Greg DeConciliis – Opening an ASC: Continuous Improvement
Here’s what to expect on this week’s episode. 🎙️
You have officially opened the doors to your new surgery centers. Patients are scheduled, physicians are ready to go, and the entire staff is excited. Now what?
The one thing that you cannot do is become complacent.
Greg DeConciliis is a PA and Administrator at Boston Out-Patient Surgical Suites. For his second appearance on the show, Greg is sharing what “continuous improvement” looks like, why it’s crucial for long-term success, and how you can build a culture and strategy around it.
Here are 10 quick ideas for continuous improvement:
1️⃣ Stay on top of trends (e.g., the explosion of the total joint and spine market)
2️⃣ Attract new physicians by encouraging existing physicians to showcase the facility
3️⃣ Hold regular staff meetings to discuss, strategize, and implement improvements
4️⃣ Use local/national benchmarks to identify areas of improvement
5️⃣ Leverage technology to enhance patient, physician, and staff satisfaction
6️⃣ Look at data for study ideas and avenues to improve
️7️⃣ Involve staff in solution creation and ensure their ideas are heard and implemented
8️⃣ Use tech like an EMR to streamline processes and enhance patient & family experiences
9️⃣ Leverage colleagues’ experiences to choose beneficial technology and services
🔟 Ensure you never get too comfortable and always reassess and reevaluate your strategies
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
• Gregory DeConciliis – Opening an ASC: Clinical Preparation
• Andy Berg – Opening an ASC: Finding Your Dream Team
• Wil Schlaff – Opening an ASC: Business Preparation
• James McClung – Opening an ASC: 30 Days from Your First Patient
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 if you’re in the ASC industry then you’re in the right place every week
0:08
we’ll start the episode off by sharing an interesting conversation we had with our featured guest and then we’ll close
0:13
the episode by recapping the latest news impacting surgery centers we’re excited to share with you what we have so let’s
0:20
get started and see what the industry’s been up to hi everyone here’s what you can expect on today’s episode today is
0:28
the final episode in our nine-part denovo Series so last but certainly not
0:34
least Greg deconcilis joins us again to talk about continuous Improvement so you
0:39
have officially opened your doors and you can certainly celebrate but what you cannot do is become complacent so Greg
0:47
walks us through keeping physician and patient satisfaction High the role of data in benchmarking how to cultivate an
0:54
environment of growth and how to continuously improve expand and thrive
1:00
in our news recap we’ll cover the 11 asc’s in California being recognized by
1:05
Casa why it’s important to screen for cognitive impairment in your patients
1:11
the latest on non-competes and the FTC and of course and the new segment with a
1:17
positive story about a new Serenity Lounge at Cedar Sinai Medical Center
1:22
hope everyone enjoys the episode and here’s what’s going on this week in surgery
1:28
centers hi Greg welcome to the podcast hi thank
1:34
you for having me appreciate it yeah can you tell our listeners a little bit about yourself please sure my name is
1:40
Greg dilus I my background is actually clinical as a PA worked in orthopedic surgery since 1999 worked initially at a
1:49
large Orthopedic Hospital um left there in 2004 to open up our Surgery Center we
1:54
a multip specialty Surgery Center located in the outskirts of Boston called Boston Outpatient Surgical Suites
2:00
uh we’re in wam Mass um we primarily do Orthopedics um pain management and some
2:06
general surgery so although we are considered the multi we just you know primarily perform those three Specialties uh fairly busy Center again
2:13
servicing the Metro West and Boston Community do about anywhere from 350
2:18
Ortho cases a month per se and couple hundred other random cases as well from Pain to General Surgery Etc so again a
2:26
fairly busy Center actually looking to grow to a 8 Center in the next 18 months
2:32
we currently have three o and again looking at the the total explosion if you will of the outpatient joint in in
2:38
spine kind of market so it’s worked out pretty well yeah been here ever since yeah and that’s exactly why I’m excited
2:44
to have you on today because for the last two months or so we’ve been compiling all sorts of podcast episodes
2:50
and content and Industry advice on how to successfully open a new Surgery Center and this episode today will be
2:58
one of our last in the series and I’m excited to pick your brain about this idea of continuous Improvement
3:03
especially with the projects you have going on after you’ve opened your doors and the dust has settled there’s still
3:09
work to be done so what does continuous Improvement mean in the context of a
3:14
surgery center and why do you think it’s so important for long-term success sure and I guess I’ll start with
3:21
we we all think of continuous Improvement differently obviously we look at outcomes and those types of things but us doing a new Surgery Center
3:29
I think is continuous Improvement because o are packed full with our three o where there’s no block time for about
3:36
15 or 20 surgeons who want to come in and use the facility and so as a result you have surgeons I’m sorry patients who
3:42
are stuck if you will in the hospital systems backed up and they can have surgery for two three four months and
3:49
our solution was to go out there and and open this new facility again almost tripling our o capacity allowing those
3:55
new surgeons to come in be a part of what we’re doing but in turn providing again more availability for high quality
4:01
outpatient surgery but back to your original question you just made me think about that continuous improvements is an
4:07
interesting thing it’s it’s almost if you will a requirement I think everybody feels like they do things very well they
4:13
that kind of things they have good outcomes and Etc but I feel like as part of the accrediting bodies that they come
4:18
in and certify organizations they require some sort of continuous Improvement structure but generally
4:24
speaking that’s what it is it’s this kind of structured strategy if you will to either quarter l or even monthly to
4:31
evaluate those outcomes and how you’re doing things about your facility your efficiencies all your benchmarks that type of stuff and doing a systematic
4:38
approach to make sure you’re making constant improvements and enhancing your outcomes and that type of stuff yeah
4:45
definitely and so if we think about Physicians really quick so in your case
4:50
of expansion there’s obviously more Physicians looking to schedule cases at your facility there was a patient need
4:57
what role does the Physicians play with continu Improvement and if you do want to expand how do you approach
5:03
Recruitment and engagement and how do you keep physician satisfaction High sure and all I’ve been doing this
5:09
for almost 20 years so I’ve seen this kind of this pattern so back in 04 when
5:15
we opened there was a lot of Surgeons who were looking to get out into the industry the GI docs and the opthalmologists they’ve all they had
5:20
already had done their stuff in late 9s early early 2000s now Ortho was the
5:26
force of the Forefront we saw this kind of big flurry to folks get to the outpatient setting then I felt like it was static a little bit and then I feel
5:33
like coid and particularly in the ortho front where the hospitals shut down appropriately and they weren’t allowing
5:39
you know any impatient surgery this kind of movement towards outpatient improved and so I think we saw this again we’re
5:45
seeing this flurry again of a lot of Surgeons ESP again in the ortho world coming to be involved in a surgery
5:51
center and kind of experience the benefits and what are those for us again we have folks just because we’ve been
5:57
around for a while who knock on our door but I I always find meeting a new surgeon is always done best through a
6:03
soft warm intro from a from another surgeon and oftentimes there’ll be a colleague they’re working with who
6:08
somebody at the hospital who frustrated from a turnover time or they didn’t have a certain device or whatever and so they
6:14
they have conversations about this the satisfaction they’re achieving at their Surgery Center and so this kind of warm
6:19
intro occurs and then my strategy is always to reach out to that surgeon I provide them with some basic information
6:25
in the facility and invite them out to the facility so they can actually look had experience it and meet some of the
6:31
folks and and get a taste of kind of what we’re all about I think the sale is an easy thing in that sense I think
6:37
surgeons are simply looking for an efficient place to operate they’re looking for a place where they don’t
