Same Day Surgery Manager: Don’t blow productivity with too many meetings

By Stephen W. Earnhart, MS
President and CEO
Earnhart & Associates

(Editor’s note: This is the second of a two-part series on productivity. Last month, we told you what productivity really means and discussed why 100% productivity may not be a good idea. This month, we offer you realistic ideas for improving productivity.)

In our informal and highly unsophisticated pool, we have surveyed same-day surgery managers about one of the biggest productivity busters and one of my great pet peeves: meetings!

The freestanding management staff reported that the formal meeting schedule was a total of seven for the month. My definition of a "formal meeting" is any meeting that is called more than three days in advance. You could call them "scheduled meetings" vs. "impromptu meetings."

The actual time spent in those seven meetings was 9½ hours or 240 minutes for the month. The meetings averaged about 45 minutes per meeting. The breakdown was as follows: one investor meeting, four staff meetings, one vendor meeting, and one meeting with a consultant. Not bad.

The hospital sector was 60 meetings per month! Time spent in meetings for the month was 3,300 minutes or 55 hours — more than one whole week. The breakdown was as follows: staff meetings, two; management meetings (mostly with areas outside of the surgical department) 40; off-site meetings with various groups, five; consultants, eight. (All of the consultant meetings were OK.) Every single hospital professional expressed anger at being called away for "silly unproductive hospital meetings."

I asked them if they were not in all these meetings, what would they be doing? They said that they would be in the operating environment being productive. They cited the following as what they considered productive: observing, seeking out the surgeons for feedback, staff training, and assessing patient satisfaction.

Of the 40 meetings that our peers have to attend that are "areas outside of the surgical department," many were dealing with Health Insurance Porta-bility and Accountability Act (HIPAA) issues, overall hospital strategy in reducing cost, budget management, compliance regulations, patient satisfaction, expansion plans for the system, senior level "pep talks," and capital equipment request from other departments. When asked, "How important would you rate these meetings to the goals of your surgical department," 90% of the individuals said, "Little, if any."

The vast majority of these types of meetings are not interactive. They serve only to "inform and make aware of" issues that affect the hospital and the various departments. In other words, very few of the meeting attendants actually contribute; they sit and take notes. I know. I have been there. A far better way to handle this is via a hospital management-level newsletter. Put all the facts in a two- or three-page newsletter and e-mail it to the department heads. Ask for a "read receipt" of the e-mail so you know they got it. No one has to waste valuable time going or taking notes — you have all the info in front of you — and you can get on with the important issues of running a productive surgical environment.

One area where the freestanding industry lags behind the hospital market is being aware of what is happening in the global industry. The hospital sector is much better at understanding the bigger picture. Granted, they spend too much time in meetings to achieve it, but they still have it.

Many freestanding managers were not aware of the change in reimbursement in the 2003 Medicare rates and did not know of changes in regulatory issues within their own states.

I suggest that one staff member who has access to the Internet be assigned to be the "information officer" of the center. Spending a few hours a month at the Federal Register (, the local department of health web sites (, and talking with peers in other surgery centers can be of enormous benefits. That person can pass on the information he or she receives in a short newsletter to the employees and investors each month. Also, participation in state associations can help keep your staff informed about proposed regulatory changes, and you can submit comments when the regulations are poorly designed.

And one more note on efficiency: Get rid of television sets in the postoperative care unit. They probably are responsible for more logjams than any other factor in the hospital and freestanding markets. Just pull the plug. No need to meet about it.

(Editor’s note: Earnhart & Associates is an ambulatory surgery consulting firm specializing in all aspects of surgery center development and management. Contact Earnhart at 5905 Tree Shadow Place, Suite 1200, Dallas, TX 75252. E-mail: Web: