Gregory DeConciliis – Opening an ASC: Clinical Preparation
Here’s what to expect on this week’s episode. 🎙️
At what point in opening a new surgery center should you start preparing the clinical side of the house?
Gregory DeConciliis is no stranger to the process of building and expanding surgery centers, and he joins us this week to answer all your clinical prep questions, such as who your first hire should be and when, which clinical team members you need for licensing, how to prepare for quality reporting, and more. Here’s a sneak preview:
➡️ In a perfect world, you’ll hire an administrator with a clinical background during the design stage. They’ll address clinical concerns, like policy creation, equipment choices, and room setup. If the administrator lacks a clinical background, then hiring a clinical manager in tandem, like a nurse manager, is essential.
➡️ Next up? An experienced OR or PACU nurse, followed by a materials manager, to help with everything from ordering large equipment to more minor details.
➡️ Overall, start with enough staff for one room for the test cases, then slowly ramp up as more rooms become operational. The nurse manager can initially function as a hands-on nurse, gradually transitioning to a managerial role.
➡️ Start prepping for quality reporting as soon as you have clinical resources. Technology, such as an EMR, can streamline processes for measuring and reporting quality metrics and help improve clinical workflows.
➡️ Regular communication and monthly meetings with staff and stakeholders can smooth out operational kinks and drive continuous improvement.
Interesting in learning more about opening a new surgery center? Check out our previous episodes:
• Michael McClain – Opening an ASC: Navigating Payer Contracts
• Wil Schlaff – Opening an ASC: Conducting a Comprehensive Feasibility Assessment
• Dawn Pfeiffer – Ask the Expert: Best Practices for Opening a New Surgery Center
• Beata Canby – Opening an ASC: Managing the Regulatory and Certification Process
Find the full episode on Apple Podcasts, Spotify, or YouTube to hear all the details.
Episode Transcript
0:01
welcome to this week in surgery centers
0:03
if you’re in the ASC industry then
0:05
you’re in the right place every week
0:08
we’ll start the episode off by sharing
0:09
an interesting conversation we had with
0:11
our featured guest and then we’ll close
0:13
the episode by recapping the latest news
0:16
impacting surgery centers we’re excited
0:18
to share with you what we have so let’s
0:20
get started and see what the industry’s
0:22
been up
0:23
[Music]
0:26
to hi everyone here’s what you can
0:29
expect on today’s episode Greg dilus is
0:32
a PA and administrator at Boston
0:34
Outpatient Surgical Suites and he’s on
0:37
today to share tips and insights on how
0:39
to properly prepare the clinical side of
0:41
the house while you’re opening a new
0:43
Surgery Center in this fifth episode of
0:46
our denovo series we’ll cover who your
0:48
first hire should be and when which
0:50
members of the clinical team you must
0:52
have in place to receive all the
0:54
necessary licensing how to prepare for
0:56
Quality Reporting and just other
0:58
clinical considerations to keep in
1:01
mind in our news recap we’ll cover what
1:04
the feature holds for the outpatient
1:06
surgery Workforce a decapitated young
1:08
boy who was saved by his surgical team
1:11
tips for working with local authorities
1:14
to create an emergency plan and of
1:16
course end the new segment with a
1:18
positive story about a ground bre
1:20
breaking surgery uh that gave a woman
1:23
her voice back hope everyone enjoys the
1:25
episode and here’s what’s going on this
1:28
week in surgery centers
1:31
[Music]
1:34
Greg welcome to the show thank you for
1:36
having me so Greg we are doing a series
1:39
of podcasts here on the NOA process to
1:41
open a new facility and wanted to focus
1:44
our conversation today on the clinical
1:47
side of the operation and so first
1:49
question for you at what point in the
1:52
denovo process should owners start to
1:54
think about preparing for the clinical
1:57
side of the house sure so I look at at
2:00
this in a couple of different ways first
2:01
off if it was just owners and they had
2:04
nobody else affiliated with the ASC a
2:06
group of docs out there trying to go
2:07
open up a surgery center you should have
2:09
somebody who’s involved again and this
2:11
isn’t like a selfish plug here but
2:13
somebody like an administrator or
2:14
something like that who is there who you
2:16
commit the cost to to oversee docs are
2:18
busy being docs yeah and if there’s a
2:20
management company typically the
2:21
management company may handle some of
2:23
these services but they look at their
2:24
situation and it’s good to have somebody
2:27
on board a higher level person admin
2:29
ministrator type who has the authority
2:31
to the function as a CEO and make some
2:32
of these everyday decisions that you’re
2:35
going to need so the docs can’t be
2:37
bogged down with all the details and so
2:38
that that question of then who is that
2:40
administrator who is that person
2:42
administrators I think we see as often
2:45
clinical like they’re often nurses who
2:46
have transitioned to this administrator
2:48
role but they could also just be
2:49
business focused and so with the
2:51
clinical question that you asked if
2:53
they’re not clinical I think then you
2:55
look at having bringing on some kind of
2:57
manager as like a nurse manager or some
3:00
kind of person who has some clinical
3:01
background to answer all of these
3:03
clinical questions that’ll pop up and
3:05
it’s not just what kind of products we
3:07
have to order and all that kind of stuff
3:08
it’s also like how do we set up polic
3:10
and procedures what kind of equipment or
3:13
even early on airflow and different
3:16
devices we may put in the room or we
3:17
build in the room that you may need to
3:20
make sure it it functions to be
3:22
clinically efficient and clinically
3:24
approved and all that kind of stuff and
3:25
so every situation is different and and
3:28
the answer is simply clinical person
3:30
should be on very early because those
3:31
ISS start very early on even in design
3:34
but if somebody’s listening they’ve
3:36
already passed design and they’re at the
3:37
stage of it’s being built Etc all those
3:40
equipment decisions have to take place
3:42
and they those take a while there’s lead
3:43
times and some of these things and so I
3:45
would say it it would be worthwhile to
3:47
make the investment as early as possible
3:49
and if that person can also handle
3:51
higher level decisions CEO type
3:53
decisions that’s even better got it so
3:56
it sounds like in an Ideal World you’ve
3:58
got an administrator someone with some
4:00
clinical experience that can help in the
4:02
design and preparation stage what about
4:05
as you get closer to opening yeah what
4:09
is the order of operations around hiring
4:12
clinical staff yeah so then if you’re
4:15
close to opening there’s so many
4:17
clinically applicable processes that
4:19
have to take place that again if you’re
4:20
an administrator who’s just been running
4:22
the show the whole time getting things
4:24
going you should bring a clinical person
4:26