6:43
have a new staff member each time they operate who has to be retrained in the things they like and dislike they know
6:49
they’re looking for the supplies and equipment they need to be on that back table and ready to be used and so
6:55
there’s no secret sauce to it there’s no secret recipe it’s simply just being attentive to the surgeon we always do it
7:01
for the patients right that’s where we’re all on Healthcare but being attentive to the surgeon as well making sure early on we have a consistent staff
7:07
with them so they get familiar with them making sure their preference cards are accurate making sure they have their equipment and supplies they need for the
7:13
most part and the efficiency is kind of built into the to the facility and so they’ll have a better day and know by
7:19
the way they get out probably two three four hours earlier with the same amount of volume or more and again it’s it’s
7:24
what makes facilities such as ours really successful is is that key that key piece surgeons want to bring their
7:30
cases to our facility and operate there so it works out pretty nicely yeah and I think that’s such good advice too
7:36
because even if you don’t have the reputation that your facility has and has built over the years if you have
7:42
Physicians that are obviously in the hospital ask them if you are looking to expand and grow keep your ears open let
7:47
it happen organically bring them on in and show them how positive The Experience can
7:53
be and you had mentioned patience which is the perfect segue obviously keep
7:59
keeping the Physicians satisfied is one thing keeping patients satisfied is another what strategies do you suggest
8:06
people Implement to measure patient satisfaction and then the second piece of that would be Translating that
8:12
feedback into actual tangible changes sure a couple things we do first
8:18
off I think we’re all been I say use the word benefited but not that we all want to do it but we’ve C with the changes from regulations and that type of stuff
8:24
we’ve worked towards our a computerized kind of assessment server like a prescy type thing which is what we use because
8:30
we know that we’re going to be you know heading that way and so most of us are already there and so we utilize that and
8:36
I think the key with this is not just having the scores be reported out to you and reading them and then putting them
8:42
aside we make it a point of every single one of our staff meetings and every single one of our board meetings and our
8:47
meetings with Physicians to communicate those outcomes and I think that’s the biggest PE that’s the biggest piece is
8:53
really just one of the keys to Our Success is we used to have board meetings monthly and it was every with
8:59
every single surgeon who was an had an ownership interest and was a part of that facility and the same thing with staff meetings I think the most
9:05
successful uh centers are ones that have staff meetings monthly not just quarterly and they um have a set agenda
9:13
and we talked earlier about continuous improvements again a set strategy and there’s certain items on there and one of them is patient satisfaction and I
9:19
think we always report about Trends and then again most importantly once we see things slip in some fashion and again
9:24
the nice thing about some of these like prescy they they put they list a certain for example Administration and check-in
9:31
recovery and discharge instructions things like that and so whenever we see those items um start to slip a bit we
9:37
always put it on the staff’s shoulders if you will and not in a negative way but say listen what’s changed are we
9:42
just busier are we just is there new staff do we have to train and we always put it upon them to come up with Solutions and most importantly we
9:50
remember those Solutions and is myself and our nurse managers and we and report back to the staff on how things are
9:56
doing are we improving what can we do better and that kind of stuff stuff and so we’ve really spent a lot of time on this and and I will say transparently
10:03
and I don’t know if it’s just a Northeast thing but we have we don’t have the best patient satisfaction scores and I’m sure you might be
10:09
listening to this and saying the same thing you think you provide great care and you we have great outcomes and how can we do better on the patient
10:14
satisfaction side and we talk to our patients we call them the next day and they’re all doing great that type of
10:20
thing but you have to look at the whole piece but really dive down to those numbers again don’t just read them read
10:25
them process them communicate them with staff and and look at the the minutia of the different areas where you think you
10:31
can improve because I think it can really contribute to an overall higher scores and again that’s how we approach
10:37
it yeah it’s interesting I’m in Connecticut I totally get it we are a a
10:42
complicated bunch in the Northeast but um yeah it’s interesting I think patient
10:49
satisfaction as a whole is interesting because there’s so many elements that go into it that are actually sometimes out
10:55
of your control I don’t know about your facility specifically but it could be parking it could be maybe the financial piece of
11:01
it things that they don’t realize really aren’t related to the surgery center directly but it still added to their
11:08
experience as a whole and then ours is ours is location finding it
11:14
and they come in the door frustrated to start it just set starts that first impression of they don’t forget it so
11:19
it’s a really good point some’s are out of your control yeah that’s tough but the data to your point earlier is key
11:26
and also being able to share that with your staff and not saying oh I have this feeling that we’re underperforming in
11:32
this specific area but being able to point to the actual comments you’re getting from patients and the trends month over month is huge and could help
11:39
catch something before it becomes a really big issue so let’s talk more about that data
11:45
collection and benchmarking how does benchmarking specifically against industry standards help identify areas
11:53
that need Improvement and and what do you currently do in terms of data collection and benchmarking yeah again I I think
12:00
benchmarking is really key it’s one of those things where as I mentioned earlier I think we all believe that
12:05
we’re doing providing great care again we have good outcomes that type of thing but it’s always nice to Benchmark
12:11
against others and again if I if our patient satisfaction scores were 89% or
12:16
85% overall overall recommendation I so that’s pretty good that’s it’s you know it’s not 65 it’s not 75 but I realized
12:23
that the national average or the average for the area was 95% then again you it puts all your thoughts and your
12:29
perspective into into reality into real numbers and so for us again it’s worked out really well we have a management
12:35
company and we’re able to Benchmark amongst all of those centers and then of course the Our National Association has
12:42
their industry standards as well and I think benchmarks are important and again it level sets things even for again I mentioned the staff and the surgeons
12:48
they want to know is is 85 a good number the national average is 86 or whatever
12:54
or 84 and then makes you makes it seem a little bit better I think I think particularly in the quality side and
13:00
then the continuous Improvement side I think having an Avenue to obtain benchmarking again nationally but also
13:06
regionally we talked about some of those aspects already is really key and fortunately again we have a National
13:11
Association that provides some of those benchmarks and and certainly there’s Pharmacy consultants and local folks who
13:17
can do the same thing so it’s helpful yeah definitely how about Cappy
13:23
Studies have you any tips there about Cappy studies you could focus on that
13:29
kind of focus on or give tips for continuous Improvement or any that you’ve seen that are really good that
13:36
you’d recommend yeah I think I actually think that sometimes we struggle to come up
13:41
with good copy study topics and I think that benchmarking is a great start for it so pick an area where maybe you’re
13:47
not meeting the average for the national or local Benchmark and discover why one
13:53
of ours again I hate to keep beating a dead horse but one of ours was patient satisfaction and we spent a lot of or it’s ongoing and we spent a lot of time
14:01
on on things like scripting and doing our own survey outside of the benchmarking and utilizing different
14:06
technology we started using and trying trying to figure out what what are the key pieces that kind of are contributing
14:13
to a higher or lower lower scores in different areas and attacking those scores and so our quality study in that
14:19
