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By Stephen W. Earnhart, RN, CRNA, MA
CEO, Earnhart & Associates, Austin, TX
Budgeting is never fun. Many Same-Day Surgery readers are budgeting for 2020 right now or reworking the numbers because some low-level executive wants the numbers smaller — or eliminated entirely.
While budgeting, consider these tips for saving money, what not to do to make up budget shortfalls, and even advice on spending a little extra here and there:
• Never agree with a budget you cannot live with. Often, we are pressured into accepting a budget into which we put little input; nevertheless, we are expected to achieve those numbers. It is better to argue for a realistic budget now than to explain every month to someone why you did not hit the mark.
• When totaled, the little things can catch everyone off guard. Examples include staff lunch, surgeon car washes, Christmas parties, and birthday cakes. While these sound like small potatoes, the costs always are much higher than expected on an annual basis. Some of these items (e.g., surgeon car washes) may be difficult to justify.
• The cost of just about everything rises annually. A safe forecast for known expenses is to increase them by 7% per category over the previous year.
• Avoid company credit cards. With little or no oversight, these cards are subject to abuse and accidental use, leading to spiraling costs. If possible, avoid these cards.
• Three separate individuals should be involved in supplies or equipment for your facility. The one who orders it, the one who receives it, and the one who pays for it. Too many of us have been burned by rogue employees selling supplies out the back door of the hospital or ASC.
• Annual bonuses are a waste of money and intent. Make the staff bonus worthwhile and distribute it over the year rather than in one lump sum. Twelve small bonuses each year make a much more lasting impression to staff.
• Usually, outsourcing services is more cost-effective than in-house services. Look at outsourcing as an alternative to services no one wants to deal with or for which the cost is too variable. Speaking of which ...
• The smell of laundry detergent and fabric softener in your facility cheapens the effect of your surgery facility. Spend the money on outsourcing linen cleaning. You cannot detect the smell anymore because you have grown accustomed to the odor. However, there is a strong chance patients can smell it.
• Budget for Wi-Fi in your waiting area. It keeps patients and family members busy with social media and less on bugging the receptionist.
• If it is under your control, do not charge patients for parking. Patients have to spend plenty of money on many other services. If staff have to pay for parking, reimburse them.
• Every vendor should bring lunch for your staff occasionally. Insist on this one.
• Stop budgeting for magazines in the waiting room. Everyone’s nose is in screens they brought from home. Books and magazines only clutter an area that you have to pay someone to clean.
• Budget for patient gifts. These could be a small plant or a garment bag patients can use after discharge. Small tokens like this can improve satisfaction scores.
• Budget for a gift for your surgeon’s office scheduler. Rarely are these important individuals noticed for the challenging but vital work they complete. Buy them a small gift with your name, number, and website printed on it that goes on their desk.
• Do not hire someone to provide one-time services. You may be stuck with this person until you get the nerve to fire him or her. Outsource the function.
• Update your website. If there is not a website for your facility, budget for one. These are gateways for patients looking to validate the services you provide.
• Typically, money spent on physician recruiters is wasted. Allocate those funds for something else.
(Earnhart & Associates is a consulting firm specializing in all aspects of outpatient surgery development and management. Earnhart & Associates can be reached at 5114 Balcones Woods Drive, Suite 307-203, Austin, TX 78759. Phone: (512) 297-7575. Fax: (512) 233-2979. Email: email@example.com. Web: . Instagram: Earnhart.Associates.)
Financial Disclosure: Consulting Editor Mark Mayo, CASC, MS, reports he is a consultant for ASD Management. Nurse Planner Kay Ball, PhD, RN, CNOR, CMLSO, FAAN, reports she is a consultant for Ethicon USA and Mobile Instrument Service and Repair. Editor Jonathan Springston, Editor Jill Drachenberg, Author Melinda Young, Author Stephen W. Earnhart, RN, CRNA, MA, Physician Editor Steven A. Gunderson, DO, FACA, DABA, CASC, RN, CRNA, MA, Editorial Group Manager Leslie Coplin, and Accreditations Manager Amy M. Johnson, MSN, RN, CPN, report no consultant, stockholder, speaker’s bureau, research, or other financial relationships with companies having ties to this field of study.