Who’s Who in the Ambulatory Surgery Industry: The Facilities

For four years, we have provided this special “Who’s Who” section to focus on noteworthy ambulatory surgery centers (ASCs) within the United States. Each year, we see a different focus. Some years have featured centers successfully holding their own among competitors; other years, we have seen conversions from ASCs to specialty surgical hospitals. This year, we focus on quality — ASCs are consistently showing powerful statements of patient satisfaction. Patients are inevitably delighted with their experiences at ASCs, which provide the best of healthcare in a positive, comfortable setting.

THE FACILITIES

Berks Center for Digestive Health
Wyomissing, Pa.

The Berks Center for Digestive Health is a three procedure room, 5,000-square-foot ambulatory endoscopy surgery center located in Wyomissing, Pa. The center is a partnership between 10 gastroenterologists and Physicians Endoscopy, a management and development company headquartered in Doylestown, Pa.

“The center opened in December of 2001 and has enjoyed impressive growth and consistent profitability throughout its six years of existence,” says John Gleason, administrator.

Much of the center’s success has to be attributed to the right mix of staff, physicians and management. The 21 staff members — nurses, medical assistants, and administrative staff — are all geared to provide an experience for the patient that is second to none, with service excellence the primary value held by all. “Whatever we do in the center, each action or decision, it is evaluated in terms of how it will impact the patient. If it has the potential to improve safety, efficiency or quality, we will make it happen,” says Gail Wells, center manager.

The center recently implemented an electronic medical record system and an open endoscopy program. The open endoscopy (OE) program, which enables rapid and safe access to screening procedures, has enabled the center to grow in volume in its six years, while providing a more patient-friendly process.

“The implementation of the EMR and OE programs is a testimony to the way the center approaches each challenge it confronts — flexibility and adaptability,” Gleason adds. “Whether it is a need to add physicians (six in the last six years), increase hours, open new rooms, change staff schedules, or add new programs, the center manages it with the best interest of the patient in mind. This ability to change has resulted in impressive growth (15 percent increase in the third quarter of 2007) and consistently high patient satisfaction ratings (90 percent of returned surveys give a grade of “excellent”), and high staff retention.”

Bethlehem Endoscopy Center
Bethlehem, Pa.

The staff and physicians at Bethlehem Endoscopy Center LLC (BEC) are the brick and mortar of this successful endoscopy center located in Bethlehem, Pa. “Our facility consists of two procedure rooms, an office, and an eight-bed admission/recovery area. We are AAAHC-accredited and our patient satisfaction surveys reiterate that our performance is exceptional. Some recent comments from our patients include, ‘Staff is friendly, thoughtful, courteous and professional;’ ‘Hurrah! Convenient and positive experience;’ and ‘Don’t change a thing!’” says Karen Fioriglio, nurse administrator.

The facility opened its doors in the early fall of 2002 and has just observed its five-year anniversary. To commemorate the occasion, the six physician owners rewarded the staff with a special celebration of dinner and dancing. “We love to sing and dance!” says Fioriglio.

“Each five-year staff member was presented with a silver bracelet, a tradition we want to continue.”

The nurses, techs and office staff state that they feel appreciated and valued, she adds. “The BEC physicians enjoy working at the center because they absolutely feel a connection with the staff. And we are able to provide exemplary care with state-of-the-art equipment and advanced use of information technology.”

Both physicians and staff feel a mutual respect and trust, and it’s that team effort that projects expertise, enthusiasm, and quality care to the patients and their significant others, she explains.

“As the saying goes, ‘Excellence does not just happen. It is a decision that you make every day.’ Ask us, and we’ll tell you that we are committed to making this decision every single day. We listen to our patients and each other so we can continue to raise the bar,” she concludes.

Coronado Medical and Surgery Center
Henderson, Nev.

The Coronado Surgery Center is an 11,800-square-foot facility that resides within a newly constructed Class A building with approximately 40,000 square feet of medical space. There is a detached two-level parking garage with approximately 100 covered parking spaces. This will make parking convenient for both physicians and patients.