front and the reason why it’s ongoing is because we can we’re not 100% yet right so we continue to come up with new
14:25
Solutions we have different staff members who come in with different ideas and and it’s worked out pretty well and so again I always find I always feel
14:31
like that should be an annual study not patient satisfaction but anything where you feel like you’re whether it’s cost or somewhere you’re not you have access
14:37
to a benchmark score and uh number dvts number infections whatever it is those
14:43
quality benchmarks are a great place to start not only does it look good again you’re doing something good because
14:48
you’re going You’re trying trying to improve your patient outcome in some fashion so it’s a great place to start
14:53
for Quality study and again it’s tailor made for you right it’s you already have the you already have the answer of where you need to to be as far as that
14:59
Benchmark and so you just try to figure out how to strive to get there yeah and it’s interesting because we have a
15:06
couple speakers that that talk about different topics and we’re always doing webinars and we had one last last year
15:12
that was about just different copy study ideas and it was probably one of our most well attended and requested topics
15:18
because to your point everyone’s always looking for different ideas and something that’s useful too not just
15:25
trying to check a box but I think looking at the data is the perfect
15:31
source of inspiration for different ideas as to where you can
15:36
improve you had also mentioned technology so in with this bigger
15:41
concept of continuous Improvement at your surgery center what role does technology play or can it play yeah it’s
15:49
funny I always feel like we were just getting with the times now I think part of it was this move and planning what we
15:55
were going to do and different Partnerships and joint ventures Etc and so now that we’ve sorted out which direction we’re going we’re jumping back
16:01
into technology such as EMR which is an easy one and all the aspects of EMR that
16:07
that different add-ons and things you can do with it technology to me is so fantastic because it it improves so many
16:14
of your processes and outcomes but at the same time it’s scary as hell because there’s such a cost to it it does eat
16:20
away at your bottom line so to speak but I think it’s I think the challenge is not getting overwhelmed with a number of
16:26
different technologies that are out there number of different companies but finding companies that can streamline a lot of them have the more bigger bang
16:33
for your buck that are cost effective of what you’re doing and then again overall improve outcomes I mentioned for us
16:39
patient satisfaction here we go again but I feel like part of the patient satisfaction is their family members and
16:45
what they experience because the patients are most the time they’re out and they’re out of it and they as long as they wake up and and they feel better
16:51
like they’re happy but the family members are the ones who are waiting and who maybe not be getting a great amount of communication us employing some
16:57
technologies in terms of communicating with family members kind of trackers on where where patients are throughout the
17:02
facility I think I’ve really been helpful we’ve done that over the last few months and again there are Technologies for every single aspect
17:09
from everyone’s dreaded credentialing you know to managing employees to time management to you know Staffing to again
17:16
of course all the other aspects of of patient management and that type of stuff and so again it can be overwhelming anybody who attends a trade
17:23
show or the National Conference heading to the the vendor room there’s there’s 90 9,000 of them again it’s a matter of
17:30
I think utilizing your colleagues networking that type of stuff finding out which which great ones are out there
17:35
how people’s experiences have been and valuing them for yourself I think that’s been helpful for us yeah I always
17:41
suggest that as well if you have a good relationship with the surgery center down the street and they’re using a technology you’re interested to go ask
17:48
if you could go watch them use it for an hour or so or have that candid conversation with them because it it
17:53
really can be overwhelming especially if you haven’t started down the journey yet it’s where do we start and everyone’s
18:00
telling you they have the best software so it’s I get it bigger picture how can
18:06
you cultivate an environment where everybody not just leadership or the
18:12
board is focused on continuous Improvement yeah again I think I mentioned this earlier so it’s a little
18:18
bit of a repeat but I think when we’ve had the biggest issues that we will with staff and kind of Staffing staff being
18:25
disgruntled or which is not a great environment overall it’s when we’ve got to the point we got away from our
18:30
monthly meetings it’s very easy to do that because you become very busy and even though you’ve my recommendation
18:36
would always be to schedule in like ours this the fourth Tuesday of every month we meet at 6:30 in the morning it’s the
18:41
O staff to start because I usually start early 7 o’clock’s all your staff so you’re not repeating the basic stuff
18:48
like benefits and that type of thing then 7:30 is our pack you staff because that way the O staff can get off get the
18:53
day going and then by the time the patients come out you’re done there and that’s the way we’ve done it we start or the or at 7 o’clock and so it just it’s
18:59
worked out well but again I think the key piece though is again making sure you’re sticking to that meeting schedule
19:06
it should be monthly I think because things pop up constantly and then again not it’s not just meetings so okay you
19:12
checked the Box you’re meeting I got coffee for the staff I got some bagels and I’m sitting down and I’m talking to them but engaging with them I talked
19:18
about the patient satisfaction piece finding Solutions and you can’t do it all you and your management staff if
19:23
you’re the administrator your clinical management Etc we all have different knowledge base we all have different experience experiences experience in the
19:29
industry and so by opening up the floor if you will and and and trying to get some feedback and communicating
19:35
listening to what they’re they’re they’re talking about their ideas are I think that’s really the key but then again that could all be just just talk
19:43
if you’re not actually acting on it so again one of our keys is trying to get feedback from staff and then actually
19:49
doing something about it that way they don’t feel like they’re just talking and it falls on deaf ears and so for us it’s
19:54
worked out well anytime we’ve ever had a challenge on any kind of continuous Improvement plan or uh process or
20:01
whatever we’ve oftentimes gone to the staff and communicated with them and looked for Solutions and they often have them and makes your job a lot easier
20:08
engaging them is really key I think yeah that’s great advice have you ever been
20:13
your quest for continuous Improvement are there any challenges that you’ve
20:18
been faced with that you’ve had to overcome or any kind of major hurdles what I think about over the
20:24
years are besides the aforementioned ongoing try make patients in their famili happy is things like when you’re
20:30
bring a new surgery in or a new surgeon that type of stuff trying to trying to make them happy and make sure you’re
20:37
providing great care to that patient is really key I’ll use an example we again I mentioned we do Orthopedics and Pain
20:43
Management since 2004 but a few years ago we had a general surgeon come aboard and since he’s hired another partner and
20:49
when as she’s added procedures on particularly like he was doing open hernas now she does lap hernas so she’s
20:55
been doing here probably for six months we have another in service tomorrow morning at 6:30 because you can never
21:01
ever be satisfied she had a bad day one time she had some newer staff and she just didn’t have all the things she
21:06
needed and it it was the day dragged out a little bit and that type of thing and so we put it on her and that ke kind of
21:12
key staff member that works with her a lot to come up with a solution and there one of them was to do an inservice and so we’re doing that again tomorrow so
21:19
the the point there is we all there’s new equipment that comes in or again a new surgeon new uh procedure that type
21:25
of stuff again don’t just think you have the answer on how to start implement the whole process again involve staff
21:32
involve the surgeons and come up with a good plan to roll out and make sure that everything runs smoothly and again
21:38
re-evaluate it like I just mentioned we’re re-evaluating it and we’re acting again tomorrow and so it’s just you’re
