Same-Day Surgery Manager: Answers to outpatient surgery questions
Answers to outpatient surgery questions
By Stephen W. Earnhart, MS
CEO
Earnhart & Associates
Austin, TX
Question: Our surgery center executive committee replaced our retiring administrator last month with a kid right out of (seemingly high) school who has no experience whatsoever in health care or clinical experience. I always thought the administrator must be a registered nurse.
Answer: I think what you are referring to is that each ambulatory surgery center [ASC] is required to have a RN in the center as long as there are patients in the facility. The administrator does not have to be a RN.
More of the freestanding centers are putting business-minded (vs. clinically oriented) individuals in this role. One of the reasons is that there just isn’t a pool of experienced RNs with a business background available anymore. They are working or retiring (like your administrator).
Investors in ASCs are relying more on a team approach in the day-to-day operations of an ambulatory surgery center with a strong nurse manager and business manager. Don’t confuse the business office manager with this role. However, a strong business-oriented administrator can oversee the business office operations as well as function as the administrator, thus saving money on that position. Surgery centers are big business, and most investor/users are demanding that they be managed as such.
Question: Our hospital is surrounded by surgery centers. They are taking all the "bread-and-butter" cases from our hospital, they hire all the cute and perky staff we once had, and now have the gall to call us during the day to borrow supplies or equipment. I think it is rude and unprofessional to even ask for items like this. What do you think?
Answer: The chance is very high that the individuals wishing to borrow supplies and equipment from you are not the same individuals that caused the glut of ASCs in your town. They are probably nurses or staff members much like you and are reaching out for your help.
Life is short, and circumstances can change quickly and roles reverse. It is good policy to help out other same-day surgery programs because it helps patients. One day, you may need to borrow something or otherwise cancel a case or endanger a patient already on the OR table. I would think about how you want to deal with it, and know that the professional approach is always the best approach. Show your true colors by rising above it. (Note: The person that sent me this e-mail back in March now is the administrator of the very ASC that she was complaining about.)
Question: A new orthopedic surgeon just started using our facility. He is a nice guy and is supposed to bring lots of new cases to us. Apparently, one of the negotiation points of his coming here was that he brings his private scrub and that we pay for her. She is making about three times what my staff are making, and it really is irking the rest of the scrubs. First, is that legal, and second, shouldn’t she be paid the going rate here for her level of experience?
Answer: It isn’t a matter of whether or not it is legal; it is more a question of what your policy is on outside scrubs. If you have a policy on it, review it or adopt a new one to cover this situation. When I spoke to you about this, we found out that the private scrub was paid only for the hours that she was at your facility and is probably less than you would pay for a "traveler" scrub tech. I would focus more on accommodating the new surgeon rather than finding a reason not to like the scrub tech.
Question: Our ASC wants to start doing total knee replacements in the ASC. They want to keep them overnight and then discharge them to a rehab hospital the next morning. They even want to start "gait training" while they are here. Can that be done?
Answer: Many centers do just that. As long as you legally can keep the patient overnight and they are not Medicare patients (it’s not a covered procedure for them), then yes, it can and has been done for years. Welcome to 2005.
(Contact Earnhart at 3112 Windsor Road, Suite A-242, Austin, TX. 78703. E-mail: [email protected]. Web: www.earnhart.com.)
Question: Our surgery center executive committee replaced our retiring administrator last month with a kid right out of (seemingly high) school who has no experience whatsoever in health care or clinical experience. I always thought the administrator must be a registered nurse.Subscribe Now for Access
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