on ASAP I feel again it’s an expense but
4:29
there’s be so much to do bringing on
4:31
somebody to the higher level like a
4:32
manager type thing is probably going to
4:34
be easier and they probably would have
4:35
the skill set then to do some of the
4:36
hiring and some of those processes and
4:39
so I think that nurse manager type
4:41
person or maybe even somebody who if
4:43
there’s you can’t find a good nurse
4:44
manager or the group doesn’t want to
4:46
make that commitment right away it could
4:48
be somebody who an O nurse or an
4:51
experienced pacing nurse somebody who
4:52
can actually help with some of those
4:54
again policies and clinical decisions so
4:57
I think that’s the first person and the
4:58
second person or even one a is probably
5:00
a materials manager type person who
5:02
would help with a lot of the ordering
5:04
from things like again lights and Booms
5:06
as as big as that down to bedside tables
5:08
and kick buckets so there’s a lot of
5:11
things that take place and don’t forget
5:12
when those things come in they have to
5:13
be put together and there’s all that
5:15
element of so I think there’s when that
5:17
decision-making tree cost is probably
5:19
part of it and how much to spend how
5:21
much you want to spend and at what point
5:23
but my my point is like the bang for the
5:25
buck type thing you may get somebody
5:27
who’s a little more experienced with a
5:28
little more of a manag type function in
5:30
the past that that can really help you
5:32
out sure what about licensing which is
5:36
certainly part of the denovo process and
5:38
getting licensed and credentialed does
5:40
clinical background and expertise
5:43
important or play into that licensing
5:46
process yeah I think so many of those
5:48
lure and certification elements are
5:50
clinical there’s certainly a lot of
5:52
business aspects as well and so having
5:54
someone who’s clinical to help even with
5:56
the application but to prepare for those
5:58
surveyors to come in in we usually have
6:00
to start with these test cases and and
6:02
then you have to go through the business
6:03
aspects of Contracting if you don’t go
6:04
through test cases and your facility
6:07
doesn’t get CMS certified and Triple H
6:09
whoever they’re going to use you can’t
6:11
get those insurance contracts and so
6:12
that clinical person tees you up for
6:14
that and tees you up for those test
6:15
cases and the ability to actually start
6:18
performing surgery so I I keep talking
6:20
about kind of spending and bringing
6:21
people in and all that kind of stuff I
6:23
think where you can cut back is that
6:25
there is definitely a lag between
6:26
forming those test cases having this
6:28
accreditation certifications all that
6:30
kind of stuff done the licens your stuff
6:32
and so you don’t want to just hire all
6:34
your staff assuming that in our case
6:36
we’re going to open up eight rooms all
6:37
eight rooms are open you get enough
6:39
staff a nurse a tech and again support
6:42
staff sterilization Texs all that kind
6:44
of stuff enough to just run one room and
6:46
do those required test cases and then
6:49
you can take that lag time to then do
6:50
hiring and bring in new folks I think
6:52
it’s helpful I always say the best way
6:54
to hire people is word of mouth and so
6:56
utilize your docs and again bring in
6:59
your best person to start maybe your
7:00
person is more of a go-getter who’s
7:02
going to be willing to put some extra
7:03
time into again build something put
7:05
something together and that type of
7:06
thing really they’re not shy from
7:08
looking at policies and procedures and
7:10
doing paperwork and all that kinds of
7:11
stuff those are your first in and then
7:13
you can start highing do that second
7:15
round after those test cases are done
7:17
those kind of certifications are done
7:18
and then you’re getting ready to open
7:20
just everything went well from your
7:22
survey yeah and I think that’s a good
7:24
tip because it sounds like those test
7:25
cases are important part of the process
7:28
and the licensing process and so you
7:30
know Staffing up for one room and then
7:32
as you get closer to opening you know
7:34
for your facilities as an example I’m
7:36
sure you didn’t go day one all 8s are
7:39
just full go right your your case volume
7:42
over time which allows you to staff in
7:44
phases and use your head like so if your
7:46
nurse manager is also an or nurse or
7:49
also a Pac you nurse or preup nurse have
7:51
them be in the mix early on at the onset
7:53
let them realize that you’re going to be
7:55
manager do all these things but early on
7:56
you’re going to have to be a working
7:58
manager and it’s going to allow us to
7:59
hold off on on hiring that additional o
8:02
nurse that additional pack un nurse
8:03
You’re Going to function that role until
8:05
we have enough insurances on board Etc
8:08
to start open up the volume you know
8:09
what I mean so yeah a step-wise plan
8:11
that is smart is thought out well and
8:14
hopefully relies on somebody with some
8:15
experience to help you formulate that
8:17
yep yep okay great wanted to talk a
8:20
little bit Greg about the Quality
8:22
Reporting side of it and I think the CMS
8:24
currently has 20 or so Quality Reporting
8:27
measures that you’ve got to report on I
8:29
think there’s another one proposed for
8:30
for 2024 they’ll take it to
8:33
21 what tips or best practices have you
8:36
seen for new asc’s to develop
8:38
infrastructure groundwork systems to
8:41
start measuring and Reporting on those
8:43
quality measures from the beginning take
8:45
that in mind as you build out the
8:47
process yeah it’s a really good question
8:49
because some things like this sometimes
8:51
are on put in the back burner and then
8:52
again you start with your processes and
8:54
you’re like oh I forgot and I forgot
8:56
about this so I think the key piece for
8:58
us has been assigning
8:59
individuals to handle each quality
9:01
measure that one two three five 20
9:03
whatever they are and how are they going
9:05
to be able to collect the data and how
9:07
be a to report it do they have all the
9:08
resources they need to go ahead and get
9:10
that going and so yeah I think if we’re
9:12
thinking about denova projects putting
9:14
systems in place that allow you to track
9:17
this efficiently to maybe even the
9:19
technology reports it for you whatever
9:21
it is but making sure that there’s
9:23
accountability reporting it and again
9:25
it’s as easy to do it as possible and
9:27
again for us technology help with that
9:29
different systems that we use we just
9:31
went to an EMR in January and so I think
9:35
again some of the smarter systems now
9:37
the newer Technologies are aware of
9:39
these types of things and help you with
9:40
the data collection Etc Great what about
9:44
the clinical workflows is you get set up
9:46
just in terms of hey how do we treat
9:48
different types of cases who does what
9:51
how do we get the Rhythm and Mojo going
9:53
is it challenging to do that from
9:55
scratch with the new facility definitely
9:57
I think what I find challenging and
9:59
again we’re an existing Center and I’ve
10:01
been here for 19 years and I’m fortunate
10:03
to have that experience now going
