During the interview process, it can be difficult to tell who will be an invaluable part of your ASC and who will lose you money and waste your time. Theresa Palicki, administrator of Eastside Surgery Center in Columbus, Ohio, discusses key characteristics of nurses, anesthesiologists and medical directors who fit best in an ASC to ensure that you hire staff members who work well with others prioritize your center's success.
The best nurses are:
1. Focused on patient, not policy. Ms. Palicki says the best nurses are those who don't concentrate on every minute detail of an ASC's policy. Of course, policy is important, but a nurse who nitpicks every detail of a process will likely frustrate your physicians, decrease efficiency and won't necessarily produce a better outcome. Instead, choose nurses who are committed to the best interests of the patient. "If there's a problem with the physician's practices, you want the nurse to say, 'Huh, the policy states this, but we seem to be doing something different. What do you think?'" instead of being overly pedantic and critical. "They have to be constantly thinking about what is best for the patient," she says. "You won't annoy the physicians that way, and you will never get yourself in trouble if you put the patient first."
2. Strong enough to stand up to a physician without being difficult. Ms. Palicki says it's hard to strike a balance between a nurse who can say "no" when necessary and a nurse who is rude and difficult to work with. "I don't want somebody who takes a physician's word as the gospel, yet I also don't want someone has a chip on their shoulder from an anesthesiologist or a surgeon who treated them badly in the past," she says. She says you can distinguish a good nurse during the interview process by asking questions about problems the nurse had with his or her previous employers and co-workers. If the nurse says, "My old boss was a jerk" without offering any of his or her own faults, you can bet he or she will be difficult to work with at your center. If the nurse says, "I didn't have any problems," it's likely that he or she's not being honest — and may not have the courage to tell surgeons when they're wrong.
3. Interested in pursuing education. The ideal nurse should be constantly pushing to learn more about the practice. "Our very best nurse is constantly trying to teach herself additional skills," Ms. Palicki says. "She started as a scrub tech, put herself through nursing school, became an OR nurse and then wanted to learn how to do pre-op and PACU," she says. "She became the material manager, and then she wanted to learn how to be in charge of all the other nurses." She says your best nurses will want to understand how each of the clinical areas functions and how they are interrelated.
The best anesthesiologists are:
1. Responsible for the patient. Ms. Palicki says the best anesthesiologists will feel personally responsible for the safety of the patient. Some anesthesia groups see the patient as the surgeon's responsibility and will therefore mentally "check out" as soon as they're finished with surgery, she says. On the other hand, a great anesthesiologist will be present during pre-operative care, surgery and post-operative care, constantly ensuring the patient is in the right state and they're safe to go home after surgery. This will also decrease your risk for patient safety errors.
In order to tell whether an anesthesiologist feels that patient connection, she recommends asking how the anesthesiologist would settle a disagreement between the surgeon and the anesthesia team. If a candidate says he would always defer to the surgeon, he may put the patient at risk if the surgeon ever makes a mistake. You should also ask about staffing ratios to determine how involved the anesthesiologist will be in patient care. "Are you going to have five CRNAs, or are you going to have one CRNA and an anesthesiologist who can run into the room if something goes wrong?" Ms. Palicki suggests asking.
2. Loyal to the ASC. You should pursue anesthesiologists who have experience working in an ASC and will be loyal to your center, Ms. Palicki says. If the anesthesia group is salaried by a hospital, they may not be willing to align closely with your center's goals. In order to pick loyal anesthesiologists, Ms. Palikci recommends you ask about surgery center experience and include financial incentives based on annual quality outcomes in the anesthesia group's contract. Make sure that you and the group benefit when they do good work for your center.
3. Respectful of your nursing team. You don't want to make your nurses unhappy by picking anesthesiologists who will try to push off all their work on the nurses. "If your anesthesia group is lazy, they will want the nurses to do everything, and your nurses will end up doing too much," she says. Instead, pick anesthesiologists who seem eager to prove themselves at your center. If they come into the ASC with an upbeat attitude and don't seem rushed or overburdened, they'll probably work well with your staff and be willing to take on extra work when necessary.
The best medical directors are:
1. Dedicated to the community. It helps to appoint a medical director who has close ties to other surgeons and providers in your community. If your medical director is in touch with the community's needs, he or she can give input on your ASC's strategic goals and help you understand how to offer the best possible services to your community. If the medical director is in touch with local surgeons, you can count on an ally who will reach out and get in touch with potential recruits for your center.
Ms. Palicki says her center's medical director is a dynamic medical force in their community. "He has a lot of sway and knows what's going on in the community," she says. "Regularly, he'll be on the phone with nine surgeons from competing ASCs in one day, talking to them about why they should come to our center. He tells me they want to meet the next week, and all I have to say is, 'Sure!'"
2. Powerful and respected. Everyone has to start somewhere, but when it comes to medical directors, you want someone who has been in the field for a while. When a medical director is respected and powerful, people will listen to him or her — and therefore to you. "If you appoint someone who's low on the totem pole and doesn't have clinical expertise, people will say, 'Go away. How old are you?'" she says. She says the best directors will have sway over local surgeons and attract providers who recognize their experience to your ASC.