The ultra-modern surgery center will be as innovative as any of the surrounding valley’s newest health care facilities. The surgery center includes private entrances, pre-operative rooms, two state-of-the-art surgery suites, anesthesia work-up rooms and private recovery rooms, exam rooms, and nurses’ stations, as well as inviting waiting areas and a spacious reception center for easy check-in.

The facility is located on a high-visibility corner lot, with frontage and signage along two busy roadways, Horizon Ridge Parkway and Coronado Center Drive. It is in close proximity to several master- planned residential communities and anchored next to St. Rose Siena Hospital campus with strong potential for referrals.

Peak Performance and the Bone and Joint Institute are anchor tenants, with several other well-established medical practices in negotiation. The project is being developed by Stable Development. The contractor is the Korte Company. Construction is expected to be completed by March of 2008.

Dothan Surgery Center
Dothan, Ala.

The Dothan Surgery Center in Dothan, Ala., is a six-OR, four-endoscopy suite facility that performs 1,100 cases a month. The 25,000-square-foot center has been open for 21 years with one year of closure for remodeling back in 2001.

Gastroenterology, orthopedics, ENT, general surgery and plastic surgery make up the ASC’s offerings, and the constant influx of patients and staff means efficiency and patient safety is the focus.

“I think one of the things that make us special is the flow of patients — being able to get people in and out in a timely manner,” says Doris White, resource manager. “Based on information I’ve seen from FASA, none of the other ASCs in this region are doing this many cases a month.”

Dothan Surgery Center is located in the southeast corner of Alabama, and also serves residents from Georgia and Florida. Despite the busy-ness of the center, the DSC business office team has managed to achieve a very fast turnaround for accounts receivable — with an average time in accounts receivable (A/R) of 37 days.

The ASC could not be so efficient without its excellent staff, White points out. “The staff works very well together, and is very team oriented; they will do whatever it takes to get the job done. Teamwork is a number one priority for us.”

Customer satisfaction surveys regularly feature numerous compliments on the quality of care and the quality of employees. “Patients feel like the staff is very light-hearted. They enjoy a light atmosphere here, instead of worrying about the procedures they’re going to have,” she adds.

Although the ASC has not yet switched to an EHR, they have been scanning in their paper files, and are able to pull up records at their fingertips. “We have also put in a new billing system, using Source Medical with its vision application, which has improved our turnaround tremendously.”

The facility also plans some volunteer work for 2008, and is organizing a “Women Build” project for Habitat for Humanity in the spring of next year.

“Dothan Surgery Center is an excellent place to work,” White concludes. “We all know that it takes a team to get every patient through this facility, and that’s the way we act — as a team. I’ve never heard anybody say, ‘That’s not my job.’ It starts from the top down, with our administrator Denise Harrington, RN, setting the example.”

Hershey Outpatient Surgery Center, LP
Hershey, Pa.

Hershey Outpatient Surgery Center (HOSC), LP, opened for business in May of 2004. The multi-specialty center boasts over 100 surgeons utilizing the center, which features seven operating rooms for colorectal, dental, general, neurology, oral, orthopedics, otolaryngology, pediatrics, podiatry, plastics, pain management and urology.

“The key element to operating a relatively new center of this size is having quality and experienced staff,” says David W. Orskey, administrator of the center. “The clinical staff is well-seasoned with experience in all of the specialties we provide, and are flexible to meet the needs of the case and surgeon. Our administrative staff are focused on seamless hand-offs of patient scheduling, insurance, and patient accounts. Leading the center is a management team that relies on data, teamwork, and experience to manage and carry out the operational requirements of a large center.”

Dedication to patient satisfaction and safety is paramount to the center’s success, Orskey adds. Patients receive pre-stamped satisfaction surveys, and the clinical staff monitors their responses. The results are used in quality assessment and performance improvement projects. Quarterly results are shared with the facility’s safety, executive, and governing committees. And quarterly staff meetings are used to celebrate the team’s successes.

“As the number of ambulatory surgery centers in Pennsylvania grows, and the competition and political forces that want to detract from the success and efficiency of ASCs clamor on the surgeons, investors and the administrator actively campaign for the benefits ASCs provide. Recently in Pennsylvania, certificates of need and bills relating to physician ownership and referrals have been proposed by our state that would directly affect the financial savings that ASCs provide patients, employers and payors. Independently and collectively, these issues have been addressed through personal letters to our senators, membership in FASA, our state organization (PASA), and through attendance at national conferences that support our industry,” Orskey says.