10:04
forward with our new project but there’s
10:06
so many different Technologies out there
10:08
it’s who can you work with to get the
10:11
biggest bang for your buck there’s just
10:12
no question that the margins in our
10:14
business have to be tight because of how
10:16
we’re reimbursed and so utilizing
10:18
technology to streamline your processes
10:20
and that type of stuff is really key and
10:22
so my thought would be take that time as
10:24
you’re ramping up in the early stages as
10:26
you’re filling your days with a million
10:28
different things but looking evaluate
10:30
Technologies and find out the ones that
10:32
can work for you best that you can
10:33
Implement right off the bat and again
10:34
they’re going to help you with
10:35
efficiencies and costs and Staffing all
10:38
these types of things that are out there
10:39
so work smarter not harder again people
10:41
say it all the time but it’s really true
10:43
there’s a lot and try and get a
10:44
technology that gives you multiple
10:46
offerings and biggest bank for your buck
10:49
yep and I think sometimes facilities
10:51
that are looking to implement emrs that
10:54
are established facilities and have
10:57
processes in place
10:59
sometimes find it a challenge to shift
11:01
to a software based system where they
11:03
may have to change some process and
11:04
operations have you found that it’s
11:06
potentially easier if you’re starting
11:08
facility from scratch and hey we’re
11:10
going to use an EMR we’re going to use a
11:11
clinical workflow system you can design
11:13
your processes without in mind thousand
11:16
per I think it’s just it’s the all that
11:18
is everyone hates change right and so if
11:19
you do it from the onset and I think
11:21
it’s an important thing to think about
11:23
and I’m happy you bought it up because
11:25
it’s one of those things where again
11:26
everyone’s concerned about cost and so
11:28
you’re like oh to pay this at the onset
11:29
why don’t we just open up and then when
11:31
we get a little bit of some money
11:33
together and we get some good volume
11:34
going we’ll transition I just think
11:36
things like again like EMR is a perfect
11:38
example starting from scratch is the way
11:40
to go and I actually find that companies
11:43
these days if you actually talk to them
11:45
and treat them as a true partner and go
11:47
over your pain points and your
11:49
hesitations they’ll often times will
11:51
work with you everyone wants the
11:52
business right and they’ll probably
11:54
understand that having you as an early
11:55
adopter is key and so you know so many
11:58
of these em R companies now have add-on
12:00
features that you can do and so as I
12:02
mentioned biggest bang for your bucket
12:04
I’d start there and see what those
12:06
companies can add on and it’s just a
12:09
little bit of a plug for you guys but
12:10
you guys have so much in your bag right
12:13
and so does some of the other companies
12:14
as well and so see what’s offered under
12:16
one umbrella first and then you can go
12:19
on and peace meal some of the other
12:20
things sure sure yep yep what about
12:24
working out the Kinks as you start to
12:26
ramp up case volume is you start to go
12:28
for one room to two what have you found
12:31
is helpful in terms of the early days
12:34
the clinical operations in terms of
12:37
working out the process in The Kinks as
12:38
you scale my biggest recommendation
12:41
would be don’t get stagnant and just
12:43
keep going I think early meetings as
12:45
much as can be painful I think there’s
12:47
time early on but meeting with the staff
12:49
as often as possible and for us and I
12:52
mentioned this in my last podcast I
12:53
think one of our biggest keys to success
12:55
was having monthly meetings for not only
12:57
our staff but our surgeons as well that
12:59
were owners in the facility could have
13:01
some kind of impact and communicating
13:03
everything to them it was really key not
13:05
a a long meetings it was a focused
13:08
meeting on certain topics some things
13:10
could get brushed over but some things
13:11
they were involved in and so I think
13:12
same thing with the staff as you get
13:14
going you figure out what went well this
13:15
last case or this last week and what can
13:17
we do better and again it sounds cheesy
13:19
but it’s really important I think to
13:21
make sure you’re running things as
13:22
smoothly as possible and then when new
13:23
folks come in even in the hiring process
13:25
you have to let them know listen you’re
13:26
going to have to be really flexible when
13:28
you come in and realize this is the way
13:29
we do things and you’re going to have to
13:30
adopt the way we do things we’re always
13:32
open to listen to to change and to doing
13:33
things better Etc but you’re going to
13:35
have to listen to How we do things we
13:37
have a process we go about and like we
13:39
turn over a room we do it this way when
13:40
we admit a patient we do it this way
13:42
tell us how we can do it better but this
13:44
is our process and this is how we’re GNA
13:45
do it so we’re always gonna be
13:47
reevaluating but involving the staff and
13:49
the docs in that I think it’ll be really
13:51
beneficial yep makes sense Greg final
13:54
question for you and we do this each
13:56
week with our guests what is one thing
13:57
our listeners can do this week to
13:59
improve their surgery
14:01
centers yeah I think it just goes hand
14:03
in hand what I was just talking about I
14:05
know for myself it’s the same thing we
14:07
know there’s all this technology out
14:09
there and they know there’s all these
14:10
different ways we can do things using
14:12
computers and iPads and streamlining
14:13
processes but I think all of us
14:15
associate it with cost and I think
14:18
people just got to take the time to
14:20
evaluate some of these companies realize
14:22
that they may be putting some money up
14:24
front for sure but the return on that on
14:27
efficiencies and on doing things better
14:29
from Clinical quality to staff
14:32
satisfaction patient satisfaction
14:34
surgeon satisfaction the return is
14:36
exponential and so take the time to do
14:38
it don’t be scared of it and I think
14:40
you’ll find that there’s going to be a
14:41
lot of benefits in the back end I know
14:42
we’re coming to end of the summer here
14:44
and that’s when people have a little
14:45
extra time to do things it’s going to
14:46
get busy again in the fall but if you
14:47
can carve out some time to do some
14:49
evaluations early on I think we found
14:51
that we took the plunge on a lot of
14:52
these things and it’s really changed the
14:54
way we do things for the better
14:56
fantastic Greg appreciate your time
14:58
enjoyed the conversation thanks thanks
15:00
for joining us today thanks again for
15:01
having me appreciate
15:05
it as always it has been a busy week in
15:08
healthcare so let’s Jump Right In five
15:11
administrators shared their predictions
15:13
with Becker’s ASC on what the future
15:15
holds for the outpatient surgery
15:17
Workforce and how they see it changing
15:20
in the next two to three years so at a
15:22
high level here’s what each admin shared
15:26
Les jebson from Prisma Health shared
