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22 Operational Efficiency H iring the right staff members is essential for an ambulatory surgery center to remain efficient and profitable. Here four ASC adminis- trators discuss hiring strategies, mistakes to avoid and the interview questions they never fail to ask. Question: What are the qualities you look for in a candidate for a staff member position at your ASC? John D. Brock, NorthStar Surgical Center (Lubbock, Tex- as): One of the big things we look for is the ability of the in- dividual to work independently. In ASCs, you don't have the means to supervise staff the way you do at a hospital and so we need people who are skilled and can work independently. Also we look for a person with a good personality. We want everyone — physicians, employees and patients — to have a good experience, and the experience is the staff. They are what give us the competitive edge and so their personality and demeanor must be pleasant. Cindy Young BSN, RN, CASC, Surgery Center of Farming- ton (Mo.): When hiring nurses, I look for previous surgical experience, intensive care unit experience or postoperative recovery room experience. I do not hire graduate registered nurses or an RN with less than one year experience in a clini- cal setting. When it comes to surgical technologists, I only hire people who have previous experience in a hospital or surgical center setting or those who graduated from a surgical tech school. The surgery center environment is very fast and we have found it difficult for people with no experience to learn even the basic duties. For business office personnel hires, I look for someone who has excellent communication skills and who has previous office experience. If we cannot find a candidate with previous experience we look for candidates we feel are trainable. This is not something you find in an application; it is something you find during the personal interview. Martha Colen, RN, MBA, CASC, Virginia Beach (Va.) Am- bulatory Surgery Center: When hiring any staff, whether clinical or administrative, one of the most important quali- ties we look for is flexibility. Not only must your new hire have the requisite work experience, education, training and credentials, but he or she needs to be able to adapt to the many variables we deal with in the ambulatory surgery set- ting on a daily basis, ranging from variable work schedules to fast-tracking. The second most important quality we seek in applicants is emotional in- telligence. These are individuals who demonstrate self-awareness, empathy and are able to realistically identify their strengths and weaknesses. The third quality we place importance on is work ethic and an inherent desire to "do a good job." Put these together and you get a high performing, adaptable, great team member and care provider, whether in the OR, PACU or at the registration desk. Q: What are some challenges you have faced when hiring ASC staff? Angie Blankinship, BSN, BAA, CASC, Longmont (Colo.) Surgery Center: The biggest problem is that often you don't find the people who have the skills and education you need. It seems as though so many people are out of work. In fact, we have had engineers apply for scheduling or front-desk posi- tions. Just finding the right person and lining them up for the right job is a challenge. Longmont is a small town, though. My best source of finding new hires is the newspaper. Ms. Young: Even though the person has excellent references, perfect quali- fications and has an amazing interview, if they do not fit, personality-wise, with your other staff and physicians they don't work out. We overcome this by attempting to match applicants we feel would be good candidates with current staff members. This does not always work and you don't always get enough applicants to consider this technique. Q: have you hired from the inpatient setting? if so, what are the challenges you faced? Ms. Colen: We look for individuals who have had prior experience and subsequently we often interview nurses who come to us from the inpa- tient setting. Salary ranges for RNs in ambulatory surgery appear low in comparison to inpatient pay scales for nurses, who are able to earn differential pay for evenings, nights and weekends and time-and-a-half for holidays. The challenge is that individuals coming from the hospital setting may perceive that they will be getting a pay cut if they go to am- bulatory surgery. We address this up front and discuss the overall benefit package in financial terms to help the applicant see the true value of taking the position. We of- fer annual bonuses for financial and quality performance and address the potential bonus earnings upfront when we extend the offer. We also have a healthy benefit package that we put a financial value on for the individual. Add that to the quality of life and great work environment in our ASC and we are usually successful. Ms. Blankinship: The environment in an ASC is very fast-paced and we flex our staff according to the schedule. It may not be as consistent as it is in a hospital. So I have a conversation with potential hires about that because I want them to know beforehand. I want to see if they can handle the pace and scheduling. Q: What are some of innovative hiring and retention strategies you use? Ms. Blankinship: In our ASC, the staff has been there for years and years. Sometimes it's difficult for a new person to fit into the team. Sometimes I hire them per diem and not permanently. It gives me time to see how they fit in with the team and then decide whether to keep them on permanently. Also, while I interview all potential hires, we have a committee of staff mem- bers who interview the candidate. They have been here for so long and have their own questions. Ms. Colen: We have employed several creative ways to staff our center to get the job done, to retain great staff and to keep compensation costs under con- trol. Because our case volumes vary from day to day and week to week, one day we may need the full staff on the schedule, and the next may be so light that we only need a few. One of the things we have done is ensure that all clinical staff positions are variable. As long as the staff works the minimum number of hours required, they will earn all their benefits. Full time minimum work/pay requirement is 72 hours per pay period and part time requirement is 32 hours per pay period. This way we build flexible scheduling into the hir- ing process. Also, whenever possible we hire "per diem" nursing staff. Per diems must work a minimum of 16 hours a month. Many per diem staff are hired with Avoid Dire Hires: ASC Administrators Reveal Innovative Hiring Strategies By Anuja Vaidya