21:43
just never can be satisfied we all get in a rut at some point we we feel like things going on you’re happy and that’s
21:49
why I think strategic planning sessions as part of the as part my my I was too still there my light went out strategic
21:55
planning sessions as part of your continuous quality Improvement is is really key and analyzing things and
22:01
making sure you don’t just stay static is is a key part of what your continuous Improvement should be yeah and it sounds
22:07
like in that case having that honest conversation being transparent and collaboration was the key to and being
22:14
willing to continue to work together and figure out a solution was the key there all right Greg last question we do
22:21
this every week with our guests what is one thing our listeners can do this week to improve their surgery centers yeah I
22:28
think and you’ve heard this as a theme already and I think maybe it’s a good time because if you’re listening to this and it’s after the summer it’s the fall
22:34
right before the we get busy again is get get in front of your staff have a good have a staff meeting with them open
22:40
the floor get some feedback on anything pick something pick from again efficiencies to how you to your vacation
22:47
plan your how you assign vacation time or who gets their vacation off some kind of area but yet again focus on the
22:53
continuers Improvement area and get the feedback from them and act on it I think you’re staff will really really
22:59
appreciate that and feel like you’re listening to them and that it’s a nice place to work and they know they’re heard and that kind of stuff and I think
23:05
when that happens and your staff is happier I think your surgeons are then happier because they recognize the staff
23:11
is happy and obviously your patients are going to be happy because the staff is happy they they’re enthusiastic and again that all leads to good outcomes I
23:17
would say that I think we all just talking to so many colleagues who just get busy and it just gets crazy
23:23
constantly it’s one of the areas where I think a lot of people sacrifice but have that staff meeting maybe do it out of
23:28
the bar or at a restaurant in the area and get the get the company credit card and keep it under control but do
23:34
something that if it’s a slower day in the afternoon and staff really appreciate that that would be one thing that I think has can have really
23:40
Monumental impact on your facilities perfect that is great advice thank you Greg I really appreciate all your time
23:47
and expertise today no problem thanks for having
23:53
[Music] me as always it has been a busy week in
23:58
healthcare so let’s Jump Right In the California Ambulatory Surgery Association recently awarded 11 asc’s
24:07
with the casa award for ASC Excellence so according to Casa’s website the awards were established to acknowledge
24:14
the fact that California as’s are drivers of excellent health care and that they provide opportunities and
24:20
solutions for healthc care reform the program is built around five pillar categories acknowledging facilities that
24:27
exemplify best practices in the surgery center industry plus actively promote and advocate for ASC excellence and
24:35
inclusion in the healthc care delivery system so certainly a tall order and as
24:40
always we’ll link to the article so you can see all of the surgeries who surgery centers who were recognized but I did
24:46
want to call out 90210 surgery medical center so in addition to winning the
24:52
casa award for ASC Excellence they also won the prestigious Casa ASC of the year
24:57
year so the staff at 90210 surgery medical center hosted four tours at both
25:03
the con Congressional and state level they participated in the ASA DC Flyin
25:10
they have committed to the casa safe opioid pledge they provide free
25:15
surgeries to underprivileged children in the greater LA area and as if all of
25:20
that it was not enough they also coordinate a crucial initiative to provide supplies to Ukraine so congrats
25:28
to everyone who was recognized and thank you for all that you do for your
25:33
communities Switching gears a recent study reveals the pervasive issue of
25:39
cognitive impairment among older adults undergoing surgery so those with
25:44
cognitive impairment which spans from mild cognitive issues to severe dementia experience an increase in postoperative
25:52
complications and further cognitive decline and so cognitive impairment can
25:57
negatively impact things like memory language and decision-making so if it’s undetected you can imagine how difficult
26:05
it can be for them to smoothly go through um a surgical procedure it affects communication it increases the
26:12
risk of surgical sight infections and then can hinder patient involvement in pre- and post-stop care so spotting any
26:20
potential signs during the preassessment process is key and there are proven screening tools that only take 10 to 15
26:27
minutes for patients to complete that can help identify patients at risk as early on as possible so if you’re not
26:34
already screening for something like this identifying and managing cognitive impairment pre-surgery could help lower
26:41
risks optimize care and ensure that the surgery and recovery process go
26:46
smoothly in our third story according to Becker’s ASC non-competes appear to be
26:52
going away so this story is a bit of a followup to one that we had reported on
26:57
back in July and here are a few of the latest things to know so the Federal Trade Commission
27:04
proposed a rule that would actually ban non-competes Nationwide but there’s still a long road ahead so the FTC will
27:12
vote on the rule in this coming April and numerous small business groups and the US Chamber of Commerce have
27:18
submitted letters in opposition but in the meantime states are taking things into their own hands
27:25
regardless of what’s going on at the Federal ederal level and they’re trying to make non-competes harder to enforce
27:31
so California recently passed laws declaring non-competes void in the state even if they were entered into outside
27:38
of state lines Minnesota North Dakota and Oklahoma have also ban non-competes
27:45
and New York recently passed a bill that would outlaw non-competes it’s just waiting on the governor’s signature and
27:51
then in Colorado and Washington DC they both recently pass laws limiting non-competes to employees who make a
27:58
certain pay threshold and if you haven’t picked this up already in general courts have grown increasingly skeptical
28:05
skeptical about employers need for non-competes except in cases when employees have access to truly sensitive
28:13
information this will be very interesting to see how this plays out this will be a huge change for the
28:20
healthcare industry and when it comes to healthcare the argument is that non-competes actually depress worker
28:26
wages limit competition and result in higher health care costs and it’s estimated that by eliminating
28:33
non-competes it opens up a potential annual healthc care cost Savings of up
28:38
to $148 billion now they gave no insight into how they calculated that number so
28:44
please take that with a grain of salt the FTC votes in April so we will have to wait and see how it goes but we will
28:50
certainly be providing an update once there is one and to end our new segment on a
28:57
positive note Cedar Sinai has expanded a nurse-led workplace Wellness initiative
29:03
by adding in a Serenity Lounge so two nurses found an underutilized locker
29:09
room and equipped it with massage chairs aromatherapy oils artwork and other
29:14
amenities to provide nurses and staff with a much deserved break and in a
29:20
study recently published in the American Journal of Nursing Cedar sin nurse investigators found that nurses who used
29:28
a massage chair in a quiet room for as little as 10 minutes experience mental and emotional relief allowing them to
29:35
return to Patient Care better equipped to handle the stress so kudos to the two
29:40
nurses that took this initiative to improve the workplace for themselves and for their
29:46
colleagues and that news story officially wraps up this week’s podcast thank you as always for spending a few
29:52
minutes of your week with us make sure to subscribe or leave a review on whichever platform you’re listening from
29:58
I hope you have a great day and we will see you again next
30:10
week
welcome to this week in surgery centers if you’re in the ASC industry then you’re in the right place every week
0:08
we’ll start the episode off by sharing an interesting conversation we had with our featured guest and then we’ll close
0:13
the episode by recapping the latest news impacting surgery centers we’re excited to share with you what we have so let’s
0:20
get started and see what the industry’s been up to hi everyone here’s what you can expect on today’s episode today is
