Staffing Your Ambulatory Surgery Center For Success

Recruiting talent in healthcare is likely more difficult than in any other industry. According to the American College of Surgeons, the U.S. is on track to face a shortage between 15,000 and 30,000 surgeons within the next decade. As ASC development and HOPD-to-ASC conversions continue, independent ASCs will face an increasingly competitive talent market for surgeons.

The same can be said for nurses. From 2020 to 2021, the U.S. nursing supply dropped by more than 100,000. Taken alongside the fact that enrollment in four-year nursing programs dropped in 2022, it appears likely that nurse shortages will continue for the foreseeable future, providing another challenge for ASC. 

Finally, anesthesiologists are critical for ASCs, but finding anesthesiologists has grown increasingly difficult. The U.S. is expected to be short as many as 12,000 anesthesiologists by 2034.

Despite these challenges, it’s not all doom and gloom for your ASC. While ASCs are far from untouched by the staffing challenges plaguing the healthcare industry, they are uniquely prepared to attract staff. For example, ASCs may give surgeons the potential to own equity in their workplace, with greater control over their schedule and improved efficiency when compared to practicing at a hospital. This allows surgeons to increase their earnings and attain a better work-life balance, naturally increasing an ASC’s ability to attract top talent in a strained market. Likewise, ASCs can help attract and retain other healthcare professionals like anesthesiologists, nurses, and surgical assistants thanks to comparatively predictable schedules and working hours.

In this article, we’ll delve into the staffing challenges your ASC will face as it enters the market, and share best practices for reaching financial stability.

Optimize Your Staffing Based on Your ASC’s Scale, Specialization, and Demographics

Staffing your facility is a formidable challenge, but when it comes to recruitment, ASCs have several advantages and opportunities compared to the traditional hospital setting. One of the key advantages that ASCs face is that their scale requires only a fraction of the staff of a hospital OR thanks to the outpatient basis of work. However, there are numerous other factors that ultimately influence an ASC’s staffing needs. Some of those factors include:

  • The size of the ASC: A larger ASC may require more staff across all categories to handle a higher volume of patients and a broader range of services.
  • The specialty of the ASC: Some ASCs perform a wide variety of outpatient procedures. Others, on the other hand, only offer a few common procedures, which they do more of. This is especially true of newly established ASCs, they may focus on a limited number of procedures until their cash flow stabilizes. The procedures your ASC performs will inform your need for surgical staff, support nurses, administrators, and more.
  • The ASC’s location and patient population demographics: The location of your ASC and the demographics of the patient population can also affect your staffing needs. For example, an ASC in an urban area with a largely young population will have different staffing needs than one in a rural community with an aging population.

At the end of the day, establishing a successful and sustainable ASC isn’t just about hiring the right people, but assuring that your staff composition aligns with the facility’s operational dynamics and patient needs. 

As you work toward establishing your facility, consult with experts in ASC management. Sullivan Healthcare Consulting’s team has decades of experience with ASCs and can help you identify the right staffing needs for your facility based on the market it operates in. To learn more, talk to an expert today

Define the Key Staff Roles For Your ASC

If your ASC was a structure, your staff would be the foundation. How strong or weak that foundation is will ultimately determine your ASC’s success. While you’re likely already familiar with the essential positions for a successful team, we’ll touch on them briefly here.

1. Surgical Staff

If you haven’t already formed a group of surgeons who will join your ASC, you’ll need to recruit board-certified surgeons to join the organization. Depending on the procedures that your facility will offer, you may want to target candidates with specialized training and clinical experience in those procedures. Regardless of what direction your ASC takes to bring surgeons on board, they should have a proven track record in outpatient surgery or prior experience in an ASC.

Finally, anesthesiologists are absolutely pivotal to the success of your ASC. Their ability to develop and administer anesthetic plans is foundational for patient safety and your facility’s ability to build a strong reputation with referring physicians and the patient population.