15:28
that es have historically benefited from
15:31
predictability in work hours and
15:33
perceived overall quality of
15:34
professional life but with labor market
15:37
strains and Rising salaries due to
15:40
limited labor pools they suggest keeping
15:42
an eye on employee turnover rates in
15:45
frequency and doing a semiannual market
15:48
analysis on Market
15:51
compensation Omar shakar from Illinois
15:54
gastro Health suggests that we meet our
15:57
employees where they are just like we do
15:59
with our patients so previously we could
16:02
say hours are 8 to5 Monday through
16:04
Friday but your staff might want early
16:07
morning hours or evening hours so
16:10
adapting to what your limited staff
16:12
wants assuming you can accommodate it is
16:15
important to provide both routine and
16:17
flexibility in order to retain the best
16:20
staff Matthew reader from Harris health
16:23
outpatient Center predicts that younger
16:25
individuals will be entering the
16:27
peroperative arena and second career
16:30
individuals will start moving to asc’s
16:32
due to attractive nursing compensation
16:35
he’s also anticipating an expected rise
16:37
in gender diversity and increasing
16:40
demands for part-time or supplemental
16:43
status Ken sha from Brentwood Surgery
16:47
Center says some challenges are headed
16:49
this way such as early retirements
16:51
burnout or career shifts which will
16:54
result in increased wage demands longer
16:56
surgical uh days and a competitive
16:59
Advantage for larger asc’s or Hospital
17:02
Systems so asc’s will likely need to
17:05
match hospital system pay scales
17:07
abandoning the previously lesser pay
17:10
compensated by shorter working
17:12
hours and lastly Andrew Weiss from
17:15
Summit Surgical Center is seeing a trend
17:18
in increased competitiveness in terms of
17:21
salaries benefits and scheduling
17:23
flexibility he’s also seeing that many
17:25
employees now prefer part-time hours or
17:28
per DM shifts due to work life
17:31
balance so there’s definitely some
17:33
Trends in there that are consistent and
17:35
shouldn’t surprise anybody but there’s
17:37
also some good reminders in there about
17:39
being flexible and what you can expect
17:41
to come in the next couple of
17:44
years our second story comes from
17:47
Medscape and it’s wild as a non-clinical
17:50
person I’m not going to lie this story
17:52
did make me a little squeamish to think
17:55
about but we will get through it and
17:56
it’s too fascinating not to share
18:00
Soloman Hassan is a 12-year-old boy who
18:03
was riding his bicycle on the West Bank
18:06
and he was involved in a car accident
18:08
where he suffered life-threatening
18:10
injuries he was transported by
18:13
helicopter from the scene of the
18:15
accident to hadassa Medical Center in
18:18
Jerusalem when he arrived they realized
18:21
he actually had atlanto occipital
18:24
dislocation often referred to as
18:27
internal
18:29
decapitation so when I hear decapitation
18:33
I think of terrible scenes from movies
18:35
and things like that this is not that
18:37
but when he arrived he was in a neck
18:39
brace and actually fully conscious so
18:42
they monitored and treated him and made
18:45
sure he was stable but they did quickly
18:47
realize that he had a pretty severe neck
18:51
injury so his doctor was Dr Ohad aav and
18:56
thankfully once he saw the C t scan he
18:59
knew exactly what needed to be done and
19:02
luckily had similar experiences during
19:05
his Fellowship so he went into the
19:08
surgery with plan a and also two
19:11
contingency plans and only allowed the
19:13
most experienced members of his team to
19:16
help now in the article Dr aav explains
19:21
the entire process in detail so I highly
19:23
recommend giving it a read but basically
19:26
the surgery went incredibly well and
19:28
they were able to use Hardware to fuse
19:30
The Head and the neck back together he
19:33
spent the 12-year-old boy spent a few
19:35
weeks recovering and they were
19:37
monitoring him for infections and and
19:40
any other complications and everyone is
19:42
doing great so this could have been a
19:45
really tragic story but instead thanks
19:47
to the brilliant surgical team this
19:49
12-year-old boy is alive and well so a
19:53
lot of news stories or a lot of news
19:55
stations are picking this up because you
19:57
hear decapitation and you hear somebody
19:59
lived and it’s just it’s fascinating to
20:02
see what the doctors had to do to keep
20:05
this young boy alive and that they
20:07
expect him to have a great
20:10
recovery our third story comes from ASC
20:13
focus and they’re sharing tips for
20:15
working with local authorities to create
20:17
an emergency plan so this story has two
20:21
angles to it the first is letting local
20:24
authorities know that if your surgery
20:26
center isn’t experiencing an emergency
20:28
here are the resources that you’ll need
20:31
but the second angle is the reverse if
20:33
your community is in a state of
20:35
emergency here’s how the surgery center
20:37
can help so let’s tackle the first Marcy
20:41
moon is the emergency coordinator for
20:44
Union City Surgery Center in Union City
20:46
which is a small rural town in Northwest
20:49
Tennessee and she shared that the center
20:52
does not have access to many of the
20:54
resources available in metropolitan
20:56
areas making it even more more important
20:58
for the ASC to collaborate with local
21:01
authorities and by sharing knowledge and
21:03
experience and pulling resources they
21:06
can all be better protected and prepared
21:08
for emergencies or natural
21:10
disasters Marcy did extensive Outreach
21:14
to various entities in her community
21:16
including the EMA director police and
21:19
fire departments and the emergency
21:21
coordinator at the local hospital she
21:23
said it’s very similar to networking and
21:25
they’ve already made recommended
21:26
improvements to the A se’s
21:29
plants now the second scenario is how
21:32
can you help what value do you bring to
21:34
your community Anne hadex CEO of
21:37
Southwest Surgical Suites in Fort Wayne
21:39
Indiana shared that local authorities
21:42
may not understand the capabilities of a
21:44
surgery center and the role it can play
21:46
in an emergency so hadex recommends
21:49
being prepared to discuss your asc’s
21:51
capabilities and resources it can offer
21:53
during any and all meetings with your
21:55
local authorities and if face with a
21:58
public health emergency Southwest
22:00
Surgical Suites is prepared to transform
22:02
into a dispensing site to assist with
22:05
countermeasures and dispensing so this
22:08
definitely reminds me of that famous JFK
22:10
quote ask not what your country can do
22:12
for you ask what you can do for your
22:15
country except SWA in communities and
22:17
surgery centers and that is the essence
22:19
of this article so thanks to ASA for the
22:22
helpful reminders and
22:24
tips and to end our new segment on a
22:27
positive note a groundbreaking surgery
22:30
gave a woman her voice back Shirley has
22:33
not been able to speak easily for over a
22:35
decade and recently her doctors
22:37
diagnosed her with spasma dysphonia a
22:41
voice disorder that causes involuntary