0:28
the final episode in our nine-part denovo Series so last but certainly not
0:34
least Greg deconcilis joins us again to talk about continuous Improvement so you
0:39
have officially opened your doors and you can certainly celebrate but what you cannot do is become complacent so Greg
0:47
walks us through keeping physician and patient satisfaction High the role of data in benchmarking how to cultivate an
0:54
environment of growth and how to continuously improve expand and thrive
1:00
in our news recap we’ll cover the 11 asc’s in California being recognized by
1:05
Casa why it’s important to screen for cognitive impairment in your patients
1:11
the latest on non-competes and the FTC and of course and the new segment with a
1:17
positive story about a new Serenity Lounge at Cedar Sinai Medical Center
1:22
hope everyone enjoys the episode and here’s what’s going on this week in surgery
1:28
centers hi Greg welcome to the podcast hi thank
1:34
you for having me appreciate it yeah can you tell our listeners a little bit about yourself please sure my name is
1:40
Greg dilus I my background is actually clinical as a PA worked in orthopedic surgery since 1999 worked initially at a
1:49
large Orthopedic Hospital um left there in 2004 to open up our Surgery Center we
1:54
a multip specialty Surgery Center located in the outskirts of Boston called Boston Outpatient Surgical Suites
2:00
uh we’re in wam Mass um we primarily do Orthopedics um pain management and some
2:06
general surgery so although we are considered the multi we just you know primarily perform those three Specialties uh fairly busy Center again
2:13
servicing the Metro West and Boston Community do about anywhere from 350
2:18
Ortho cases a month per se and couple hundred other random cases as well from Pain to General Surgery Etc so again a
2:26
fairly busy Center actually looking to grow to a 8 Center in the next 18 months
2:32
we currently have three o and again looking at the the total explosion if you will of the outpatient joint in in
2:38
spine kind of market so it’s worked out pretty well yeah been here ever since yeah and that’s exactly why I’m excited
2:44
to have you on today because for the last two months or so we’ve been compiling all sorts of podcast episodes
2:50
and content and Industry advice on how to successfully open a new Surgery Center and this episode today will be
2:58
one of our last in the series and I’m excited to pick your brain about this idea of continuous Improvement
3:03
especially with the projects you have going on after you’ve opened your doors and the dust has settled there’s still
3:09
work to be done so what does continuous Improvement mean in the context of a
3:14
surgery center and why do you think it’s so important for long-term success sure and I guess I’ll start with
3:21
we we all think of continuous Improvement differently obviously we look at outcomes and those types of things but us doing a new Surgery Center
3:29
I think is continuous Improvement because o are packed full with our three o where there’s no block time for about
3:36
15 or 20 surgeons who want to come in and use the facility and so as a result you have surgeons I’m sorry patients who
3:42
are stuck if you will in the hospital systems backed up and they can have surgery for two three four months and
3:49
our solution was to go out there and and open this new facility again almost tripling our o capacity allowing those
3:55
new surgeons to come in be a part of what we’re doing but in turn providing again more availability for high quality
4:01
outpatient surgery but back to your original question you just made me think about that continuous improvements is an
4:07
interesting thing it’s it’s almost if you will a requirement I think everybody feels like they do things very well they
4:13
that kind of things they have good outcomes and Etc but I feel like as part of the accrediting bodies that they come
4:18
in and certify organizations they require some sort of continuous Improvement structure but generally
4:24
speaking that’s what it is it’s this kind of structured strategy if you will to either quarter l or even monthly to
4:31
evaluate those outcomes and how you’re doing things about your facility your efficiencies all your benchmarks that type of stuff and doing a systematic
4:38
approach to make sure you’re making constant improvements and enhancing your outcomes and that type of stuff yeah
4:45
definitely and so if we think about Physicians really quick so in your case
4:50
of expansion there’s obviously more Physicians looking to schedule cases at your facility there was a patient need
4:57
what role does the Physicians play with continu Improvement and if you do want to expand how do you approach
5:03
Recruitment and engagement and how do you keep physician satisfaction High sure and all I’ve been doing this
5:09
for almost 20 years so I’ve seen this kind of this pattern so back in 04 when
5:15
we opened there was a lot of Surgeons who were looking to get out into the industry the GI docs and the opthalmologists they’ve all they had
5:20
already had done their stuff in late 9s early early 2000s now Ortho was the
5:26
force of the Forefront we saw this kind of big flurry to folks get to the outpatient setting then I felt like it was static a little bit and then I feel
5:33
like coid and particularly in the ortho front where the hospitals shut down appropriately and they weren’t allowing
5:39
you know any impatient surgery this kind of movement towards outpatient improved and so I think we saw this again we’re
5:45
seeing this flurry again of a lot of Surgeons ESP again in the ortho world coming to be involved in a surgery
5:51
center and kind of experience the benefits and what are those for us again we have folks just because we’ve been
5:57
around for a while who knock on our door but I I always find meeting a new surgeon is always done best through a
6:03
soft warm intro from a from another surgeon and oftentimes there’ll be a colleague they’re working with who
6:08
somebody at the hospital who frustrated from a turnover time or they didn’t have a certain device or whatever and so they
6:14
they have conversations about this the satisfaction they’re achieving at their Surgery Center and so this kind of warm
6:19
intro occurs and then my strategy is always to reach out to that surgeon I provide them with some basic information
6:25
in the facility and invite them out to the facility so they can actually look had experience it and meet some of the
6:31
folks and and get a taste of kind of what we’re all about I think the sale is an easy thing in that sense I think
6:37
surgeons are simply looking for an efficient place to operate they’re looking for a place where they don’t
6:43
have a new staff member each time they operate who has to be retrained in the things they like and dislike they know
6:49
they’re looking for the supplies and equipment they need to be on that back table and ready to be used and so
6:55
there’s no secret sauce to it there’s no secret recipe it’s simply just being attentive to the surgeon we always do it
7:01
for the patients right that’s where we’re all on Healthcare but being attentive to the surgeon as well making sure early on we have a consistent staff
7:07
with them so they get familiar with them making sure their preference cards are accurate making sure they have their equipment and supplies they need for the
7:13
most part and the efficiency is kind of built into the to the facility and so they’ll have a better day and know by
7:19
the way they get out probably two three four hours earlier with the same amount of volume or more and again it’s it’s
7:24
what makes facilities such as ours really successful is is that key that key piece surgeons want to bring their
7:30
cases to our facility and operate there so it works out pretty nicely yeah and I think that’s such good advice too
7:36
because even if you don’t have the reputation that your facility has and has built over the years if you have
7:42
Physicians that are obviously in the hospital ask them if you are looking to expand and grow keep your ears open let
7:47
it happen organically bring them on in and show them how positive The Experience can
7:53
be and you had mentioned patience which is the perfect segue obviously keep
7:59
keeping the Physicians satisfied is one thing keeping patients satisfied is another what strategies do you suggest
8:06
people Implement to measure patient satisfaction and then the second piece of that would be Translating that
8:12
feedback into actual tangible changes sure a couple things we do first
8:18
off I think we’re all been I say use the word benefited but not that we all want to do it but we’ve C with the changes from regulations and that type of stuff
8:24
we’ve worked towards our a computerized kind of assessment server like a prescy type thing which is what we use because
8:30
we know that we’re going to be you know heading that way and so most of us are already there and so we utilize that and
