BEST PRACTICES BY VANESSA SINDELL, MSN, RN ASC PHYSICIAN-OWNER ENGAGEMENT CAN IMPACT THE BOTTOM LINE For quality of care, staff retention and profit, your participation is irreplaceable. W ith the ever-rising cost of doing business, physician owners of ambulatory sur-gery centers (ASCs) can financially help their organizations by being en-gaged leaders. A 2011 study (tinyurl. com/4wndbp5b) found that in key metric areas such as financial perfor-mance, companies with high-quality leaders were 13 times more likely to surpass their industry competitors. Ad-ditionally, organizations with quality leadership have up to three times high-er employee retention. With statistics like those, it makes good business sense as an ASC owner to be involved in operations. However, it can be tricky to stay engaged in facil-ity operations when there are so many moving parts to ASC management. Below I recommend three focus ar-eas to ensure your active engagement within the ASC and yield a positive impact on the organization’s bottom line. KNOW YOUR FINANCIALS I cannot emphasize this enough: The financials of an ASC are different than those of a practice. For instance, they are labor and supply intensive (more on that later), so effective management of both can greatly impact your bottom line. Knowing that, a financial pack-age, which includes a balance sheet, in-come statement and case volume, along with a dashboard of key performance indicators (KPIs) should be distribut-ed to you and other physician owners monthly. Additionally, and maybe even more importantly, those financial documents should be discussed and reviewed be-tween you and the ASC management team. All variances in the financials on a month-to-month or year-over-year basis should have an explanation, and the management team should work with you to address any issues. These financials and KPIs provide ASC owners insight into the operational decisions made every day. They also provide the opportunity to set new operational goals for nurse leaders and other key ASC positions to improve the fiscal performance of the center. When looking for improvements, a key area to focus on is labor cost. An ASC’s highest expense is labor. While this is similar to other organizations, an ASC’s payroll is heavy with nursing personnel — meaning it has a much higher payroll per person than a prac-tice. Managing nursing cost by strate-gically using ancillary and support staff to expedite patient flow through the ASC can dramatically affect staffing cost. It is also imperative that staffing is driven by the surgery schedule; if there are no cases or a low volume for the day, staff must be called off. This is effectively done with the use of per diem staff instead of an all full-time staff. Properly managing staffing cost is essential to a profitable ASC. Another key area to focus on is sup-ply cost. As I mentioned earlier, the ASC setting is supply intensive, mean-ing that every time a patient enters an ASC, a supply cost is associated with that visit. Therefore, all supply costs should be meticulously managed. It is imperative that the cost is known, accurate and scrutinized. When you are clued into seemly small supply de-cisions, like which blade to use, more strategic decisions that affect the big picture can be made. Even small sup-ply adjustments can have a large — and likely positive — impact on the financial performance of the ASC. KNOW YOUR QAPI PROGRAM An ASC’s Quality Assessment and Performance Improvement, or QAPI, program indicates the quality of care the center is providing. As the physi-cian owner, it is imperative that you hold, attend and actively participate in quarterly QAPI meetings. While some items, such as medical record audits, may not seem to directly affect Vanessa Sindell, MSN, RN , is a senior consultant with Progressive Surgical Solu-tions, a division of BSM Consulting. Prior to joining Progressive Surgical Solutions, she worked for 8 years as the director of nursing for an ophthalmic surgery center. 10 AUGUST 2022 OPHTHALMOLOGY MANAGEMENT AUGUST 2022
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