What ASCs need most right now, per 6 leaders

Six healthcare professionals joined Becker's to share what the ASC industry needs most, from training and retaining staff to technological upgrades and other necessities.

Q: What do ASCs need most right now?

Editor's note: Responses have been lightly edited for length and clarity. If you would like to contribute to our next question, please email phaeffele@beckershealthcare.com.

Kimberly Cantees, MD. Vice Chair of Equity, Diversity and Inclusion, and Clinical Director, University of Pittsburgh Medical Center Presbyterian Hospital: These are unprecedented times in healthcare. Hospital  profit margins for 2022 were historically low, and 2023 is not forecasted to improve. However, as we move to a more value-based/patient centered experience in healthcare in general, it makes sense to move high revenue generating cases from the hospital to ambulatory surgery centers for the "patient experience." This could  include traditional inpatient procedures such as joint replacement, minor spine surgery, urologic procedures, and gynecologic and general surgery procedures, to name a few.

In order for an ambulatory surgery center to be successful in this next phase, two things will be necessary. First, a review of all local, state and national requirements for care has to be reviewed and in some cases challenged in order to care for these patients outside of the hospital. Secondly, as more complex cases are performed in ambulatory surgical centers, the individual patient's stay might exceed the traditional work hours of care in an ambulatory surgical center. This will be a shift in the labor paradigm for those individuals working in this environment.

Garth Dahdah. Senior Director of Facilities and Planning, the Ohio State University Wexner Medical Center (Columbus): Ambulatory surgery centers need several things at the moment to continue providing high-quality healthcare services:

  • Adequate staffing: ASCs need enough staff, including nurses, anesthesiologists and surgeons, to handle surgical procedures and provide patient care. Staffing challenges put a strain on ASCs.
  • Financial support: ASCs are facing economic challenges due to the pandemic's heavy hit, including decreased patient volume and increased expenses for PPE and other supplies of ASCs and ensure they can continue providing essential healthcare services.
  • Technological upgrades: ASCs require the latest technologies and equipment to deliver the best possible outcomes for patients. Upgrades in telehealth, electronic medical records, and other technologies can help ASCs streamline operations and improve patient care, but they are incredibly costly.

David Kim, MD. Chief Executive, Providence Clinical Network (Irvine, Calif.): At Providence, we are hyper-focused on retention and recruitment of staff. Historically, attracting caregivers to ASCs was relatively easy with many positives, including predictable hours, no weekend or night shifts, no call, and relatively healthy patients who were discharged the same day. Today our ASCs are feeling the effects of the nationwide staffing shortage. We are working on multiple levels to support our valued staff and stabilize our staffing model to ensure patients in our communities have access to high quality, affordable same day surgeries and procedures.  

Joe Schomburg, MSN, RN. Senior Vice President, Lehigh Valley Orthopedic Institute (Allentown, Pa.): The priority for ASCs is consistent, specialty-trained staffing that can provide the appropriate anesthesia, surgical, and nursing care to support the transition of advanced orthopedic cases from the inpatient to ASC environment.

Larry Sobal. CEO, Heart and Vascular Institute of Wisconsin (Appleton): Clarity from CMS on what procedures will or won't remain on the "hospital only" list. Since our ASC will be focused on cardiovascular procedures, cardiovascular ASCs need the American College of Cardiology to initiate a registry, or create an add-on to existing registries, so that ASC cases can be benchmarked on an apples to apples basis.

Also related to cardiovascular ASCs, the various sub-societies such as SCAI and Heart Rhythm need to create a clear road map for what procedures will likely transition from hospitals to ASC settings in the future and what guidelines should be followed in making that determination

Kathleen Wright, MSN, RN. Administrator, Methodist Surgery Center Landmark (San Antonio): What ASCs need most right now is to retain their staff. The employees we have are the best asset of our business and replacing good people is expensive.

With the excessive pay that is given to travelers, raising salaries isn't always the practical or even possible approach.

Look at ways to improve the culture, creative gestures of fun and recognition and demonstrate genuine authenticity towards your team.

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