7 Simple Things Your ASC Should Be Doing to Boost Productivity (But Probably Isn’t)

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• 7 Simple Things Your ASC Should Be Doing to Boost
  Productivity (But Probably Isnt)
• If you have ownership interest in an ASC, youre
  always on the lookout for ways to boost
  productivity and profits. These ideas come from
  Donna Giles, RN, BSN, VP Clinical Operations, and
  Terry Bohlke, CASC, VP Operations, National
  Surgical Healthcare, who presented at the ASCA
  Annual Meeting.
• Simplify your benchmarking. Some ASCs make the
  mistake of hiring expensive consultants to do
  complicated metrics based on national data and
  not necessarily relevant to your ASC, says Giles.
  The best productivity metrics compare your ASCs
  current performance to past performance. Where
  were you last year and how can you beat that?
  Bohlke asks. Thats the best way to gauge whether
  the productivity improvements youve implemented
  really work.
• And those complicated daily productivity tools
  companies want to sell you? Save some money and
  develop your own simple metric that doesnt
  require loads of staff time to enter data thats
  irrelevant to you, Giles suggests. If you have
  someone on staff who is good at Excel, you can
  develop your own simple, customized tool. Bohlke
  and Giles recommend your ASC look at 3 metrics
• Total worked surgical staff hours divided by
  total hours patients are in the ORwheels-in to
  wheels-out.
• Total worked staff hours in PreOp and PACU
  divided by total patient hours in PreOp and PACU.
  Tip This is where most ASCs have lots of
  opportunity to improve productivity.
• Total worked staff hours divided by total number
  of adjusted cases.
• Make sure your ASCs managers are having fierce
  conversations with staff about high, medium, and
  low efficiency. If your ASC has data your
  managers and staff can look at together, they can
  have crucial conversations in transparent,
  non-threatening ways. For example, some PACU
  staff are really good at moving patients along,
  says Bohlke. These patients get out the door
  safely and their satisfaction levels are high. But

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• some PACU staff arent as skilled with patient
  flow. Team up different kinds of PACU staff so
  they can learn from each other.
• Cross-train staff. Some ASCs bump up salary each
  time a staffer builds up a certification in one
  specialized area. But its really important to
  reward breadth, says Bohlke. An employee who can
  work in several areas is a treasure when it
  comes to managing staff productivity. If you have
  a staffer who wants to broaden her skill set, it
  may well be a good investment for your ASC to
  reward that.
• Evaluate your ASC staffs skill mix. Do you have
  the proper balance of RNs, LPNs and CNAs? Are
  your RNs bogged down in tasks a nurses aide
  might handle just as well?
• Pay attention to how your time clock works. Your
  ASCs managers need to understand how the time
  clock rounds for time, Bohlke says. Some time
  clocks record the exact time, but most round
  backward or forward. Your staff most likely know
  how that works whether you do or not, he says.
  If youve got a time clock that rounds in
  15-minute increments, its possible you have
  staff who are gaming the system, and that can add
  up to a lot of money. One ASC found enough money
  to hire six additional full- time employees once
  it dug into time clock monitoring, Giles reports.
• Eyes Open ASC productivity is typically great in
  the mornings, but tapers off in afternoons,
  Bohlke and Giles note. The tapering happens
  because managers finally get their late lunches
  and check their emails and they tend not to make
  sure staff clock out when its time during the
  afternoons.
• Pay attention to where your time clock is.
  Position it near clinical and administrative work
  areas so that employees clock in when theyre
  actually ready to work. If your ASCs time clock
  is in the break room, you will get even
  well-intentioned employees absent-mindedly
  clocking in, and then getting a cup of coffee,
  changing clothes, and doing other non-work
  activities on the clock.
• Eyes Open There are FSLA regulations governing
  time clock details, and your state may have rules
  as well.

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7. Monitor overtime. Make sure a manager approves
all OT before its incurred and that someone
monitors overtime patterns. Two percent of ASC
hours should be overtime, Bohlke says. If
overtime is less than 2 percent, thats a sign
your ASC is paying out too much for full-time
staff. If overtime is more than 2 percent, its a
good idea to do a cost benefit analysis to make
sure you dont need more full-time staff.