Minnesota Valley Surgery Center
Burnsville, Minn.

Minnesota Valley Surgery Center opened its doors in Burnsville, Minn., on Sept. 6, 2006. “Since that time, we have performed surgery on over 3,000 patients,” says Sharon Richmond, administrator of the facility.

The facility consists of three operating rooms and a 14-bed PACU, comprising approximately 11,000-square-feet. The building is currently occupied by orthopedic consultants and physical therapy upstairs, and by the Minnesota Valley Surgery Center and MRI on the lower level.

Twenty-five surgeons perform orthopedics, plastics, pain management, podiatry, ophthalmology and general surgery.

“We are very proud to report our patient satisfaction scores to be at 100 percent in overall experience; they would definitely recommend our facility to others,” Richmond says. “Our experienced nursing staff strives to ensure that each patient is treated specially and leaves the facility feeling as thought they experienced a ‘spa-type environment’. Our satisfaction surveys are given to each patient, and we receive about 45 percent returns.”

The surveys indicate that patients prefer the spa atmosphere and the efficiency of the whole process to that of a hospital. That, Richmond says, is due to a staff of motivated, upbeat people who have great ideas and take a real interest in their patients.

The staff commits itself to providing the very best patient care, but also recognizes the importance of cost savings. “Our SVAC committee has worked diligently over the past year to provide the center with approximately $157,000 in cost savings,” Richmond reports.

Minnesota Valley Surgery Center provides the community of Burnsville an alternate facility for outpatient surgical care with the added convenience of seeing a physician, getting an MRI, and having surgery and post-surgical physical therapy all in one building.

Mount Nittany Surgical Center
State College, Pa.

Mount Nittany Surgical Center (MNSC) opened its doors in April 1994. The surgical center was, at the time of its opening, the only surgery center in Centre County, Pa.

MNSC is an 18,000-square-foot ambulatory surgical facility in State College, Pa. It is a hospital-based surgical center in association with Mount Nittany Medical Center (MNMC). The surgical center has four operating rooms and two special procedure rooms.

“We do approximately 5,400 cases per year,” says Michael Lehr, RN, BSN, CNOR, administrator. “Our medical staff is comprised of 55 physicians; all are board-certified in their respective disciplines. And our facility is accredited by AAAHC.”

The surgery center staff is comprised of 34 full time equivalents, including registered nurses, surgical technicians, radiology technicians, clerical staff, materials management personnel, and plant management personnel. The anesthesiologists and CRNA staff are contracted through MNMC.

Disciplines practiced at the surgery center include orthopedics, ENT, ophthalmology, general surgery, pain management, podiatry and urology.

Press Ganey scores have consistently ranged in the 96th to 98th percentile nationwide.

The competitive field is constantly changing. “There is one single-specialty surgical center in the State College area, and there is a possibility of a new, smaller, multi-specialty surgery facility in the area within two years,” Lehr reports.

Advocating on behalf of surgery centers is an important part of their involvement in the industry, Lehr reports. The facility is a member of both the Pennsylvania Ambulatory Surgery Association (PASA) and FASA, and makes a point of being politically involved through those organizations.

St. Luke’s East Surgicenter
Lee’s Summit, Mo.

St. Luke’s Surgicenter of Lee’s Summit, Mo., is a multi-specialty facility serving all surgical specialties and gastroenterology. The three-OR, two-procedure room center sees more than 500 patients every month.

“Our center is located in one of the fastest-growing communities in the state of Missouri. We have about 50 active physicians and 35 wonderful employees,” says Mary Hibdon, RN, administrator. “Our patient satisfaction scores are extremely high, with overall satisfaction scores continually running at greater than 97 percent. The comments noted on the questionnaires are always complimentary of the staff and tell us to ‘keep up the good work.’”

The facility realizes excellent revenues, and the net income (as a percent of net revenue per case) has increased 7 percent over 2006. “My business office manager and her staff have successfully reduced the net days in accounts receivable by 27 percent this year,” Hibdon adds.

