Same-Day Surgery Manager: Q&A: Getting surgeons to use your facility
Q&A: Getting surgeons to use your facility
Nonnurse administrators, other issues addressed
By Stephen W. Earnhart, MS
CEO
Earnhart & Associates
Austin, TX
Question: Why are our investors not using the surgery center they built after they convinced us to give up our jobs at the local hospital? I am a pretty savvy RN who understands business as well as the next person, but this doesn't make sense. We built out five operating rooms. We are lucky if we are using two, and that is stretching it. Is it us?
Answer: I wish that it were! What you are talking about is more common than you would believe. The key is having a person or a group to push them. Left to their own devices, many surgeons have a hard time making the change from the "mother ship" hospital to their own center. Perseverance is the only recourse, although it really shouldn't have to be that way. Publish the number of cases the investors do each month, and circulate it to the other investors. Public humiliation works.
Question: The administrator of our surgery center that the management company put in here is not a nurse! He has never even been in the operating room, and he passed out when he observed his first case. Have you ever heard of this before?
Answer: (Gulp!) Well, yes. We have placed a number of nonclinical administrators in for-profit surgery centers over the years and probably will continue when the right nurse is not available. Remember that surgery centers are multimillion-dollar businesses and need to be treated as such. Most hospital CEOs and presidents are not nurses or surgeons either, but they hire wise clinical personnel who make up for their deficits.
Question: Our hospital is developing a GI Center of Excellence within the walls of the actual hospital. However, they are using an outside company to design the "flow" (patient, equipment, staff, surgeons, etc.) and then manage the center. They are even using dedicated staff to operate the center. Apparently, we (the existing staff members) who have been doing the docs cases for years are suddenly not good enough to work in the new "pavilion" with the docs anymore.
Answer: While it is not really a question, I can tell you that developing centers of excellence is becoming increasingly more commonplace in hospitals. It often avoids the development of a costly surgery center and affords a lower-cost option for many surgical cases that compete for time and staff with emergency cases and overtime of staff. We are going to see more of these types of facilities spring up. For your own comfort: It is not that your staff are not good enough, but it's more of a function of having a dedicated staff for the one specialty.
Question: We are working on reducing our supply cost at the hospital. Any thoughts that can help us?
Answer: Oh yes! There are several things to look at:
- Let your staff and the surgeons know what you are doing and post your goals.
- Price your surgeons' preference cards, and let them see what things cost.
- Unit price your sterile supply room so the staff are aware of what things cost.
- Beat your vendors up (regularly) to get better pricing and "samples."
- Compare one surgeon's supply costs with another for the same procedure. Share your finds with both.
- Talk to the materials manager for your center or hospital and ask them why things cost so much. They get buried in the details of thousands of items per year. Let them know you are looking over their shoulder.
- Ask your boss for an incentive to reduce cost. Be careful here. They may say, "Is keeping your job enough?"
I have many people send me great questions weekly, and some I save for publication. Let me know if you have one.
(Earnhart & Associates is an ambulatory surgery consulting firm specializing in all aspects of surgery center development and management. Contact Earnhart at 1000 Westbank Drive, Suite 5B, Austin, TX 78746. E-mail: [email protected]. Web: www.earnhart.com.)
Question: Why are our investors not using the surgery center they built after they convinced us to give up our jobs at the local hospital? I am a pretty savvy RN who understands business as well as the next person, but this doesn't make sense. We built out five operating rooms. We are lucky if we are using two, and that is stretching it. Is it us?Subscribe Now for Access
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