Related read: Anesthesia workforce shortages and how to navigate them

2. Nursing Staff

In addition to surgical staff, your ASC will need to hire nurses to prepare patients for surgery. Nurses are essential for assuring success throughout the entire perioperative process, from admission and the procedure itself, to the recovery and discharge process.

Nursing staff play an important role in supporting your ASC’s patient throughput goals, which is vital for achieving profitability and sustainability. Invest in retention from the moment a nurse accepts a position. By doing so, your nursing staff will be stable and loyal, even during challenging times. 

3. Support and Administrative Staff

Finally, your ASC will need support and administrative staff. Medical office administrators, facility managers, medical technicians such as sterile processing staff, and more will help move patients through the facility seamlessly. 

While your facility’s surgeons, assistants, and nurses may be the proverbial stars of the show, your administrators and managers are the crew who keep things moving smoothly outside the OR. 

As you establish your ASC, give abundant care to identifying the roles that you need to fill. Finding and recruiting the right staff can ultimately make or break your facility, regardless of whether they’re inside the OR or greeting patients at the front desk. 

Develop a Payroll Budget

In most healthcare settings, the labor-to-supplies cost ratio is roughly 80:20. However, in the OR, that ratio is flipped to 35:65. It’s not that labor is less costly than outside of the surgical setting, it’s simply that equipment costs are significantly higher. 

As your ASC gets up and running, a comprehensive payroll budget will prevent you from burning your cash and truncating your facility’s runway. A payroll budget will help guide your organization’s hiring decisions and provide the economic framework to reach financial stability.

While you create your payroll budget, identify your minimum viable staff level. While your ASC is getting established, finding the right staffing balance is more important than ever. Understaffing can put patient safety at risk, hinder your ability to build a referral network, and drive burnout and therefore a poor employer reputation. Alternatively, overstaffing can inflate your operating expenses beyond a sustainable level, damaging your organization’s ability to remain a going concern. Identifying your minimum viable staffing level — essentially, the right amount of staff — is vital for building a fiscally sustainable ASC.

To keep your payroll budget in control while still attracting top candidates, consider creative benefits that have little to no immediate cost to your organization, while still offering candidates what they want.

And if you don’t know where to start when it comes to defining a payroll budget for your ASC, get in touch with Sullivan Healthcare Consulting. We’ve helped ASCs across the country to develop sustainable practices from day one.

Assure Your Compliance With Staffing and Employment Laws and Regulations 

There’s no question that maintaining legal and regulatory compliance for ASCs is a significant hurdle for new ASCs. When it comes to staffing your facility, the same concerns apply. Carefully navigating the intricate web of employment laws and regulations your ASC faces at the federal, state, and local level is essential, not only for compliance but also for ensuring the highest standards of patient care and safety.

In addition to ensuring each employee in your facility possesses the proper licensure and performing thorough background checks, your ASC needs to stay apprised of changes to employment laws and healthcare regulations. To accomplish this, consider designating a compliance officer who is responsible for monitoring regulatory changes and making updates or escalating information when necessary.

For example, many medical specialities had changes made to their continuing education requirements during COVID-19. Since then, some have returned to their prior requirements. A compliance officer should monitor these changes and help keep staff and key stakeholders up to date. Doing so not only benefits other staff, but protects your ASC from regulatory liabilities and risks.

Ready to Develop an ASC That Attracts Top Talent? Talk to Sullivan’s Consultants Today

Your ASC’s staffing is crucial for long-term stability and profitability. To attract and retain that talent in a fiercely competitive labor market, your organization needs to be set up for success. Sullivan Healthcare Consulting can help you get there.

SHC has the experience and expertise to guide your group to create and operate a successful ASC that provides high-quality surgical care to patients conveniently and efficiently while achieving a healthy bottom line. Contact Sullivan Healthcare Consulting’s team of experts today to learn more about starting an ASC.

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