4 Critical Issues Facing Clinical Leaders Today Clinical leadership often is the difference between a good ambulatory surgery center and a great one. A key attribute of all top-tier clinical managers is an ability to identify and address challenges before they cause big problems. Healthcare is a high-stakes business, with little room for clinical and financial error. Getting out in front of the issues, particularly in these four important areas, ensures delivery of the highest quality care and a high-performing healthcare business:
Labor costs Managing staffing costs is particularly challenging for ambulatory surgery centers, which must balance clinical considerations with the realities of running a high-volume business. Benchmarking and other financial tools, however, can help measure your true labor costs and determine whether adjustments should be made. By monitoring the total worked hours per case on a weekly basis and benchmarking against your ASC’s previous performance, as well as similar ASCs, you can determine if your team is operating efficiently. Your budgeted total hours per case goal is determined by the projected volume and the anticipated case mix. The typical multispecialty ASC can fall anywhere into a 10-14 hours per case range depending on the weighted average of the case mix and volume for the individual center. Part-time and per diem staff also are very effective way to control labor costs, while ensuring that the appropriate staffing levels are met. In addition, staff can be asked to take a mandatory day off, start later or go home early. These can often be difficult conversations, which is why it’s crucial for ASC leadership to reinforce that the schedule always dictates the staffing needs – not vice versa.
Motivating Staff This can be accomplished by letting them know they are heard and are included in the decision-making processes that occur at the center. Leaders must be committed to listening attentively, understanding the staff’s needs and articulating consistent responses. Pay close attention to both verbal and non-verbal communication. All communications with staff should be delivered with courtesy, clarity and care. Structured monthly department meetings provide an effective forum for dialogue, where all participants are feel comfortable to contribute. A healthy team encourages involvement, works through conflict and sets goals. Following through on goals and conversations also is extremely important in achieving staff satisfaction. Clinical leaders who are involved in day-to-day operations, understanding current staff dynamics and the team’s strengths and weaknesses, typically are most the respected by the staff. Asking these questions regularly can ensure leaders remain effective:
- Does your staff feel listened to?
- Do they believe you are interested in them?
- Do they feel leadership invests in them and helps them stay focused on goals?
- Do they feel encouraged?
Leadership development Identifying and hiring strong clinical leaders is one of the most important responsibilities of ASC decision makers. Regent believes that character and integrity are essential characteristics of those who lead. Quiet confidence also is a strong attribute; it’s genuine, not arrogant and is a quality usually possessed by those who simply want to get things done. Instilling confidence in your leaders also has to be part of an ASC’s culture. This includes regular meetings so the leadership team supports each other and is kept up to speed of all activities. It also includes ongoing education and personal goals specific to each person. Identifying each leader’s strengths and weaknesses can be a helpful tool for setting goals and pursuing growth. SWOT analysis tools can help identify particular attributes and areas of improvement for all team members. It’s also important to remember that confidence is acquired through experience, and often by trial and error.
Reporting management “How do you eat an elephant?” a good friend of mine is fond of saying. “One bite at a time!” This phrase is particularly relevant today in the areas of ASC outcome monitoring and quality reporting, requirements that can often overwhelm the clinical leaders. With a little organization and planning, however, that stack of reports – just like the elephant – will quickly become a manageable task. Here are three tips that can make you more efficient:
- Organize the tools provided for you on Qualitynet and NHSN. Sometimes it helps to print off the latest version of the specification manual from the Qualitynet website.
- Create a quick-reference binder. Place the specification manual there and highlight only what you need to know as you begin collecting your data for each measure. Also keep the reporting schedule nearby for quick reference.
- Work with the IT team to automate as much of the data collection processes as possible. For example, for ASC measure 9, you will need to extract a list of patients who fall into the criteria, as well as the CPT codes listed in the specification manual. Subsequently, depending the ASC’s volume, six to eight patients are then randomly selected for the monthly report.
Addressing these issues proactively can improve your clinical management team and create the best results for your patients and staff. For more information on successful clinical leadership strategies, please contact Kathleen Bernicky at kbernicky@regentsh.com.
