What a historic year 2020 has turned out to be so far. I was so optimistic about this new year and decade, but little did any of us know what was ahead. It is going to be interesting how history categorizes this incredible event. During our lifetime, other events have happened that changed the world, including:
- The fall of the Berlin Wall in 1991. The obvious change was the unification of Germany, but it also marked the end of the Cold War, and ultimately the fall of the Soviet Union.
- The terrorist attacks of Sept. 11, 2001. This event triggered the global war on terrorism, of which we are still feeling the effects.
The COVID-19 pandemic has exposed global vulnerability in our healthcare system and showed how unprepared the world was and is for emergencies of this magnitude.
In the United States, the way we handle more than 50 million surgical procedures annually is bound to transform after the pandemic ends. We are poised to see sweeping changes, and all of us need to be ready. From multiple sources, there are great ideas that we can list here. However, the mostly likely source of sweeping changes is going to come from the Centers for Medicare & Medicaid Services (CMS).
Each year, CMS dictates the types of surgeries that can be performed in ambulatory surgery centers (ASCs), and what procedures must be performed in hospitals. There are thousands of procedures CMS allows in an ASC, and the agency adds more each year.
There are many other procedures that could be moved from hospitals and hospital outpatient departments into ASCs. I expect this development once we move past the COVID-19 crisis. How can your facility prepare?
• Look within. Do you have the time slots available to add to your block time? Do you have the space to expand? Do you employ enough staff? Most ASCs have laid off staff to save costs during the pandemic. Keep in touch with these employees, and be ready to bring them back. Also consider whether you can expand the hours of operation to include an evening schedule and a Saturday block.
• Spread the word. Let your surgeons know you are interested in new cases and specialties. Surgeons only make money when they operate, and they are struggling right now to find places to work.
Notify the director of surgery at the local hospitals that you have capacity and can handle their elective surgeries. Reopening their own surgical program puts elective cases at the end of the process, and they are looking for ways to accommodate their patients and surgeons.
Make yourself available for interviews with your local TV and radio stations. Let them know you are ready to put elective cases back on the schedule.
• Follow protocol. Secure permission, in writing, from your governing board indicating all members agree with your plans. Notify your accreditation agency and let them know your intentions, too. Most ASCs allow new surgeons immediate 90 days privileges to handle cases with a phone call and some paperwork. Review your policies and procedures on how to make it happen.
Start looking at an equipment budget for more intensive procedures from your governing body. Be sure to check state regulations and stay in compliance.
• Bring in cases — and keep them. Welcoming cases through your door should be relatively easy, but keeping them might be a challenge after the pandemic crisis passes. Market yourself accordingly, and be prepared to offer equity to new users.
Look for the best staff to accommodate new procedures when they happen. Be wary of purchasing new equipment and supplies and hiring staff for surgeons who do not want to purchase equity.
No one wants to capitalize over the loss of life, the pain and suffering, and economic tragedy of the COVID-19 pandemic, but these changes are overdue and need to happen. There is no reason why you should not be involved in the transformation of the industry.
(Earnhart & Associates is a consulting firm specializing in all aspects of outpatient surgery development and management. Address: 5114 Balcones Woods Drive, Suite 307-203, Austin, TX 78759. Phone: (512) 297-7575. Fax: (512) 233-2979. Email: searnhart@earnhart.com. Web: www.earnhart.com. Instagram: Earnhart.Associates.)