22:44
spasms of the muscles in the larynx a
22:47
doctor in Tel Aviv brought promising
22:49
news when she shared that doctors in
22:51
Japan developed an Innovative surgical
22:53
treatment involving taking fat from the
22:56
abdomen and inserting it into the vocal
22:58
fold to prevent spasms Charley was so
23:01
excited she didn’t question it for a
23:03
second and she became the first person
23:06
in Israel to undergo the surgery and as
23:08
soon as she woke up she was able to talk
23:11
again she said I feel like I’ve been
23:13
reborn and no one is stopping me from
23:15
speaking now so another really cool
23:18
story about surgeons all over the world
23:20
changing
23:22
lives and that news story officially
23:24
wraps up this week’s podcast thank you
23:27
as always always for spending a few
23:28
minutes of your week with us make sure
23:30
to subscribe or leave a review on
23:32
whichever platform you’re listening from
23:35
I hope you have a great day and we will
23:36
see you again next
23:46
week
welcome to this week in surgery centers
0:03
if you’re in the ASC industry then
0:05
you’re in the right place every week
0:08
we’ll start the episode off by sharing
0:09
an interesting conversation we had with
0:11
our featured guest and then we’ll close
0:13
the episode by recapping the latest news
0:16
impacting surgery centers we’re excited
0:18
to share with you what we have so let’s
0:20
get started and see what the industry’s
0:22
been up
0:23
[Music]
0:26
to hi everyone here’s what you can
0:29
expect on today’s episode Greg dilus is
0:32
a PA and administrator at Boston
0:34
Outpatient Surgical Suites and he’s on
0:37
today to share tips and insights on how
0:39
to properly prepare the clinical side of
0:41
the house while you’re opening a new
0:43
Surgery Center in this fifth episode of
0:46
our denovo series we’ll cover who your
0:48
first hire should be and when which
0:50
members of the clinical team you must
0:52
have in place to receive all the
0:54
necessary licensing how to prepare for
0:56
Quality Reporting and just other
0:58
clinical considerations to keep in
1:01
mind in our news recap we’ll cover what
1:04
the feature holds for the outpatient
1:06
surgery Workforce a decapitated young
1:08
boy who was saved by his surgical team
1:11
tips for working with local authorities
1:14
to create an emergency plan and of
1:16
course end the new segment with a
1:18
positive story about a ground bre
1:20
breaking surgery uh that gave a woman
1:23
her voice back hope everyone enjoys the
1:25
episode and here’s what’s going on this
1:28
week in surgery centers
1:31
[Music]
1:34
Greg welcome to the show thank you for
1:36
having me so Greg we are doing a series
1:39
of podcasts here on the NOA process to
1:41
open a new facility and wanted to focus
1:44
our conversation today on the clinical
1:47
side of the operation and so first
1:49
question for you at what point in the
1:52
denovo process should owners start to
1:54
think about preparing for the clinical
1:57
side of the house sure so I look at at
2:00
this in a couple of different ways first
2:01
off if it was just owners and they had
2:04
nobody else affiliated with the ASC a
2:06
group of docs out there trying to go
2:07
open up a surgery center you should have
2:09
somebody who’s involved again and this
2:11
isn’t like a selfish plug here but
2:13
somebody like an administrator or
2:14
something like that who is there who you
2:16
commit the cost to to oversee docs are
2:18
busy being docs yeah and if there’s a
2:20
management company typically the
2:21
management company may handle some of
2:23
these services but they look at their
2:24
situation and it’s good to have somebody
2:27
on board a higher level person admin
2:29
ministrator type who has the authority
2:31
to the function as a CEO and make some
2:32
of these everyday decisions that you’re
2:35
going to need so the docs can’t be
2:37
bogged down with all the details and so
2:38
that that question of then who is that
2:40
administrator who is that person
2:42
administrators I think we see as often
2:45
clinical like they’re often nurses who
2:46
have transitioned to this administrator
2:48
role but they could also just be
2:49
business focused and so with the
2:51
clinical question that you asked if
2:53
they’re not clinical I think then you
2:55
look at having bringing on some kind of
2:57
manager as like a nurse manager or some
3:00
kind of person who has some clinical
3:01
background to answer all of these
3:03
clinical questions that’ll pop up and
3:05
it’s not just what kind of products we
3:07
have to order and all that kind of stuff
3:08
it’s also like how do we set up polic
3:10
and procedures what kind of equipment or
3:13
even early on airflow and different
3:16
devices we may put in the room or we
3:17
build in the room that you may need to
3:20
make sure it it functions to be
3:22
clinically efficient and clinically
3:24
approved and all that kind of stuff and
3:25
so every situation is different and and
3:28
the answer is simply clinical person
3:30
should be on very early because those
3:31
ISS start very early on even in design
3:34
but if somebody’s listening they’ve
3:36
already passed design and they’re at the
3:37
stage of it’s being built Etc all those
3:40
equipment decisions have to take place
3:42
and they those take a while there’s lead
3:43
times and some of these things and so I
3:45
would say it it would be worthwhile to
3:47
make the investment as early as possible
3:49
and if that person can also handle
3:51
higher level decisions CEO type
3:53
decisions that’s even better got it so
3:56
it sounds like in an Ideal World you’ve
3:58
got an administrator someone with some
4:00
clinical experience that can help in the
4:02
design and preparation stage what about
4:05
as you get closer to opening yeah what
4:09
is the order of operations around hiring
4:12
clinical staff yeah so then if you’re
4:15
close to opening there’s so many
4:17
clinically applicable processes that
4:19
have to take place that again if you’re
4:20
an administrator who’s just been running
4:22
the show the whole time getting things
4:24
going you should bring a clinical person
4:26
on ASAP I feel again it’s an expense but
4:29
there’s be so much to do bringing on
4:31
somebody to the higher level like a
4:32
manager type thing is probably going to
4:34
be easier and they probably would have
4:35
the skill set then to do some of the
4:36
hiring and some of those processes and
4:39
so I think that nurse manager type
4:41
person or maybe even somebody who if
4:43
there’s you can’t find a good nurse
4:44
manager or the group doesn’t want to
4:46
make that commitment right away it could
4:48
be somebody who an O nurse or an
4:51
experienced pacing nurse somebody who
4:52
can actually help with some of those
4:54
again policies and clinical decisions so
4:57
I think that’s the first person and the
4:58
second person or even one a is probably
5:00
a materials manager type person who
5:02
would help with a lot of the ordering
5:04
from things like again lights and Booms
5:06
as as big as that down to bedside tables
5:08
and kick buckets so there’s a lot of
5:11
things that take place and don’t forget
5:12
when those things come in they have to
5:13
