Ralph Gambardella, MD, an orthopedic surgeon and president of Kerlan-Jobe Surgery Center in Los Angeles, discusses five key leadership roles essential to the success of an ASC and describes the characteristics necessary for these positions to find success.
1. Medical director. ASCs should have a medical director who is focused on making sure the facility maximizes efficiency and continuously improves clinical outcomes by applying processes and procedures that achieve those goals. In addition to this, medical directors must ensure fellow physicians and staff members are complying with the processes and procedures to minimize risk and maximize positive outcomes for both the ASC and the patient, Dr. Gambardella says.
"The medical director first needs to set the appropriate criteria in place for having a surgery center because it's all about managing risk," he says. "For example, if a physician has a patient in need of an operation, the medical director should disapprove that operation if the patient doesn't meet the medical criteria for the procedure."
The medical director should be setting up guidelines that are as simple as when to cancel or postpone a surgery, whether the reason is lack of medical clearance from payors or poor communication between the physician and the patient about an upcoming surgery. "It's all about setting up the appropriate guidelines to make sure the patients are well taken care of," he says.
2. Administrator. The administrator of an ASC is responsible for overseeing business and clinical operations of the facility. Dr. Gambardella says that although administrators generally could benefit from having a background in business, great customer service should by and large be the administrator's first priority.
"A lot of what administrators do is put out fires, so they have to be able to interact with patients," he says. "If there is patient who traveled two hours to see a surgeon at an ASC but finds out his insurance isn't accepted at the facility, it's the administrator who is called to handle that. So even though there may be added benefit for hiring an administrator from a great business school, that person has to have the skills to interact with multiple kinds of people in various circumstances."
3. Director of nursing. The director of nursing is tasked with ensuring the ASC has the appropriate personnel to operate the facility on a day-to-day basis. It is critical that the nursing director has excellent communication skills and is constantly keeping in touch with other staff members, such as the scheduler, technicians and nursing staff, so there is a right balance of staff members to maximize case load and patient flow.
"The director of nursing has to be able to react and keep all operations of the ASC moving," Dr. Gambardella says. "How do you get another staff member to fill in for another co-worker until 4 p.m. when they don’'t have to? It's all about people skills and how the director of nursing can get the most out of their staff members."
This position also typically works with the medical director for guidelines on infection control, which is a growing issue and concern for ASCs as they scramble to implement programs to minimize the incidence of infection and meet accreditation standards.
4. Materials manager. An often-overlooked position in ASCs, the materials manager is focused on monitoring inventory or par levels of all supplies, closely watching the prices of each supply and minimizing waste as much as possible. Dr. Gambardella says this position is crucial from a financial standpoint as ASCs look for ways to cut down costs and maximize profits in light of decreasing reimbursements.
"The head of materials management supervises every single item in an ASC, whether it is as simple as drapes to implants and arthroscopic equipment," he says. "This person has to make sure his or her priority is getting the lowest price point on all the goods and thinking of innovative ways to lower costs of supplies because supply costs are typically the largest expense after salaries."
5. Business office manager. Business office managers are critical to protecting an ASC's bottom line because they are typically charged with collecting money from patients in a timely and efficient manner, Dr. Gambardella says. An effective business office manager also monitors payor contracts and reimbursements for procedures.
"Our business office manager's major goals have been aimed at trying to figure out how to receive payments from patients sooner and getting paid correctly for the medical service that was [performed]," he says. "They also are constantly reviewing, updating and changing somewhere around 30 different payor contracts to maximize coverage and making sure the [insurance] companies are reimbursing us properly according to the contracts."
Learn more about Kerlan-Jobe Surgery Center.
1. Medical director. ASCs should have a medical director who is focused on making sure the facility maximizes efficiency and continuously improves clinical outcomes by applying processes and procedures that achieve those goals. In addition to this, medical directors must ensure fellow physicians and staff members are complying with the processes and procedures to minimize risk and maximize positive outcomes for both the ASC and the patient, Dr. Gambardella says.
"The medical director first needs to set the appropriate criteria in place for having a surgery center because it's all about managing risk," he says. "For example, if a physician has a patient in need of an operation, the medical director should disapprove that operation if the patient doesn't meet the medical criteria for the procedure."
The medical director should be setting up guidelines that are as simple as when to cancel or postpone a surgery, whether the reason is lack of medical clearance from payors or poor communication between the physician and the patient about an upcoming surgery. "It's all about setting up the appropriate guidelines to make sure the patients are well taken care of," he says.
2. Administrator. The administrator of an ASC is responsible for overseeing business and clinical operations of the facility. Dr. Gambardella says that although administrators generally could benefit from having a background in business, great customer service should by and large be the administrator's first priority.
"A lot of what administrators do is put out fires, so they have to be able to interact with patients," he says. "If there is patient who traveled two hours to see a surgeon at an ASC but finds out his insurance isn't accepted at the facility, it's the administrator who is called to handle that. So even though there may be added benefit for hiring an administrator from a great business school, that person has to have the skills to interact with multiple kinds of people in various circumstances."
3. Director of nursing. The director of nursing is tasked with ensuring the ASC has the appropriate personnel to operate the facility on a day-to-day basis. It is critical that the nursing director has excellent communication skills and is constantly keeping in touch with other staff members, such as the scheduler, technicians and nursing staff, so there is a right balance of staff members to maximize case load and patient flow.
"The director of nursing has to be able to react and keep all operations of the ASC moving," Dr. Gambardella says. "How do you get another staff member to fill in for another co-worker until 4 p.m. when they don’'t have to? It's all about people skills and how the director of nursing can get the most out of their staff members."
This position also typically works with the medical director for guidelines on infection control, which is a growing issue and concern for ASCs as they scramble to implement programs to minimize the incidence of infection and meet accreditation standards.
4. Materials manager. An often-overlooked position in ASCs, the materials manager is focused on monitoring inventory or par levels of all supplies, closely watching the prices of each supply and minimizing waste as much as possible. Dr. Gambardella says this position is crucial from a financial standpoint as ASCs look for ways to cut down costs and maximize profits in light of decreasing reimbursements.
"The head of materials management supervises every single item in an ASC, whether it is as simple as drapes to implants and arthroscopic equipment," he says. "This person has to make sure his or her priority is getting the lowest price point on all the goods and thinking of innovative ways to lower costs of supplies because supply costs are typically the largest expense after salaries."
5. Business office manager. Business office managers are critical to protecting an ASC's bottom line because they are typically charged with collecting money from patients in a timely and efficient manner, Dr. Gambardella says. An effective business office manager also monitors payor contracts and reimbursements for procedures.
"Our business office manager's major goals have been aimed at trying to figure out how to receive payments from patients sooner and getting paid correctly for the medical service that was [performed]," he says. "They also are constantly reviewing, updating and changing somewhere around 30 different payor contracts to maximize coverage and making sure the [insurance] companies are reimbursing us properly according to the contracts."
Learn more about Kerlan-Jobe Surgery Center.