8:36
I think the key with this is not just having the scores be reported out to you and reading them and then putting them
8:42
aside we make it a point of every single one of our staff meetings and every single one of our board meetings and our
8:47
meetings with Physicians to communicate those outcomes and I think that’s the biggest PE that’s the biggest piece is
8:53
really just one of the keys to Our Success is we used to have board meetings monthly and it was every with
8:59
every single surgeon who was an had an ownership interest and was a part of that facility and the same thing with staff meetings I think the most
9:05
successful uh centers are ones that have staff meetings monthly not just quarterly and they um have a set agenda
9:13
and we talked earlier about continuous improvements again a set strategy and there’s certain items on there and one of them is patient satisfaction and I
9:19
think we always report about Trends and then again most importantly once we see things slip in some fashion and again
9:24
the nice thing about some of these like prescy they they put they list a certain for example Administration and check-in
9:31
recovery and discharge instructions things like that and so whenever we see those items um start to slip a bit we
9:37
always put it on the staff’s shoulders if you will and not in a negative way but say listen what’s changed are we
9:42
just busier are we just is there new staff do we have to train and we always put it upon them to come up with Solutions and most importantly we
9:50
remember those Solutions and is myself and our nurse managers and we and report back to the staff on how things are
9:56
doing are we improving what can we do better and that kind of stuff stuff and so we’ve really spent a lot of time on this and and I will say transparently
10:03
and I don’t know if it’s just a Northeast thing but we have we don’t have the best patient satisfaction scores and I’m sure you might be
10:09
listening to this and saying the same thing you think you provide great care and you we have great outcomes and how can we do better on the patient
10:14
satisfaction side and we talk to our patients we call them the next day and they’re all doing great that type of
10:20
thing but you have to look at the whole piece but really dive down to those numbers again don’t just read them read
10:25
them process them communicate them with staff and and look at the the minutia of the different areas where you think you
10:31
can improve because I think it can really contribute to an overall higher scores and again that’s how we approach
10:37
it yeah it’s interesting I’m in Connecticut I totally get it we are a a
10:42
complicated bunch in the Northeast but um yeah it’s interesting I think patient
10:49
satisfaction as a whole is interesting because there’s so many elements that go into it that are actually sometimes out
10:55
of your control I don’t know about your facility specifically but it could be parking it could be maybe the financial piece of
11:01
it things that they don’t realize really aren’t related to the surgery center directly but it still added to their
11:08
experience as a whole and then ours is ours is location finding it
11:14
and they come in the door frustrated to start it just set starts that first impression of they don’t forget it so
11:19
it’s a really good point some’s are out of your control yeah that’s tough but the data to your point earlier is key
11:26
and also being able to share that with your staff and not saying oh I have this feeling that we’re underperforming in
11:32
this specific area but being able to point to the actual comments you’re getting from patients and the trends month over month is huge and could help
11:39
catch something before it becomes a really big issue so let’s talk more about that data
11:45
collection and benchmarking how does benchmarking specifically against industry standards help identify areas
11:53
that need Improvement and and what do you currently do in terms of data collection and benchmarking yeah again I I think
12:00
benchmarking is really key it’s one of those things where as I mentioned earlier I think we all believe that
12:05
we’re doing providing great care again we have good outcomes that type of thing but it’s always nice to Benchmark
12:11
against others and again if I if our patient satisfaction scores were 89% or
12:16
85% overall overall recommendation I so that’s pretty good that’s it’s you know it’s not 65 it’s not 75 but I realized
12:23
that the national average or the average for the area was 95% then again you it puts all your thoughts and your
12:29
perspective into into reality into real numbers and so for us again it’s worked out really well we have a management
12:35
company and we’re able to Benchmark amongst all of those centers and then of course the Our National Association has
12:42
their industry standards as well and I think benchmarks are important and again it level sets things even for again I mentioned the staff and the surgeons
12:48
they want to know is is 85 a good number the national average is 86 or whatever
12:54
or 84 and then makes you makes it seem a little bit better I think I think particularly in the quality side and
13:00
then the continuous Improvement side I think having an Avenue to obtain benchmarking again nationally but also
13:06
regionally we talked about some of those aspects already is really key and fortunately again we have a National
13:11
Association that provides some of those benchmarks and and certainly there’s Pharmacy consultants and local folks who
13:17
can do the same thing so it’s helpful yeah definitely how about Cappy
13:23
Studies have you any tips there about Cappy studies you could focus on that
13:29
kind of focus on or give tips for continuous Improvement or any that you’ve seen that are really good that
13:36
you’d recommend yeah I think I actually think that sometimes we struggle to come up
13:41
with good copy study topics and I think that benchmarking is a great start for it so pick an area where maybe you’re
13:47
not meeting the average for the national or local Benchmark and discover why one
13:53
of ours again I hate to keep beating a dead horse but one of ours was patient satisfaction and we spent a lot of or it’s ongoing and we spent a lot of time
14:01
on on things like scripting and doing our own survey outside of the benchmarking and utilizing different
14:06
technology we started using and trying trying to figure out what what are the key pieces that kind of are contributing
14:13
to a higher or lower lower scores in different areas and attacking those scores and so our quality study in that
14:19
front and the reason why it’s ongoing is because we can we’re not 100% yet right so we continue to come up with new
14:25
Solutions we have different staff members who come in with different ideas and and it’s worked out pretty well and so again I always find I always feel
14:31
like that should be an annual study not patient satisfaction but anything where you feel like you’re whether it’s cost or somewhere you’re not you have access
14:37
to a benchmark score and uh number dvts number infections whatever it is those
14:43
quality benchmarks are a great place to start not only does it look good again you’re doing something good because
14:48
you’re going You’re trying trying to improve your patient outcome in some fashion so it’s a great place to start
14:53
for Quality study and again it’s tailor made for you right it’s you already have the you already have the answer of where you need to to be as far as that
14:59
Benchmark and so you just try to figure out how to strive to get there yeah and it’s interesting because we have a
15:06
couple speakers that that talk about different topics and we’re always doing webinars and we had one last last year
15:12
that was about just different copy study ideas and it was probably one of our most well attended and requested topics
15:18
because to your point everyone’s always looking for different ideas and something that’s useful too not just
15:25
trying to check a box but I think looking at the data is the perfect
15:31
source of inspiration for different ideas as to where you can
15:36
improve you had also mentioned technology so in with this bigger
15:41
concept of continuous Improvement at your surgery center what role does technology play or can it play yeah it’s
15:49
funny I always feel like we were just getting with the times now I think part of it was this move and planning what we
15:55
were going to do and different Partnerships and joint ventures Etc and so now that we’ve sorted out which direction we’re going we’re jumping back
16:01
into technology such as EMR which is an easy one and all the aspects of EMR that
16:07
that different add-ons and things you can do with it technology to me is so fantastic because it it improves so many
16:14