be put together and there’s all that
5:15
element of so I think there’s when that
5:17
decision-making tree cost is probably
5:19
part of it and how much to spend how
5:21
much you want to spend and at what point
5:23
but my my point is like the bang for the
5:25
buck type thing you may get somebody
5:27
who’s a little more experienced with a
5:28
little more of a manag type function in
5:30
the past that that can really help you
5:32
out sure what about licensing which is
5:36
certainly part of the denovo process and
5:38
getting licensed and credentialed does
5:40
clinical background and expertise
5:43
important or play into that licensing
5:46
process yeah I think so many of those
5:48
lure and certification elements are
5:50
clinical there’s certainly a lot of
5:52
business aspects as well and so having
5:54
someone who’s clinical to help even with
5:56
the application but to prepare for those
5:58
surveyors to come in in we usually have
6:00
to start with these test cases and and
6:02
then you have to go through the business
6:03
aspects of Contracting if you don’t go
6:04
through test cases and your facility
6:07
doesn’t get CMS certified and Triple H
6:09
whoever they’re going to use you can’t
6:11
get those insurance contracts and so
6:12
that clinical person tees you up for
6:14
that and tees you up for those test
6:15
cases and the ability to actually start
6:18
performing surgery so I I keep talking
6:20
about kind of spending and bringing
6:21
people in and all that kind of stuff I
6:23
think where you can cut back is that
6:25
there is definitely a lag between
6:26
forming those test cases having this
6:28
accreditation certifications all that
6:30
kind of stuff done the licens your stuff
6:32
and so you don’t want to just hire all
6:34
your staff assuming that in our case
6:36
we’re going to open up eight rooms all
6:37
eight rooms are open you get enough
6:39
staff a nurse a tech and again support
6:42
staff sterilization Texs all that kind
6:44
of stuff enough to just run one room and
6:46
do those required test cases and then
6:49
you can take that lag time to then do
6:50
hiring and bring in new folks I think
6:52
it’s helpful I always say the best way
6:54
to hire people is word of mouth and so
6:56
utilize your docs and again bring in
6:59
your best person to start maybe your
7:00
person is more of a go-getter who’s
7:02
going to be willing to put some extra
7:03
time into again build something put
7:05
something together and that type of
7:06
thing really they’re not shy from
7:08
looking at policies and procedures and
7:10
doing paperwork and all that kinds of
7:11
stuff those are your first in and then
7:13
you can start highing do that second
7:15
round after those test cases are done
7:17
those kind of certifications are done
7:18
and then you’re getting ready to open
7:20
just everything went well from your
7:22
survey yeah and I think that’s a good
7:24
tip because it sounds like those test
7:25
cases are important part of the process
7:28
and the licensing process and so you
7:30
know Staffing up for one room and then
7:32
as you get closer to opening you know
7:34
for your facilities as an example I’m
7:36
sure you didn’t go day one all 8s are
7:39
just full go right your your case volume
7:42
over time which allows you to staff in
7:44
phases and use your head like so if your
7:46
nurse manager is also an or nurse or
7:49
also a Pac you nurse or preup nurse have
7:51
them be in the mix early on at the onset
7:53
let them realize that you’re going to be
7:55
manager do all these things but early on
7:56
you’re going to have to be a working
7:58
manager and it’s going to allow us to
7:59
hold off on on hiring that additional o
8:02
nurse that additional pack un nurse
8:03
You’re Going to function that role until
8:05
we have enough insurances on board Etc
8:08
to start open up the volume you know
8:09
what I mean so yeah a step-wise plan
8:11
that is smart is thought out well and
8:14
hopefully relies on somebody with some
8:15
experience to help you formulate that
8:17
yep yep okay great wanted to talk a
8:20
little bit Greg about the Quality
8:22
Reporting side of it and I think the CMS
8:24
currently has 20 or so Quality Reporting
8:27
measures that you’ve got to report on I
8:29
think there’s another one proposed for
8:30
for 2024 they’ll take it to
8:33
21 what tips or best practices have you
8:36
seen for new asc’s to develop
8:38
infrastructure groundwork systems to
8:41
start measuring and Reporting on those
8:43
quality measures from the beginning take
8:45
that in mind as you build out the
8:47
process yeah it’s a really good question
8:49
because some things like this sometimes
8:51
are on put in the back burner and then
8:52
again you start with your processes and
8:54
you’re like oh I forgot and I forgot
8:56
about this so I think the key piece for
8:58
us has been assigning
8:59
individuals to handle each quality
9:01
measure that one two three five 20
9:03
whatever they are and how are they going
9:05
to be able to collect the data and how
9:07
be a to report it do they have all the
9:08
resources they need to go ahead and get
9:10
that going and so yeah I think if we’re
9:12
thinking about denova projects putting
9:14
systems in place that allow you to track
9:17
this efficiently to maybe even the
9:19
technology reports it for you whatever
9:21
it is but making sure that there’s
9:23
accountability reporting it and again
9:25
it’s as easy to do it as possible and
9:27
again for us technology help with that
9:29
different systems that we use we just
9:31
went to an EMR in January and so I think
9:35
again some of the smarter systems now
9:37
the newer Technologies are aware of
9:39
these types of things and help you with
9:40
the data collection Etc Great what about
9:44
the clinical workflows is you get set up
9:46
just in terms of hey how do we treat
9:48
different types of cases who does what
9:51
how do we get the Rhythm and Mojo going
9:53
is it challenging to do that from
9:55
scratch with the new facility definitely
9:57
I think what I find challenging and
9:59
again we’re an existing Center and I’ve
10:01
been here for 19 years and I’m fortunate
10:03
to have that experience now going
10:04
forward with our new project but there’s
10:06
so many different Technologies out there
10:08
it’s who can you work with to get the
10:11
biggest bang for your buck there’s just
10:12
no question that the margins in our
10:14
business have to be tight because of how
10:16
we’re reimbursed and so utilizing
10:18
technology to streamline your processes
10:20
and that type of stuff is really key and
10:22
so my thought would be take that time as
10:24
you’re ramping up in the early stages as
10:26
you’re filling your days with a million
10:28
different things but looking evaluate
10:30
Technologies and find out the ones that
10:32
can work for you best that you can
10:33
Implement right off the bat and again
10:34
they’re going to help you with
10:35
efficiencies and costs and Staffing all
10:38
these types of things that are out there
10:39
so work smarter not harder again people
10:41
say it all the time but it’s really true
10:43
there’s a lot and try and get a
10:44
technology that gives you multiple
10:46
offerings and biggest bank for your buck
10:49
