Benchmarking is an integral part of any ASC's growth and long-term success. Bunny Twiford, RN, president of Twiford Consulting in Warminster, Pa., discusses four core things ASCs should benchmark.
1. Staffing models. Depending on the size, maturity and specialty make-up of the facility, ASCs should benchmark staffing models to see which model helps achieve improved operational efficiency, especially if an ASC is growing and expanding. Ms. Twiford says this requires ASCs to take a long, hard look at all the individual staff members that make up an entire ASC staff. Individual skill sets and expertise should be considered when ASCs configure the appropriate staffing model so that work schedules, and therefore payroll and long-term ASC profitability, are established appropriately.
"ASCs will want to see what duties are done by a registered nurse and examine if those duties can be carried out by another staff member," Ms. Twiford says. "A nurse's job is to ask patient questions and use their nursing knowledge to take care of patients. What a nurse doesn't necessarily have to do is walk the patient from the waiting area to an admit bed or clean and make beds."
Ms. Twiford adds that while nurses can certainly carry out the aforementioned duties, bringing on a medical assistant or nurse's aid can help alleviate these other tasks to allow nurses to have more face time with patients.
2. Patient flow. Benchmarking patient flow involves a number of different things, including measuring where patient flow is most frequently backed up and how long delays are drawn out in certain areas of an ASC. Ms. Twiford says two main areas ASCs should focus on for patient flow is the admit area and the recovery room.
"There may be a back-up in the patient admit area because an ASC has multiple physicians working with patients in multiple rooms, so unless those patients are being moved along efficiently and the physician is keeping on time, you're going to have some delays and irate patients," Ms. Twiford says. "Also, a common reason for back-ups in the recovery room is that patients are simply waiting for the physician to come in and discharge them."
The key behind benchmarking patient flow is determining specific patterns and finding the cause of throughput problems. "It's not definitive enough for an ASC to know that it is always backed up on Thursdays. It's better for an ASC to know that it has been backed up in the recovery room every Thursday for the past two months because oftentimes ASCs think it's one problem causing the back-ups when the root of the problem is something totally different," she says.
3. Room utilization. Room utilization is a hot topic for ASCs, especially following the downturn of the economy and declining Medicare reimbursements. Efficient and effective room utilization ensures ASCs are staying profitable in the face of such hard economic times. Ms. Twiford says ASCs should benchmark room utilization against several parameters, including patient access and specialty, to see which room utilization models help accommodate patients.
"In these economic times, patients are grateful to have their jobs and sometimes are unwilling or can't take time off for procedures, so ASCs may want think about perhaps opening later into the evening or opening for weekend hours," Ms. Twiford says. "Another way to benchmark room utilization is to look at how physicians from different specialties are using the rooms. ASCs may need to look at adding another specialty to their facilities."
4. Impending changes resulting from healthcare reform or changing standards. Ms. Twiford says healthcare reform and changing healthcare standards may force ASCs to dramatically change the way healthcare is provided. Benchmarking operational processes around these changes will help ASCs improve their overall long-term success.
"ASCs can benchmark ideas on how to deal with healthcare reform and what changes facilities will undergo as a result of that," she says. "For example, GI ASCs may want to discuss or benchmark ideas on how to accommodate the new patient population that may enter the ASC population, especially if these patients have not been seen by a physician on a routine basis."
Expanded infection prevention programs and AORN’s new Recommended Practices for Surgical Attire, which does not condone home laundering of surgical attire, are some other topics ASCs should benchmark process improvement ideas around.
Bunny Twiford, RN is a member of SGNA, AORN and APIC. She is currently president of the Bux-Mont Chapter 3912 of AORN in Pennsylvania. Learn more about Twiford Consulting at www.twifordconsulting.com or you can contact Ms. Twiford through twifordconsulting@gmail.com.
1. Staffing models. Depending on the size, maturity and specialty make-up of the facility, ASCs should benchmark staffing models to see which model helps achieve improved operational efficiency, especially if an ASC is growing and expanding. Ms. Twiford says this requires ASCs to take a long, hard look at all the individual staff members that make up an entire ASC staff. Individual skill sets and expertise should be considered when ASCs configure the appropriate staffing model so that work schedules, and therefore payroll and long-term ASC profitability, are established appropriately.
"ASCs will want to see what duties are done by a registered nurse and examine if those duties can be carried out by another staff member," Ms. Twiford says. "A nurse's job is to ask patient questions and use their nursing knowledge to take care of patients. What a nurse doesn't necessarily have to do is walk the patient from the waiting area to an admit bed or clean and make beds."
Ms. Twiford adds that while nurses can certainly carry out the aforementioned duties, bringing on a medical assistant or nurse's aid can help alleviate these other tasks to allow nurses to have more face time with patients.
2. Patient flow. Benchmarking patient flow involves a number of different things, including measuring where patient flow is most frequently backed up and how long delays are drawn out in certain areas of an ASC. Ms. Twiford says two main areas ASCs should focus on for patient flow is the admit area and the recovery room.
"There may be a back-up in the patient admit area because an ASC has multiple physicians working with patients in multiple rooms, so unless those patients are being moved along efficiently and the physician is keeping on time, you're going to have some delays and irate patients," Ms. Twiford says. "Also, a common reason for back-ups in the recovery room is that patients are simply waiting for the physician to come in and discharge them."
The key behind benchmarking patient flow is determining specific patterns and finding the cause of throughput problems. "It's not definitive enough for an ASC to know that it is always backed up on Thursdays. It's better for an ASC to know that it has been backed up in the recovery room every Thursday for the past two months because oftentimes ASCs think it's one problem causing the back-ups when the root of the problem is something totally different," she says.
3. Room utilization. Room utilization is a hot topic for ASCs, especially following the downturn of the economy and declining Medicare reimbursements. Efficient and effective room utilization ensures ASCs are staying profitable in the face of such hard economic times. Ms. Twiford says ASCs should benchmark room utilization against several parameters, including patient access and specialty, to see which room utilization models help accommodate patients.
"In these economic times, patients are grateful to have their jobs and sometimes are unwilling or can't take time off for procedures, so ASCs may want think about perhaps opening later into the evening or opening for weekend hours," Ms. Twiford says. "Another way to benchmark room utilization is to look at how physicians from different specialties are using the rooms. ASCs may need to look at adding another specialty to their facilities."
4. Impending changes resulting from healthcare reform or changing standards. Ms. Twiford says healthcare reform and changing healthcare standards may force ASCs to dramatically change the way healthcare is provided. Benchmarking operational processes around these changes will help ASCs improve their overall long-term success.
"ASCs can benchmark ideas on how to deal with healthcare reform and what changes facilities will undergo as a result of that," she says. "For example, GI ASCs may want to discuss or benchmark ideas on how to accommodate the new patient population that may enter the ASC population, especially if these patients have not been seen by a physician on a routine basis."
Expanded infection prevention programs and AORN’s new Recommended Practices for Surgical Attire, which does not condone home laundering of surgical attire, are some other topics ASCs should benchmark process improvement ideas around.
Bunny Twiford, RN is a member of SGNA, AORN and APIC. She is currently president of the Bux-Mont Chapter 3912 of AORN in Pennsylvania. Learn more about Twiford Consulting at www.twifordconsulting.com or you can contact Ms. Twiford through twifordconsulting@gmail.com.