to stay competitive. Hospitals have a leg up — they can offer higher salaries and more affordable insurance plans. Meanwhile, we've been hit with double-digit increases in employee health insurance costs for many years in a row. Reimbursement rates haven't kept up, so we're constantly tweaking what we can to attract and hold on to our talented team, even without the deep pockets hospitals have. Michael Weinstein. CEO of Capital Digestive Care (Silver Spring, Md.): e typical physician staff member of an ASC believes that the most important factor in determining the financial health of the center is how many cases they can perform in the time they schedule to be at the facility. e more cases they perform, the more revenue the center collects, and the more revenue the physician collects. ey believe that interests are aligned. Unfortunately, physicians generally don't think about, or care about, the expense side of the equation that determines the financial health of an ASC. Physicians should be considerate of staff work satisfaction, the importance of efficient scheduling to decrease staffing expenses, and consider the cost of wasted or unnecessary supplies that are not separately reimbursable. n Where ASCs are headed—and who's taking the wheel By Francesca Mathewes As the healthcare landscape shifts, ASCs are at the center of change. Robert Nelson, PA-C, former executive director of Island Eye Surgicenter, joined Becker's to offer two predictions on where ASCs may be headed next. Editor's note: This response has been lightly edited for clarity and length. Robert Nelson, PA-C. Former Executive Director of Island Eye Surgicenter (Westbury, N.Y.): 1. The share of cataract surgeries performed in ophthalmic ASCs—currently over 75%—is expected to keep growing, as ASCs offer the best value (and safest and most effective) for patients, physicians, and payers. Concurrently, due to an aging U.S. population, demand will continue to rise for cataract surgery. Reimbursement and regulatory pressures remain significant challenges. 2. Building an ASC requires major investment from physician owners, and as the economy stabilizes, there will likely be more activity on new ASCs and renovations, along with the consolidation of practices and ASCs by investors. M&As are likely to accelerate, including ownership of ASCs and care systems by insurance providers. This is a concerning issue relative to the concentration of power/control. n

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