Issue link: https://beckershealthcare.uberflip.com/i/548475
16 ASC Turnarounds E very year new technologies and tech- niques are introduced in the healthcare landscape. Ambulatory surgery center owners and operators must make prudent deci- sions for technological upgrades that will ensure their facility remains on the cutting-edge of pa- tient care. Four ASC administrators discuss the upgrades recently made at their centers and how they im- pacted operations. Question: What are some recent up- grades you made at your center? Robin Amos, Admin- istrator, Mallard Creek Surgery Center (Char- lotte, N.C.): We just celebrated our one-year anniversary. We pur- chased some additional equipment to add spine procedures and total joint replacement pro- cedures. We added TJR procedures launched in September and spine in October. When we opened the center, we wanted to make sure our operating rooms were as large as we could make them. We also needed adequate storage space and we needed processing space that could meet the demands of orthopedic instruments. So we kept these require- ments in mind during construction. Andrea Marsh, Ad- ministrator, Ortho- paedic South Surgi- cal Center (Morrow, Ga.): We implement- ed online assessment using One Medical Passport and our cor- porate office recently upgraded our servers, which increased speed and efficiency. Andrew Cash, MD, Owner, Minimally In- vasive Center of Excel- lence (Las Vegas): Our Minimally Invasive Center of Excellence was established pri- marily to treat spinal conditions with mini- mally invasive spine surgery and with diagnostic/therapeutic injec- tions. As we have grown to include orthopedic conditions, we had to upgrade our center with regard to orthopedic tables, arthroscopy towers and equipment. We had to prognosticate a time- line in which the additional services would cover the new expenses. Julie Tonsager, OR Team Leader, St. Cloud (Minn.) Sur- gery Center: We pur- chased an ultraviolet light, and as a matter of fact six months later we purchased a second light. We had a 'name the robot' contest at the center and have named both of our UV lights. They are: DORA, Disinfecting Operating Room Apparatus, and GUS, Give Us Sterility. Both of these lights are working full-time for us, and we have even expanded their use to waiting rooms and bathrooms. They are so important to us that we have center-wide goals set around their use. Q: Why did you decide to make these up- grades? RA: We wanted to be a full-fledged orthopedic surgery center that was a one-stop shop for our group. All the physicians from the group wanted to provide some type of surgical care here and so we wanted to add the TJR and spine options as well as sports medicine services. AC: Supplementing our ambulatory services with orthopedic cases improved our service line, nego- tiating power and value to patients. AM: A number of reasons, including cost efficien- cy, improving patient outcomes and satisfaction as well as reducing cancellations. JT: We had been looking at these devices over the past several years. We were in the process of gear- ing up to do some outpatient total joint cases. The surgeon involved wanted us to look at a UV light and purchase one so we could decrease our poten- tial for infection. Q: How has it affected ASC operations since implementation/addition? Have you seen a return-on-investment as yet? RA: With celebrating our one-year anniversary, we have seen our volumes steadily increase, espe- cially after adding the TJR program and spine ser- vices. These have added to our monthly stats and have been very useful in growing volume. AC: Our orthopedic services became available less than a year ago, and we have not recuperated the capital outlay; however, we remain optimis- tic through the utilization of more surgeons and augmented case volume. AM: It has increased efficiency, patient satisfac- tion, quality of assessment — that is thorough as- sessment — as well as improved communication and cost-savings because we were able to shift the pre-assessment nurse to assist with lunch cover- age, among other changes. Approximate savings for us is $24,000 per year. The upgrades have also resulted in increased employee satisfaction and decreased stress because the staff no longer has to worry about tracking the patient down or playing phone tag. JT: We are proud to announce that since last Oc- tober we have done 33 total joint cases with no infections. We have seen a return on investment and we are doing cases that we would not have been able to do if we did not have the UV light. Plus we are using the light in other areas of the center and this decreases the risk of infection for all patients. Saving one infection is an awesome return on investment in my estimation! Q: What are some considerations for ASCs thinking about an upgrade? RA: I think an electronic medical record system is extremely important for efficiency. We did not start our facility with an EMR, but implement- ing one is a target of ours for the future. An EMR helps drive your statistical data and it allows us to ensure that we are performing at our best. It's a huge productivity tool. Also, another consider- ation is making sure you are getting the best price on supplies with your GPO. AM: Make sure you partner with a reliable com- pany and product. Do your homework. Look at the product from a patient standpoint. Ask ques- tions like: "Does the system save or timeout and lose data? Can the patient access information to make changes?" AC: Any upgrade to the center falls under the same scrutiny, even more so for expensive tech- nologies like the O-arm and robotic-assisted sur- gery; higher expense equates to higher financial risk. I feel that a conservative approach to return- on-investment is the most prudent. By definition, there is a built-in margin of error for anticipated case volume, payer reimbursement and unfore- seen expenses. While financial deliberations are integral, they will always be secondary to the paramount considerations of patient outcomes, satisfaction and safety. Q: What are some common mistakes to avoid when deciding on and implement- ing an upgrade? Staying State-of-the-Art: The Investments That ASC Administrators Most Recommend By Anuja Vaidya