Small ASC Doubles, But Experiences Few Growing Pains
Focus on staff for success
EXECUTIVE SUMMARY
Staff satisfaction and cooperation is crucial to running a surgery center that’s focused on quality and productivity. There are some strategies to achieve success — even as a center is growing by leaps and bounds.
- Keep communication lines open.
- Provide scheduling flexibility to enhance staff’s need for work-life balance.
- Physician recognition through lunches, doughnuts can boost staff morale.
As an ASC grows, a key strategy to its success is focusing on staff, staying sensitive to their need for work-life balance, and keeping lines of communication open.
“Traditionally for us, we have focused on [staff] caregivers, trying to realize they have a life outside of work,” says Terri Mahoney, RN, CNOR, CASC, administrator at Bluffton Okatie Surgery Center in Bluffton, SC.
“If we can be understanding and accommodating, within reason, then we will keep some high-quality providers where, maybe if we were not quite so flexible, we would not have that ability,” Mahoney says.
During Bluffton Okatie Surgery Center’s early years, it was challenging to find qualified nurses and other employees who were interested in part-time work. “So we had to think outside the box,” Mahoney says.
“How could we attract people and receive a commitment from them, when our case volume fluctuates so much and we’re not as consistent as most people need?” she asks.
The answer was to inject blatant honesty into the interview process.
“We had to be really honest with people during the interview process about what we’re offering,” Mahoney says. “Usually, I would start the conversation with how this is our volume, and these are our procedures, and these are the days we work.”
Mahoney would tell prospective employees that the schedule would fluctuate, and she’d ask about their financial expectations.
“People appreciated the fact that we were open with them and that they could make an informed decision,” she says.
As a result, the ASC attracted semi-retired nurses with great clinical experience. It helped that Bluffton is on the coast of South Carolina, near Hilton Head Island and Savannah, GA. Some of the PRN nurses lived in neighboring retirement communities, and they were not interested in full-time work.
To keep the staff content, the ASC offered them scheduling flexibility. If a nurse needed a summer month off for a long vacation, the surgery center could make this work.
“When you have a large PRN population of employees, you have a little more flexibility on your staffing,” Mahoney says. “When working with a semi-retired population, it’s not unusual for them to love to travel and take frequent time off, and we were able to accommodate that.”
But this strategy did not work for the long-term as the ASC was growing, including a major expansion in the past year. The ASC has shifted from a corporate ownership structure to a joint venture that includes physician owners. Bluffton Okatie Surgery Center’s focus turned to finding and hiring qualified full-time staff, nearly doubling its staff to 16.
This was a different challenge that required competing for staff within an hour radius of Bluffton. “There are a lot of healthcare facilities close to us for a relatively small community,” Mahoney says.
Staffing flexibility remains an important way to keep employees happy, although employee requests are a bit different than before. For example, Mahoney says an ASC employee recently wanted to leave her shift a couple of hours early so she could see her child perform in a school play. She told Mahoney a couple of days in advance, and Mahoney filled in for her.
“When we can help them, we try really hard to do that,” she says. “We can’t always accommodate things, but we try to make it a priority.”
Additionally, Mahoney says the center tries to create an open atmosphere at staff meetings. Mahoney will review both successful situations and unsuccessful ones, and ask staff for feedback.
“When we sit down as a staff, it’s very informal,” she says. “Usually, I’ll ask people for ideas, or we’ll talk about a situation that occurred that wasn’t ideal.”
The employees who were involved in the situation tell everyone what happened, which creates an atmosphere in which other employees feel more open to discussion and making suggestions, Mahoney says.
“This way, the conversation is not a negative one; it’s a learning experience where we want to make sure it doesn’t happen again, so we ask people to tell us some ideas of how to avoid it,” she says. “That’s the atmosphere — not a punitive thing.”
Staff meetings are an opportunity for an ASC to keep employees aware of changes. During Bluffton Okatie Surgery Center’s recent expansion, the staff meetings served as an important way to keep staff involved and informed about the expansion and any resulting culture changes, Mahoney notes.
The ASC’s staff also responds very positively to any gestures physicians make, such as buying them the occasional lunch, she says.
“What has had such a great impact on our staff is that one of our physicians — on a fairly regular occasion and at least once a week — brings in doughnuts,” Mahoney says. “He started doing it himself, and it’s had an amazing impact on the staff; it shows them that he appreciates them and goes out of his way for them.”
As an ASC grows, a key strategy to its success is focusing on staff, staying sensitive to their need for work-life balance and keeping lines of communication open.
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