EXECUTIVE SUMMARY

The first step to improving efficiency and productivity is to collect metrics and employee workflow habits.

  • Surgery center administrators can surreptitiously observe employees’ habits on the job.
  • Create an open environment so staff can share creative solutions and ideas.
  • Assign staff to zones to save time and improve efficiency.

ASCs and their staff develop certain processes and workflow habits over years. Managers and employees often do not imagine they could change these ingrained processes.

This is why a good way to start a project of improving efficiency and productivity is by collecting metrics on current operations.

An ASC can begin by collecting data on how employees currently perform their jobs, suggests Alfonso del Granado, administrator of Ashton Center for Day Surgery in Hoffman Estates, IL.

This is how Granado collected metrics: “I analyzed all of the staffing done for the previous year and a half,” he says. “I looked at what kind of staff were being used, what position, and for what purposes.”

Del Granado also collected national benchmark information, including staff hours per patient, to use for comparison before observing employees as they worked, which wasn’t easy. Del Granado says he had to observe surreptitiously and misdirect their attention. If workers knew he was observing them, they might change their workflow or behavior, and that would muddy the data.

“You have to be sneaky about it,” he says. “I would walk around with a clipboard and facility checklist, like I’m looking at lights and walls.”

Along with data collected through workflow observations, del Granado asked for employees’ input.

“The problem with a lot of administrators is they walk into the room and start dictating,” he says. “In my case, it was observing and asking questions.”

Through questions and communicating an openness to creative solutions, del Granado was able to get staff to think outside of their normal workflow.

“As a tech or nurse, you’re focused on a specific task to get the patient ready for a procedure, but nobody stops to look around and say, ‘Huh, there’s a hole coming up,’” he explains. “Our nurses came up with many solutions.”

For example, one solution was for the center to use zone defense in staffing. Previously, every nurse was assigned a schedule that was considered fair as it gave each person a certain number of patients to follow. During a day’s ebb and flow, nurses would run from one place to the next, with patients in pre-op, recovery, and post-op areas, and data showed this wasted time.

“We were adding time to the nurses’ work by having them move from one place to another,” del Granado says. “So we assigned nurses to zones, and whichever patient was in that zone belonged to that nurse.”

Another issue del Granado observed related to slow turnover rates among one surgeon’s patients. The physician complained that the turnover took too long, and the staff working with that physician complained that the physician was never ready when his patients were ready.

The solution? It was simply a matter of paging the surgeon when patients were ready, del Granado says.

“Inevitably, you’ll have lag time because one patient arrives late or doesn’t come for the appointed procedures, and now there’s a gap or a hole in the schedule, and these are accumulative,” he says.

The process improved as a result of information-gathering and thinking of outside-the-box solutions.