yep and I think sometimes facilities
10:51
that are looking to implement emrs that
10:54
are established facilities and have
10:57
processes in place
10:59
sometimes find it a challenge to shift
11:01
to a software based system where they
11:03
may have to change some process and
11:04
operations have you found that it’s
11:06
potentially easier if you’re starting
11:08
facility from scratch and hey we’re
11:10
going to use an EMR we’re going to use a
11:11
clinical workflow system you can design
11:13
your processes without in mind thousand
11:16
per I think it’s just it’s the all that
11:18
is everyone hates change right and so if
11:19
you do it from the onset and I think
11:21
it’s an important thing to think about
11:23
and I’m happy you bought it up because
11:25
it’s one of those things where again
11:26
everyone’s concerned about cost and so
11:28
you’re like oh to pay this at the onset
11:29
why don’t we just open up and then when
11:31
we get a little bit of some money
11:33
together and we get some good volume
11:34
going we’ll transition I just think
11:36
things like again like EMR is a perfect
11:38
example starting from scratch is the way
11:40
to go and I actually find that companies
11:43
these days if you actually talk to them
11:45
and treat them as a true partner and go
11:47
over your pain points and your
11:49
hesitations they’ll often times will
11:51
work with you everyone wants the
11:52
business right and they’ll probably
11:54
understand that having you as an early
11:55
adopter is key and so you know so many
11:58
of these em R companies now have add-on
12:00
features that you can do and so as I
12:02
mentioned biggest bang for your bucket
12:04
I’d start there and see what those
12:06
companies can add on and it’s just a
12:09
little bit of a plug for you guys but
12:10
you guys have so much in your bag right
12:13
and so does some of the other companies
12:14
as well and so see what’s offered under
12:16
one umbrella first and then you can go
12:19
on and peace meal some of the other
12:20
things sure sure yep yep what about
12:24
working out the Kinks as you start to
12:26
ramp up case volume is you start to go
12:28
for one room to two what have you found
12:31
is helpful in terms of the early days
12:34
the clinical operations in terms of
12:37
working out the process in The Kinks as
12:38
you scale my biggest recommendation
12:41
would be don’t get stagnant and just
12:43
keep going I think early meetings as
12:45
much as can be painful I think there’s
12:47
time early on but meeting with the staff
12:49
as often as possible and for us and I
12:52
mentioned this in my last podcast I
12:53
think one of our biggest keys to success
12:55
was having monthly meetings for not only
12:57
our staff but our surgeons as well that
12:59
were owners in the facility could have
13:01
some kind of impact and communicating
13:03
everything to them it was really key not
13:05
a a long meetings it was a focused
13:08
meeting on certain topics some things
13:10
could get brushed over but some things
13:11
they were involved in and so I think
13:12
same thing with the staff as you get
13:14
going you figure out what went well this
13:15
last case or this last week and what can
13:17
we do better and again it sounds cheesy
13:19
but it’s really important I think to
13:21
make sure you’re running things as
13:22
smoothly as possible and then when new
13:23
folks come in even in the hiring process
13:25
you have to let them know listen you’re
13:26
going to have to be really flexible when
13:28
you come in and realize this is the way
13:29
we do things and you’re going to have to
13:30
adopt the way we do things we’re always
13:32
open to listen to to change and to doing
13:33
things better Etc but you’re going to
13:35
have to listen to How we do things we
13:37
have a process we go about and like we
13:39
turn over a room we do it this way when
13:40
we admit a patient we do it this way
13:42
tell us how we can do it better but this
13:44
is our process and this is how we’re GNA
13:45
do it so we’re always gonna be
13:47
reevaluating but involving the staff and
13:49
the docs in that I think it’ll be really
13:51
beneficial yep makes sense Greg final
13:54
question for you and we do this each
13:56
week with our guests what is one thing
13:57
our listeners can do this week to
13:59
improve their surgery
14:01
centers yeah I think it just goes hand
14:03
in hand what I was just talking about I
14:05
know for myself it’s the same thing we
14:07
know there’s all this technology out
14:09
there and they know there’s all these
14:10
different ways we can do things using
14:12
computers and iPads and streamlining
14:13
processes but I think all of us
14:15
associate it with cost and I think
14:18
people just got to take the time to
14:20
evaluate some of these companies realize
14:22
that they may be putting some money up
14:24
front for sure but the return on that on
14:27
efficiencies and on doing things better
14:29
from Clinical quality to staff
14:32
satisfaction patient satisfaction
14:34
surgeon satisfaction the return is
14:36
exponential and so take the time to do
14:38
it don’t be scared of it and I think
14:40
you’ll find that there’s going to be a
14:41
lot of benefits in the back end I know
14:42
we’re coming to end of the summer here
14:44
and that’s when people have a little
14:45
extra time to do things it’s going to
14:46
get busy again in the fall but if you
14:47
can carve out some time to do some
14:49
evaluations early on I think we found
14:51
that we took the plunge on a lot of
14:52
these things and it’s really changed the
14:54
way we do things for the better
14:56
fantastic Greg appreciate your time
14:58
enjoyed the conversation thanks thanks
15:00
for joining us today thanks again for
15:01
having me appreciate
15:05
it as always it has been a busy week in
15:08
healthcare so let’s Jump Right In five
15:11
administrators shared their predictions
15:13
with Becker’s ASC on what the future
15:15
holds for the outpatient surgery
15:17
Workforce and how they see it changing
15:20
in the next two to three years so at a
15:22
high level here’s what each admin shared
15:26
Les jebson from Prisma Health shared
15:28
that es have historically benefited from
15:31
predictability in work hours and
15:33
perceived overall quality of
15:34
professional life but with labor market
15:37
strains and Rising salaries due to
15:40
limited labor pools they suggest keeping
15:42
an eye on employee turnover rates in
15:45
frequency and doing a semiannual market
15:48
analysis on Market
15:51
compensation Omar shakar from Illinois
15:54
gastro Health suggests that we meet our
15:57
employees where they are just like we do
15:59
with our patients so previously we could
16:02
say hours are 8 to5 Monday through
16:04
Friday but your staff might want early
16:07
morning hours or evening hours so
16:10
adapting to what your limited staff
16:12
wants assuming you can accommodate it is
16:15
important to provide both routine and
16:17
flexibility in order to retain the best
16:20
staff Matthew reader from Harris health
16:23
outpatient Center predicts that younger
16:25
individuals will be entering the
16:27
peroperative arena and second career
16:30
individuals will start moving to asc’s
16:32
