Becker's Hospital Review

85 Executive Briefing: Growing OR Case Volume One strategy is to help surgeons generate more case volume. First, help surgeons understand how to market themselves to referring physicians. Many surgeons are very reluctant to "sell themselves." Show these physicians how to use in-services and other educational opportunities to build referrals. Second, support surgeon business by plugging the holes in your hospital's own referral networks. Many hospitals with employed physician networks have not succeeded in keeping surgery re- ferrals in-house. Create a policy requiring employed physicians to provide written justification for any out-of-network referrals. In addition, leverage your hospital's physician-hospital organization contracts to capture full surgical volume. Hospitals can also create new programs that build referral streams for the surgical staff. An employer-based occupational health program, for instance, can generate many referrals for loyal orthopedic surgeons, hand surgeons, spine surgeons and other specialists. Keep in mind that financial goals are far from being surgeons' only motivation. Historically, surgeons have invested in ASCs for the opportunity to create a high-quality clinical environment. The good news is that hospitals can provide the same opportunity — by giving surgeons "ownership" of the OR. The most competitive hospital ORs today are run by a surgical services executive committee. An SSEC is a multidisciplinary gov- ernance body that puts surgeons and anesthesiologists in charge of the OR. Physician members set strategic goals, establish op- erational policies and sponsor process improvement initiatives. Hospitals that adopt the SSEC model see dramatic improvements in efficiency, costs, revenue and profitability. They also provide surgeons with a very attractive alternative to ASCs. 3. Help ASC investors exit the market Many hospitals are now pursuing an emerging strategy for coun- tering ASC competition — acquiring rival ASCs. The right course depends on your market and the characteristics of your ASC com- petitors. But for many hospitals, acquisition is a sensible strategy. First, acquiring a well-run ASC may allow your hospital to obtain the efficient outpatient surgery operation that it has not been able to build. You get instant access to market share, reputation and proven quality. Second, an ASC acquisition can often be struc- tured to produce a neutral effect on the hospital income state- ment. Ownership transition will usually enable the ASC to bill un- der hospital rates, providing revenue enhancements that offset the purchase price. Hospital acquisition makes sense for surgeon owners, too. Many surgeons who invested in ASCs during the 1990s now want to divest as they prepare for retirement. Unfortunately, fewer young surgeons today are interested in entrepreneurship. By selling all or part of their ASC interest to a hospital, surgeon owners can cash out now and avoid future capital gains tax increases. In many instances, the acquiring hospital hires the former ASC own- ers to serve as medical directors, giving surgeons ongoing control of quality and operations. Start the conversation The first step to implementing any of these strategies is to get to know the surgeons in your market. Understand their daily chal- lenges, financial needs, professional aspirations and personal goals. This effort should involve not only OR management, but hospital leadership. The better you understand how to help solve surgeons' problems, the better able you will be to compete effectively for case volume with local ASCs. n Jeffry Peters is president and CEO of Surgical Directions. Understand surgeons' daily challenges, financial needs, professional aspirations and personal goals. This effort should involve not only OR management, but hospital leadership. leader in perioperative consulting offers or, central sterile leadership interim and permanent placements perioperative & anesthesia assessment · interim management 312.870.5600 www.SurgicalDirections.com STABILITY TRANSITION challenge of change leadership can be disruptive to any organization; critical forward improvements can be hampered or even stopped by the loss of At Surgical Directions, we believe finding the experienced your need is critical to making the transition to new leadership need support for current initiatives or to move in a new direction, professionals will help you meet your needs in a time of change. interim or permanent placement, we provide experienced, leaders. Our candidates are thoroughly screened and we match experience to meet the specific needs of your situation. Our proven make a seamless transition. interiM and perManent placeMents in: Services – Nursing Managers and Directors Services – Nurse Educators Services – Business Managers Processing Department – Managers and Directors provide you with leadership that will insure stability time of transition. during during Surgical Directions LLC is a national consulting firm based in Chicago that assists hospitals in improving the operational, financial, and market performance of perioperative and anesthesia services. Our consulting team is led by nationally-recognized, practicing anesthesiologists, surgeons, and surgical service professionals experienced in organizational design, block time, surgical scheduling, patient throughput, materials, staffing, strategic planning, and physician relations. Team members have successfully helped over 500 hospitals nationally increase surgical volume, improve clinical outcomes, improve surgeon satisfaction, improve anesthesia satisfaction, and enhance overall perioperative performance.

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