The center has successfully implemented a sharps container recycling program that eliminates the nurses’ exposure to overfilled sharps containers and removes the sharps containers and their contents from the environment. It is only one of the ASC’s programs designed to help meet the national goal of reducing healthcare industry hazardous waste.

“We also have implemented a successful device reprocessing and recycling program. Our materials manager and our staff continually seek ways to reduce our costs while maintaining our high quality of care. Our supply costs as a percent of net revenue are at 12 percent, and have seen a decrease of 10 percent. Our inventory days have decreased by 30 percent from 2006,” she continues.

The ASC is a joint venture with the hospital Saint Luke’s East — Lee’s Summit. “This hospital is a member of one of the most respected health systems in the state of Missouri,” Hibdon explains. “The system hospitals have received numerous national awards for quality. Saint Luke’s East — Lee’s Summit received the Missouri quality award in 2006. The hospital has committed to support the surgicenter as its elective outpatient surgery location. The physician investors are active in the operations of the center and very supportive and complimentary of the staff.”

In 2006 and early 2007, two new hospitals and a surgery center opened within 15 miles of the ASC. Despite this, the facility has experienced growth of 9 percent over 2006.

The Endoscopy Center at Redbird Square
Dallas, Texas

Open since 1999, The Endoscopy Center at Redbird Square is a 6,000-square-foot ambulatory surgery center facility located in the Dallas/Fort Worth area. There are nine physicians specializing in gastroenterology and a full-time staff of 15 performing approximately 500 procedures per month in the center’s three procedure rooms.

“The endoscopy center focuses on quality service to our patients in a professional, friendly and caring atmosphere. With state-of-the-art digital technology, we provide our patients with an exceptional experience in a safe and comfortable outpatient environment,” says Darlene Pedigo, nurse manager of the facility.

The facility’s diverse and experienced staff demonstrates a commitment to excellence through exceptional patient care. “The staff is one of our greatest strengths,” states Pedigo. “Everyone gets along well and enjoys their work, and the patients can feel that.

Patient surveys have consistently indicated that 100 percent of patients would return to the endoscopy center should the need arise, she adds.

The Endoscopy Center at Redbird Square is a part of Digestive Health Associates of Texas.

All of the group’s centers are specifically designed to enhance the patient experience. They avoid the typical hospital experience that can be confusing, impersonal, or chaotic, instead offering the alternative of a friendly, convenient, compassionate environment.

Williamson Surgery Center
Franklin, Tenn.

Hospital-owned Williamson Surgery Center in Franklin, Tenn., is a 22,000-square-foot facility with 101 physicians. The nine procedure rooms and ORs serve patients who are just as contented as the staff.

“Without hesitation, what makes our facility exceptional is the staff,” says Laura Bustetter, public relations contact for the surgery center. “We have 41 employees who are committed to making the patient’s experience in our facility safe and efficient. Each employee brings with them a unique skill set that complements our team. Every month we review patient satisfaction survey responses, and the majority of comments are related to the care, competence and friendliness of our staff. It is the ‘human’ element that patients appreciate and remember.”

As a relatively new surgery center, the facility is in the process of educating the community about ways it can better serve outpatient surgical needs. “We communicate with our patients and their families to help them understand that together we can safely and confidently perform procedures and transition patients back into their home setting. There, they can comfortably continue their recuperation with our support,” Bustetter adds. “Family involvement and education are high priorities in our facility because we want the patients to feel comfortable with the process. I believe that as we serve one patient at a time, the community is beginning to understand and respect how a surgery center can not only meet their needs, but also exceed expectations.”

The facility’s local competitors include one other multi-specialty surgery center and two single-specialty facilities, but WSC holds its own nonetheless. “The fact that our patients and physicians have a choice of where to seek services is a daily reminder of our service and quality goals,” Bustetter observes. “Williamson Medical Center is our hospital partner, and they recognize that Williamson Surgery Center can provide optimal outpatient surgical care in a more intimate setting by streamlining the same safe processes they value. We partner with Williamson Medical Center to maximize our resources, and patients feel more secure knowing the hospital is ‘just down the hallway.’”

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