Issue link: https://beckershealthcare.uberflip.com/i/170052
ASC Turnarounds: Ideas to Improve Performance 7. Designate floaters if possible. The operating room should include experienced people who are very good at anticipating what the surgeon will need for surgery; however, sometimes they don't have enough time to do everything themselves. Have someone "float" from one room to the next to help people when necessary. "One of the opportunities you have when people are designated to float in your surgery department is increased efficiency," says Ms. Sturm. "Those people can gather equipment for the next case and deliver information about where the patient is and how long it will be be- fore they are ready for the next step in the process — it's a little bit of science and a lot of art." 8. Designate an extra room for surgeons. If your surgery center is in a position to provide surgeons with a second "flip" room, they can organize their surgery schedule to really improve efficiency. "If surgeons can do knees in one room and shoulders in another, that can be very efficient," says Ms. Sturm. "If you can't provide the surgeon with two rooms, you can give the OR managers a great deal of autonomy to arrange their surgery day in the most efficient manner possible." 19 Make sure that surgeries using similar equipment are all in a row so staff members aren't constantly moving equipment in and out of the OR several times per day. As you can see, there are a number of opportunities to assist in reducing OR turnover time in your surgery center. If you don't feel that you have the internal resources to work through these processes, look at hiring an outside expert to assist in workflow design and to assist in identifying redundancies or unnecessary steps. n Contact Laura Miller at lmiller@beckershealthcare.com. 10 Ways to Improve ASC Finances & Operations in 2013 By Rachel Fields S tuart Katz, director of TMC Orthopaedic Outpatient Surgery, Chris Bockelman, administrator of Foundation Surgery Center of Oklahoma, Greg DeConcilis, administrator of Boston Outpatient Surgical Suites, and Joe Zasa, co-founder of ASD Management, discuss 10 ways to achieve success at your surgery center in 2013. 1. Create a generic preference card. Mr. Katz says his surgery center updated physician preference cards in 2012, creating a "generic preference card" that gets pulled for every case. For example, when physicians perform knee arthroscopies, every physician receives the same items, in addition to any "extras" requested by each individual physician. For knee arthroscopies, Mr. Katz says out of approximately 25 supplies needed for the case, 20 are standardized and five are physician-by-physician. One of the differences is always glove size, because physicians have different sized hands and must be supplied accordingly. Mr. Katz says the initiative has been extremely successful in improving efficiency and cutting costs. "We started with 2,000 preference cards," he says. "We looked at the supplies used for each case, and all the things that were the same across the board automatically made the generic preference card." He says the physicians signed off on the initiative because they understood it would improve efficiency; staff are able to equip rooms much more quickly, and they don't open supplies that the physician won't use. 2. Prepare for ICD-10. ICD-10 will kick off on Oct. 1, 2014, according to a recent change by the Department of Health and Human Services. Starting on that data, anyone filing a claim with an insurer or government health program must use a new diagnostic coding system that increase the number of codes from 14,000 (under ICD-9-CM) to 68,000 (under ICD10-CM). Under ICD-10, HHS believes providers will be able to document procedures with greater specificity, improving insights into the landscape of healthcare and making diagnoses clearer for payors. At the same time, the implementation of ICD-10 will likely not be easy. going to struggle due to the voluminous nature of the change for them," he says. "It may be a real challenge." 3. Eliminate supplies you no longer use. Mr. Katz says his surgery center has also cut costs by eliminating supplies that are no longer used in the facility. "We've eliminated some stuff that we haven't used in two or three years," he says. He says the surgery center has traded in older trays that were used once or twice a year and received appropriate trays in exchange. "We got the values back in trays we use constantly, so we have them available all the time, instead of waiting for a tray to get re-sterilized," he says. He recommends looking at your trays and determining whether you could eliminate some of them: If you have discontinued a procedure or only perform it once a year, you could probably dedicate those funds to another product. 4. Complete quality reporting requirements. Mandatory quality reporting for ambulatory surgery centers began on Oct. 1, requiring all Medicare-certified ASCs to start reporting quality data G-codes or face future Medicare payment reductions. As of Oct. 1, ASCs must report data on the following five quality measures: patient burn, patient fall, wrong side/ site/patient/procedure/implant, hospital admission/transfer and prophylactic IV antibiotic timing. Starting in 2013, surgery centers will be required to report an additional two measures: safe surgery checklist use in 2012 and 2012 volume of certain procedures. This means surgery centers must start collecting quality data immediately if they are not already. Because 2013 requires surgery centers to report data based on activities conducted in 2012, surgery centers should make sure they are using safe surgery checklists and have some kind of system to capture surgical volume data. Mr. Zasa says surgery centers should be preparing for the transition to ICD-10 now, even though it's not due for another two years. A transition to ICD-10 will require training for physicians, coders and business office personnel, probable upgrades to surgery center software and discussions with payors about any changes that will occur under the new system. ASCs that do not successfully report data to the Medicare program by the specified 2012 deadlines will see their payments reduced by 2 percent in 2014. Mr. Zasa says this potential payment reduction — and the importance of proving quality care in the outpatient setting — means a focus quality reporting is absolutely necessary for ASCs in the coming year. "We [at ASD Management] have been preparing for this for two and a half years, so it's going smoothly for us," he says. "But we're hearing that not all ASCs are seeing it go so well." "You have to be budgeting for your people to attend seminars and classes," Mr. Zasa says. He also recommends setting aside money in case of payment delays, while payors adjust to the new system. "I think payors are 5. Educate per-diems on cost-cutting initiatives. Mr. DeConcilis says surgery center leaders often fail to educate per-diem staff about the ways they can contribute to the center. "You really have to have a monthly