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21 Executive Briefing Magic in the Culture: The Glue that Binds By Joseph Zasa N o two surgery centers are the same despite similarities in design and systems. We look at our surgery centers like our children — each has its own personality, likes and dislikes, all of which makes each very interesting. And while the foundation of each surgery center is its sys- tems, success is not based on the systems and processes alone. Rather, it is the human element —surgery centers are people tak- ing care of people in a safe environment. What makes this work so enriching is the magic that occurs when good systematic processes are implemented with the right people. This begs the questions: What is the magic? Who are the right people? It would be disingenuous to try pinpoint- ing exactly how to create magic. It is a bit of this and a pinch of that. It is alchemy, after all, not science. (This makes manag- ing and developing centers a lot of fun.) Perhaps more useful than defining magic is to suggest some ingredients and ideas for allowing it to happen. A happy place Magic is what occurs when a surgery center is a happy place for the patient, their family, the staff, the physicians and management. It is apparent when everyone is on the same page moving toward common goals. Cer- tainly, this can be measured somewhat by outcomes —patient satisfaction scores, in- fection rates, transfer rates, collections and physician feedback. These serve to objec- tively validate the center's success. Even financial success, while essential, is not an indicator of happiness. Making money and paying dividends result from correctly ex- ecuting several interrelated tasks. Magic is something quite different. It oc- curs when the patients, patient families, surgeons, anesthesia, staff and manage- ment feel good about the center and it earns the reputation as a quality institu- tion. This positive feeling about the cen- ter is a subjective thing with a precarious balance — similar to many life events, like buying a house or having a child. What are other signs of magic? For surgeons, the ASC reflects upon them professionally. It is a place to perform sur- gery in an efficient setting that frees up their time to see more patients in the of- fice, address personal matters and inter- ests or spend time with family. The ASC can also provide supplemental income if it is declaring regular dividends. Physi- cian commitment to the surgery center is a key element of magic. For staff, the ASC provides a specialized setting for outpatient procedures. Cer- tain staff members gravitate to outpatient surgery. They also like the lifestyle with no call. The clearest sign of a well-run surgery center and a happy staff is low turnover. Anesthesia is such a critical element to operating surgery centers. They turn cas- es around and practice outpatient anesthe- sia. When anesthesia is in sync with a sur- gery center, they act as a bridge between the surgeons, staff and management. Good management supports the staff, is fair and equitable, addresses the needs of the surgeons, ensures systems are being followed and leads the sur- gery center forward. Good management can turn a surgery center around, but bad management can hold it back from reach- ing its potential. One of the keys to magic in the management is identifying conflicts and issues before they arise. For example, it is crucial to identify unhappy staff that does not want to follow the system, and act like a cancer over the entire organiza- tion. Similarly, management must address the needs of unhappy physicians: can the unhappiness be overcome? Is it related to something outside the center? Will it cre- ate a divide among the physicians? While you cannot make everyone happy — and no ASC is blissfully happy and with- out need of some improvement — magic managers are peacemakers who see and respond to issues before they arise. They earn the respect of the staff and physicians, lead by example and put the needs of the organization at the forefront. The magic is conjured by creating a high quality, efficient, happy and well-run cen- ter as measured by objective and subjec- tive standards. The necessary ingredients are strong surgeon support along with outstanding anesthesia that understands outpatient surgery, a staff embracing the vision of the surgery center motivated to ensure superior patient care and a posi- tive physician experience. Management's influence over all of this is significant. As the leader of the busi- ness, management must hire and train the staff, develop and implement the sys- tems, contract with anesthesia and act as the conduit between anesthesia, the sur- geons and staff. Management must be the glue or the igniter of the spark. Great managers engender loyalty to the center. What fuels the magic? It is the emotional tie-in to the center. It is the staff, anesthesia, management and the surgeons feeling connected to the ASC and trusting each other. It is putting the needs of the surgery center at the fore- front and seeing that the greater good benefits all. That is the magic — the focus that binds the center together. Excerpted from Developing and Manag- ing Ambulatory Surgery Centers, by Jo- seph S Zasa and Robert J Zasa. Copyright 2016 ASD Management. Order at ASD- Management.com or Amazon. Joseph Zasa is a founder and managing partner of ASD Management. Learn more about Joe and the team of experts he leads at ASDManagement.com n Sponsored by ASC experts with a history of success since 1986. Transform and reorganize existing centers into high performing, profitable businesses. Develop and market new centers. Lead all points of physician ventures and hospital-physi- cian joint ventures. Experts in the critical success factors: patient care management, business office, risk manage- ment and managed care contracting. Publisher: Developing & Managing Ambulatory Surgery Centers (2016).