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The best nurses are:
1. Focused on patient, not policy. Ms. Palicki says the best nurses are those who don't concentrate on every minute detail of an ASC's policy. Of course, policy is important, but a nurse who nitpicks every detail of a process will likely frustrate your physicians, decrease efficiency and won't necessarily produce a better outcome. Instead, choose nurses who are committed to the best interests of the patient. "If there's a problem with the physician's practices, you want the nurse to say, 'Huh, the policy states this, but we seem to be doing something different. What do you think?'" instead of being overly pedantic and critical. "They have to be constantly thinking about what is best for the patient," she says. "You won't annoy the physicians that way, and you will never get yourself in trouble if you put the patient first."
2. Strong enough to stand up to a physician without being difficult. Ms. Palicki says it's hard to strike a balance between a nurse who can say "no" when necessary and a nurse who is rude and difficult to work with. "I don't want somebody who takes a physician's word as the gospel, yet I also don't want someone has a chip on their shoulder from an anesthesiologist or a surgeon who treated them badly in the past," she says. She says you can distinguish a good nurse during the interview process by asking questions about problems the nurse had with his or her previous employers and co-workers. If the nurse says, "My old boss was a jerk" without offering any of his or her own faults, you can bet he or she will be difficult to work with at your center. If the nurse says, "I didn't have any problems," it's likely that he or she's not being honest — and may not have the courage to tell surgeons when they're wrong.
3. Interested in pursuing education. The ideal nurse should be constantly pushing to learn more about the practice. "Our very best nurse is constantly trying to teach herself additional skills," Ms. Palicki says. "She started as a scrub tech, put herself through nursing school, became an OR nurse and then wanted to learn how to do pre-op and PACU," she says. "She became the material manager, and then she wanted to learn how to be in charge of all the other nurses." She says your best nurses will want to understand how each of the clinical areas functions and how they are interrelated.
The best anesthesiologists are:
1. Responsible for the patient. Ms. Palicki says the best anesthesiologists will feel personally responsible for the safety of the patient. Some anesthesia groups see the patient as the surgeon's responsibility and will therefore mentally "check out" as soon as they're finished with surgery, she says. On the other hand, a great anesthesiologist will be present during pre-operative care, surgery and post-operative care, constantly ensuring the patient is in the right state and they're safe to go home after surgery. This will also decrease your risk for patient safety errors.
In order to tell whether an anesthesiologist feels that patient connection, she recommends asking how the anesthesiologist would settle a disagreement between the surgeon and the anesthesia team. If a candidate says he would always defer to the surgeon, he may put the patient at risk if the surgeon ever makes a mistake. You should also ask about staffing ratios to determine how involved the anesthesiologist will be in patient care. "Are you going to have five CRNAs, or are you going to have one CRNA and an anesthesiologist who can run into the room if something goes wrong?" Ms. Palicki suggests asking.
2. Loyal to the ASC. You should pursue anesthesiologists who have experience working in an ASC and will be loyal to your center, Ms. Palicki says. If the anesthesia group is salaried by a hospital, they may not be willing to align closely with your center's goals. In order to pick loyal anesthesiologists, Ms. Palikci recommends you ask about surgery center experience and include financial incentives based on annual quality outcomes in the anesthesia group's contract. Make sure that you and the group benefit when they do good work for your center.
3. Respectful of your nursing team. You don't want to make your nurses unhappy by picking anesthesiologists who will try to push off all their work on the nurses. "If your anesthesia group is lazy, they will want the nurses to do everything, and your nurses will end up doing too much," she says. Instead, pick anesthesiologists who seem eager to prove themselves at your center. If they come into the ASC with an upbeat attitude and don't seem rushed or overburdened, they'll probably work well with your staff and be willing to take on extra work when necessary.
The best medical directors are:
1. Dedicated to the community. It helps to appoint a medical director who has close ties to other surgeons and providers in your community. If your medical director is in touch with the community's needs, he or she can give input on your ASC's strategic goals and help you understand how to offer the best possible services to your community. If the medical director is in touch with local surgeons, you can count on an ally who will reach out and get in touch with potential recruits for your center.
Ms. Palicki says her center's medical director is a dynamic medical force in their community. "He has a lot of sway and knows what's going on in the community," she says. "Regularly, he'll be on the phone with nine surgeons from competing ASCs in one day, talking to them about why they should come to our center. He tells me they want to meet the next week, and all I have to say is, 'Sure!'"
2. Powerful and respected. Everyone has to start somewhere, but when it comes to medical directors, you want someone who has been in the field for a while. When a medical director is respected and powerful, people will listen to him or her — and therefore to you. "If you appoint someone who's low on the totem pole and doesn't have clinical expertise, people will say, 'Go away. How old are you?'" she says. She says the best directors will have sway over local surgeons and attract providers who recognize their experience to your ASC.
Learn more about Health Inventures.