due to attractive nursing compensation
16:35
he’s also anticipating an expected rise
16:37
in gender diversity and increasing
16:40
demands for part-time or supplemental
16:43
status Ken sha from Brentwood Surgery
16:47
Center says some challenges are headed
16:49
this way such as early retirements
16:51
burnout or career shifts which will
16:54
result in increased wage demands longer
16:56
surgical uh days and a competitive
16:59
Advantage for larger asc’s or Hospital
17:02
Systems so asc’s will likely need to
17:05
match hospital system pay scales
17:07
abandoning the previously lesser pay
17:10
compensated by shorter working
17:12
hours and lastly Andrew Weiss from
17:15
Summit Surgical Center is seeing a trend
17:18
in increased competitiveness in terms of
17:21
salaries benefits and scheduling
17:23
flexibility he’s also seeing that many
17:25
employees now prefer part-time hours or
17:28
per DM shifts due to work life
17:31
balance so there’s definitely some
17:33
Trends in there that are consistent and
17:35
shouldn’t surprise anybody but there’s
17:37
also some good reminders in there about
17:39
being flexible and what you can expect
17:41
to come in the next couple of
17:44
years our second story comes from
17:47
Medscape and it’s wild as a non-clinical
17:50
person I’m not going to lie this story
17:52
did make me a little squeamish to think
17:55
about but we will get through it and
17:56
it’s too fascinating not to share
18:00
Soloman Hassan is a 12-year-old boy who
18:03
was riding his bicycle on the West Bank
18:06
and he was involved in a car accident
18:08
where he suffered life-threatening
18:10
injuries he was transported by
18:13
helicopter from the scene of the
18:15
accident to hadassa Medical Center in
18:18
Jerusalem when he arrived they realized
18:21
he actually had atlanto occipital
18:24
dislocation often referred to as
18:27
internal
18:29
decapitation so when I hear decapitation
18:33
I think of terrible scenes from movies
18:35
and things like that this is not that
18:37
but when he arrived he was in a neck
18:39
brace and actually fully conscious so
18:42
they monitored and treated him and made
18:45
sure he was stable but they did quickly
18:47
realize that he had a pretty severe neck
18:51
injury so his doctor was Dr Ohad aav and
18:56
thankfully once he saw the C t scan he
18:59
knew exactly what needed to be done and
19:02
luckily had similar experiences during
19:05
his Fellowship so he went into the
19:08
surgery with plan a and also two
19:11
contingency plans and only allowed the
19:13
most experienced members of his team to
19:16
help now in the article Dr aav explains
19:21
the entire process in detail so I highly
19:23
recommend giving it a read but basically
19:26
the surgery went incredibly well and
19:28
they were able to use Hardware to fuse
19:30
The Head and the neck back together he
19:33
spent the 12-year-old boy spent a few
19:35
weeks recovering and they were
19:37
monitoring him for infections and and
19:40
any other complications and everyone is
19:42
doing great so this could have been a
19:45
really tragic story but instead thanks
19:47
to the brilliant surgical team this
19:49
12-year-old boy is alive and well so a
19:53
lot of news stories or a lot of news
19:55
stations are picking this up because you
19:57
hear decapitation and you hear somebody
19:59
lived and it’s just it’s fascinating to
20:02
see what the doctors had to do to keep
20:05
this young boy alive and that they
20:07
expect him to have a great
20:10
recovery our third story comes from ASC
20:13
focus and they’re sharing tips for
20:15
working with local authorities to create
20:17
an emergency plan so this story has two
20:21
angles to it the first is letting local
20:24
authorities know that if your surgery
20:26
center isn’t experiencing an emergency
20:28
here are the resources that you’ll need
20:31
but the second angle is the reverse if
20:33
your community is in a state of
20:35
emergency here’s how the surgery center
20:37
can help so let’s tackle the first Marcy
20:41
moon is the emergency coordinator for
20:44
Union City Surgery Center in Union City
20:46
which is a small rural town in Northwest
20:49
Tennessee and she shared that the center
20:52
does not have access to many of the
20:54
resources available in metropolitan
20:56
areas making it even more more important
20:58
for the ASC to collaborate with local
21:01
authorities and by sharing knowledge and
21:03
experience and pulling resources they
21:06
can all be better protected and prepared
21:08
for emergencies or natural
21:10
disasters Marcy did extensive Outreach
21:14
to various entities in her community
21:16
including the EMA director police and
21:19
fire departments and the emergency
21:21
coordinator at the local hospital she
21:23
said it’s very similar to networking and
21:25
they’ve already made recommended
21:26
improvements to the A se’s
21:29
plants now the second scenario is how
21:32
can you help what value do you bring to
21:34
your community Anne hadex CEO of
21:37
Southwest Surgical Suites in Fort Wayne
21:39
Indiana shared that local authorities
21:42
may not understand the capabilities of a
21:44
surgery center and the role it can play
21:46
in an emergency so hadex recommends
21:49
being prepared to discuss your asc’s
21:51
capabilities and resources it can offer
21:53
during any and all meetings with your
21:55
local authorities and if face with a
21:58
public health emergency Southwest
22:00
Surgical Suites is prepared to transform
22:02
into a dispensing site to assist with
22:05
countermeasures and dispensing so this
22:08
definitely reminds me of that famous JFK
22:10
quote ask not what your country can do
22:12
for you ask what you can do for your
22:15
country except SWA in communities and
22:17
surgery centers and that is the essence
22:19
of this article so thanks to ASA for the
22:22
helpful reminders and
22:24
tips and to end our new segment on a
22:27
positive note a groundbreaking surgery
22:30
gave a woman her voice back Shirley has
22:33
not been able to speak easily for over a
22:35
decade and recently her doctors
22:37
diagnosed her with spasma dysphonia a
22:41
voice disorder that causes involuntary
22:44
spasms of the muscles in the larynx a
22:47
doctor in Tel Aviv brought promising
22:49
news when she shared that doctors in
22:51
Japan developed an Innovative surgical
22:53
treatment involving taking fat from the
22:56
abdomen and inserting it into the vocal
22:58
fold to prevent spasms Charley was so
23:01
excited she didn’t question it for a
23:03
second and she became the first person
23:06
in Israel to undergo the surgery and as
23:08
soon as she woke up she was able to talk
23:11
again she said I feel like I’ve been
23:13
reborn and no one is stopping me from
23:15
speaking now so another really cool
23:18
story about surgeons all over the world
23:20
changing
23:22
lives and that news story officially
23:24
wraps up this week’s podcast thank you
23:27
as always always for spending a few
23:28
minutes of your week with us make sure
23:30
to subscribe or leave a review on
23:32
whichever platform you’re listening from
23:35
I hope you have a great day and we will
23:36
see you again next
23:46
week
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