of your processes and outcomes but at the same time it’s scary as hell because there’s such a cost to it it does eat
16:20
away at your bottom line so to speak but I think it’s I think the challenge is not getting overwhelmed with a number of
16:26
different technologies that are out there number of different companies but finding companies that can streamline a lot of them have the more bigger bang
16:33
for your buck that are cost effective of what you’re doing and then again overall improve outcomes I mentioned for us
16:39
patient satisfaction here we go again but I feel like part of the patient satisfaction is their family members and
16:45
what they experience because the patients are most the time they’re out and they’re out of it and they as long as they wake up and and they feel better
16:51
like they’re happy but the family members are the ones who are waiting and who maybe not be getting a great amount of communication us employing some
16:57
technologies in terms of communicating with family members kind of trackers on where where patients are throughout the
17:02
facility I think I’ve really been helpful we’ve done that over the last few months and again there are Technologies for every single aspect
17:09
from everyone’s dreaded credentialing you know to managing employees to time management to you know Staffing to again
17:16
of course all the other aspects of of patient management and that type of stuff and so again it can be overwhelming anybody who attends a trade
17:23
show or the National Conference heading to the the vendor room there’s there’s 90 9,000 of them again it’s a matter of
17:30
I think utilizing your colleagues networking that type of stuff finding out which which great ones are out there
17:35
how people’s experiences have been and valuing them for yourself I think that’s been helpful for us yeah I always
17:41
suggest that as well if you have a good relationship with the surgery center down the street and they’re using a technology you’re interested to go ask
17:48
if you could go watch them use it for an hour or so or have that candid conversation with them because it it
17:53
really can be overwhelming especially if you haven’t started down the journey yet it’s where do we start and everyone’s
18:00
telling you they have the best software so it’s I get it bigger picture how can
18:06
you cultivate an environment where everybody not just leadership or the
18:12
board is focused on continuous Improvement yeah again I think I mentioned this earlier so it’s a little
18:18
bit of a repeat but I think when we’ve had the biggest issues that we will with staff and kind of Staffing staff being
18:25
disgruntled or which is not a great environment overall it’s when we’ve got to the point we got away from our
18:30
monthly meetings it’s very easy to do that because you become very busy and even though you’ve my recommendation
18:36
would always be to schedule in like ours this the fourth Tuesday of every month we meet at 6:30 in the morning it’s the
18:41
O staff to start because I usually start early 7 o’clock’s all your staff so you’re not repeating the basic stuff
18:48
like benefits and that type of thing then 7:30 is our pack you staff because that way the O staff can get off get the
18:53
day going and then by the time the patients come out you’re done there and that’s the way we’ve done it we start or the or at 7 o’clock and so it just it’s
18:59
worked out well but again I think the key piece though is again making sure you’re sticking to that meeting schedule
19:06
it should be monthly I think because things pop up constantly and then again not it’s not just meetings so okay you
19:12
checked the Box you’re meeting I got coffee for the staff I got some bagels and I’m sitting down and I’m talking to them but engaging with them I talked
19:18
about the patient satisfaction piece finding Solutions and you can’t do it all you and your management staff if
19:23
you’re the administrator your clinical management Etc we all have different knowledge base we all have different experience experiences experience in the
19:29
industry and so by opening up the floor if you will and and and trying to get some feedback and communicating
19:35
listening to what they’re they’re they’re talking about their ideas are I think that’s really the key but then again that could all be just just talk
19:43
if you’re not actually acting on it so again one of our keys is trying to get feedback from staff and then actually
19:49
doing something about it that way they don’t feel like they’re just talking and it falls on deaf ears and so for us it’s
19:54
worked out well anytime we’ve ever had a challenge on any kind of continuous Improvement plan or uh process or
20:01
whatever we’ve oftentimes gone to the staff and communicated with them and looked for Solutions and they often have them and makes your job a lot easier
20:08
engaging them is really key I think yeah that’s great advice have you ever been
20:13
your quest for continuous Improvement are there any challenges that you’ve
20:18
been faced with that you’ve had to overcome or any kind of major hurdles what I think about over the
20:24
years are besides the aforementioned ongoing try make patients in their famili happy is things like when you’re
20:30
bring a new surgery in or a new surgeon that type of stuff trying to trying to make them happy and make sure you’re
20:37
providing great care to that patient is really key I’ll use an example we again I mentioned we do Orthopedics and Pain
20:43
Management since 2004 but a few years ago we had a general surgeon come aboard and since he’s hired another partner and
20:49
when as she’s added procedures on particularly like he was doing open hernas now she does lap hernas so she’s
20:55
been doing here probably for six months we have another in service tomorrow morning at 6:30 because you can never
21:01
ever be satisfied she had a bad day one time she had some newer staff and she just didn’t have all the things she
21:06
needed and it it was the day dragged out a little bit and that type of thing and so we put it on her and that ke kind of
21:12
key staff member that works with her a lot to come up with a solution and there one of them was to do an inservice and so we’re doing that again tomorrow so
21:19
the the point there is we all there’s new equipment that comes in or again a new surgeon new uh procedure that type
21:25
of stuff again don’t just think you have the answer on how to start implement the whole process again involve staff
21:32
involve the surgeons and come up with a good plan to roll out and make sure that everything runs smoothly and again
21:38
re-evaluate it like I just mentioned we’re re-evaluating it and we’re acting again tomorrow and so it’s just you’re
21:43
just never can be satisfied we all get in a rut at some point we we feel like things going on you’re happy and that’s
21:49
why I think strategic planning sessions as part of the as part my my I was too still there my light went out strategic
21:55
planning sessions as part of your continuous quality Improvement is is really key and analyzing things and
22:01
making sure you don’t just stay static is is a key part of what your continuous Improvement should be yeah and it sounds
22:07
like in that case having that honest conversation being transparent and collaboration was the key to and being
22:14
willing to continue to work together and figure out a solution was the key there all right Greg last question we do
22:21
this every week with our guests what is one thing our listeners can do this week to improve their surgery centers yeah I
22:28
think and you’ve heard this as a theme already and I think maybe it’s a good time because if you’re listening to this and it’s after the summer it’s the fall
22:34
right before the we get busy again is get get in front of your staff have a good have a staff meeting with them open
22:40
the floor get some feedback on anything pick something pick from again efficiencies to how you to your vacation
22:47
plan your how you assign vacation time or who gets their vacation off some kind of area but yet again focus on the
22:53
continuers Improvement area and get the feedback from them and act on it I think you’re staff will really really
22:59
appreciate that and feel like you’re listening to them and that it’s a nice place to work and they know they’re heard and that kind of stuff and I think
23:05
when that happens and your staff is happier I think your surgeons are then happier because they recognize the staff
23:11
is happy and obviously your patients are going to be happy because the staff is happy they they’re enthusiastic and again that all leads to good outcomes I
23:17
would say that I think we all just talking to so many colleagues who just get busy and it just gets crazy
23:23
constantly it’s one of the areas where I think a lot of people sacrifice but have that staff meeting maybe do it out of
23:28
