Keys to Building a Business-Oriented ASC

Effective scheduling of the qualified clinicians — so essential to our industry — is key to running a business-oriented ASC.

Operating a successful ambulatory surgery center (ASC) in today’s competitive environment requires much more than providing great service. High quality of care is the fundamental requirement that earns an ASC the right to open its doors, but the most successful ASC operators are those who build upon those fundamentals with three business strategies:

1. Setting the ASC goals appropriately on day one 
2. Controlling the largest expenses: labor and supplies 
3. Identifying and managing business-oriented team members to help achieve business and clinical objectives

Appropriate Goal Setting

Annual goal setting is part of every business plan, but those who are truly successful break annual goals down into very specific, targeted goals by quarter and month. In addition, the goals must be measurable and easily tracked.

Specific
ASC leaders’ goals should not be limited to the number of surgical cases expected. Rather, they should include the types of cases, the specific physicians targeted for the increase in cases, the resources needed (supplies, equipment upgrades, etc.), and the steps necessary to achieve the goals.

Measurable
The best goals will be measurable — quantitative, time-specific, and tied to a person. This provides leadership, as well as physician partners, with a “ruler” to measure ongoing success in every area of the business. It also shows information about areas that may need improvement. Measurement is a crucial part of holding staff members accountable for their respective responsibilities. Every goal must have the name of the person — one person only — whose responsibility it is to achieve that goal.

Attainable
Setting targets and goals and being able to achieve them provides a successful manager with the opportunity to motivate employees through the recognition of their success and the effective use of competition to help achieve those goals.

Expense Control

Out-of-control expenses can prevent even the best ASC staff from achieving their goals. Our industry demands that we provide the best in personnel and supplies — the cornerstones to our success. However, a business-focused ASC works with these vital resources to utilize them as efficiently as possible for the ultimate success of the center.

Staff Scheduling

Effective scheduling of the qualified clinicians — so essential to our industry — is key to running a business-oriented ASC. The schedule should be flexible enough that adjustments can be made on days when the caseload is light. Providing your clinical staff with the processes to do this effectively while keeping them “in the loop” allows for flexibility without jeopardizing staff morale. In fact, studies have shown that ASCs that manage their staff schedules will not only boast lower labor costs per case (a critical component to the ASC value proposition for the surgeon), but will have the highest scores in clinical staff loyalty. Of course, good communication and consistency are often the keys to this success.

Supply Costs

Successful ASC operators will source and purchase supplies with the art of an orchestra conductor and persistence of a bulldog. Information is vital to a good vendor negotiation and even a single-site ASC can use this tool if they know what their competitor is paying and use it to get a better deal — sometimes all you have to do is ask. Of course, larger ASC companies are able to include volume purchasing in this equation and use it as additional leverage with vendors.

A successful purchasing department will work with physicians on items that are truly “physician-preferred.” However, they will convince physicians to evaluate lower-priced alternatives when it is appropriate. By providing physicians with an introduction to lower-priced items and having them make an assessment over time, ASCs can make an informed, physician-oriented judgment on whether to shift to a lower-priced product. You cannot ask a physician to switch from his/her preferred product unless you have provided the opportunity to truly test whether their higher-priced, preferred item is genuinely worth the cost. Does it have better clinical merit, or is their use of the item more of a comfortable habit that could be costing the ASC, and the physicians’ partnership, more money?

Business-Oriented Leadership

The ASC clinician turned successful manager is a rare breed, perhaps because many of them never shed their clinical outlook on running a business. Those who have made the transition will respect their clinical background while embracing a new, business-driven outlook that includes several key components:

• They rely on a well-selected team to move their business forward.
• A business-driven manager recognizes the unique qualities necessary to run an ASC and identifies those who can help them achieve their goals. This includes first-class RNs whose job it is to ensure that the clinical quality exceeds standards, as well as highly curious and talented business managers or analysts who help keep the back office flowing efficiently.
• They use real business data to run their ASC on a day-to-day basis.
• Managers who run reports for the sole purpose of sending them up the ladder are not effectively using the tools available to them. The reports being analyzed at the higher levels can also provide ASC managers with the data necessary to track their progress in achieving targets or goals, as well as help identify any problems or issues that could affect the ultimate success of the center.

Seek Business Lessons From Outside the Healthcare Industry

As the ASC industry becomes more competitive, good managers are looking outside the industry for ideas to more effectively run their businesses. Much can be learned from manufacturing and retail environments that can be modified for our complex industry — a good manager will take advantage of that and not try to re-invent the wheel.

Recognize the Value of Continuous Improvement

A business-minded manager is never completely happy with achieving their targeted goals. Rather, they congratulate those who helped achieve them and then ask, “What can we do to make it even better?” By constantly seeking to improve the business, a good manager will ultimately be able to adopt the best practices in all areas of the ASC to achieve the best outcomes possible. 

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