the bar or at a restaurant in the area and get the get the company credit card and keep it under control but do
23:34
something that if it’s a slower day in the afternoon and staff really appreciate that that would be one thing that I think has can have really
23:40
Monumental impact on your facilities perfect that is great advice thank you Greg I really appreciate all your time
23:47
and expertise today no problem thanks for having
23:53
[Music] me as always it has been a busy week in
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healthcare so let’s Jump Right In the California Ambulatory Surgery Association recently awarded 11 asc’s
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with the casa award for ASC Excellence so according to Casa’s website the awards were established to acknowledge
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the fact that California as’s are drivers of excellent health care and that they provide opportunities and
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solutions for healthc care reform the program is built around five pillar categories acknowledging facilities that
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exemplify best practices in the surgery center industry plus actively promote and advocate for ASC excellence and
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inclusion in the healthc care delivery system so certainly a tall order and as
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always we’ll link to the article so you can see all of the surgeries who surgery centers who were recognized but I did
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want to call out 90210 surgery medical center so in addition to winning the
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casa award for ASC Excellence they also won the prestigious Casa ASC of the year
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year so the staff at 90210 surgery medical center hosted four tours at both
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the con Congressional and state level they participated in the ASA DC Flyin
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they have committed to the casa safe opioid pledge they provide free
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surgeries to underprivileged children in the greater LA area and as if all of
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that it was not enough they also coordinate a crucial initiative to provide supplies to Ukraine so congrats
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to everyone who was recognized and thank you for all that you do for your
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communities Switching gears a recent study reveals the pervasive issue of
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cognitive impairment among older adults undergoing surgery so those with
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cognitive impairment which spans from mild cognitive issues to severe dementia experience an increase in postoperative
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complications and further cognitive decline and so cognitive impairment can
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negatively impact things like memory language and decision-making so if it’s undetected you can imagine how difficult
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it can be for them to smoothly go through um a surgical procedure it affects communication it increases the
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risk of surgical sight infections and then can hinder patient involvement in pre- and post-stop care so spotting any
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potential signs during the preassessment process is key and there are proven screening tools that only take 10 to 15
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minutes for patients to complete that can help identify patients at risk as early on as possible so if you’re not
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already screening for something like this identifying and managing cognitive impairment pre-surgery could help lower
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risks optimize care and ensure that the surgery and recovery process go
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smoothly in our third story according to Becker’s ASC non-competes appear to be
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going away so this story is a bit of a followup to one that we had reported on
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back in July and here are a few of the latest things to know so the Federal Trade Commission
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proposed a rule that would actually ban non-competes Nationwide but there’s still a long road ahead so the FTC will
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vote on the rule in this coming April and numerous small business groups and the US Chamber of Commerce have
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submitted letters in opposition but in the meantime states are taking things into their own hands
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regardless of what’s going on at the Federal ederal level and they’re trying to make non-competes harder to enforce
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so California recently passed laws declaring non-competes void in the state even if they were entered into outside
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of state lines Minnesota North Dakota and Oklahoma have also ban non-competes
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and New York recently passed a bill that would outlaw non-competes it’s just waiting on the governor’s signature and
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then in Colorado and Washington DC they both recently pass laws limiting non-competes to employees who make a
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certain pay threshold and if you haven’t picked this up already in general courts have grown increasingly skeptical
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skeptical about employers need for non-competes except in cases when employees have access to truly sensitive
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information this will be very interesting to see how this plays out this will be a huge change for the
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healthcare industry and when it comes to healthcare the argument is that non-competes actually depress worker
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wages limit competition and result in higher health care costs and it’s estimated that by eliminating
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non-competes it opens up a potential annual healthc care cost Savings of up
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to $148 billion now they gave no insight into how they calculated that number so
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please take that with a grain of salt the FTC votes in April so we will have to wait and see how it goes but we will
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certainly be providing an update once there is one and to end our new segment on a
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positive note Cedar Sinai has expanded a nurse-led workplace Wellness initiative
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by adding in a Serenity Lounge so two nurses found an underutilized locker
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room and equipped it with massage chairs aromatherapy oils artwork and other
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amenities to provide nurses and staff with a much deserved break and in a
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study recently published in the American Journal of Nursing Cedar sin nurse investigators found that nurses who used
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a massage chair in a quiet room for as little as 10 minutes experience mental and emotional relief allowing them to
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return to Patient Care better equipped to handle the stress so kudos to the two
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nurses that took this initiative to improve the workplace for themselves and for their
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colleagues and that news story officially wraps up this week’s podcast thank you as always for spending a few
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minutes of your week with us make sure to subscribe or leave a review on whichever platform you’re listening from
29:58
I hope you have a great day and we will see you again next
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week
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