James McClung – Opening an ASC: 30 Days from Your First Patient
Here’s what to expect on this week’s episode. 🎙️
🎙 You are 30 days from your first patient at your new surgery center. A little bit of stress mixed with excitement is expected, but where should you focus your time and efforts?
James McClung is an experienced ASC Developer and Consultant. In part 8 of our De Novo series, we cover final regulatory and compliance checks, necessary equipment, technology, supplies, contingency plans, and how to prepare your clinical and administrative teams.
➡️️ Start with a Plan: Develop processes early and ensure step-by-step development with a meticulous timeline.
➡️ Education & Collaboration: Don’t reinvent the wheel! Collaborate with state organizations, utilize accrediting bodies, and use available resources for educational requirements. Utilize resources like ASCA’s forum, books, and experienced professionals in the industry.
➡️ Operational Efficiency: Maximize efficiency within existing responsibilities before adding more, such as maximizing the role of pharmacy consultants for overall quality improvement and maintaining compliance.
➡️ Involve Experts: From fire drills to emergency scenarios, involving experts like fire marshals and EMS ensures you are prepared for unexpected situations.
➡️ Continuity of Care: Make sure you have a strategy to maintain quality and operational continuity, even in leadership turnovers.
➡️ Solving Challenges: Look to quality assurance and continuity of care. Involve others in processes and ensure performance evaluations guide the path toward patient-centric quality care.
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
Find the full episode on Apple Podcasts, Spotify, or YouTube to hear all the details.
Episode Transcript
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]
0:27
to hi everyone here’s what you can
0:30
expect on today’s episode we are in the
0:33
home stretch of our nine-part denovo
0:36
series and James mclung joins us this
0:39
week for part eight to walk us through
0:42
what you should be doing when you are 30
0:44
days from your first patient so it’s
0:46
critical that you are crossing all your
0:48
tees and dotting all your eyes so we’ll
0:51
go through your final Regulatory and
0:53
compliance checks necessary equipment
0:56
Tech Supplies contingency plans
0:58
preparing your clinical at
1:00
administrative teams and so much more
1:03
and in our news recap we’ll cover the
1:05
results from asa’s Price transparency
1:08
survey provide an update on the no
1:10
surprises act share how as’s are
1:13
adapting for success and of course and
1:16
the new segment with a positive story
1:18
about a nurse who reunited with a man
1:20
whose life she saved hope everyone
1:23
enjoys the episode and here’s what’s
1:25
going on this week in surgery
1:28
centers
Compliance
1:32
hi James welcome back to the podcast hi
1:35
thank you in case our listeners missed
1:38
your episode with us last year can you
1:40
share a little bit about
1:44
yourself yeah my name is James mclung
1:46
I’m a registered nurse bachelor’s
1:48
registered nurse I have been a
1:51
administrator and pretty much filled any
1:53
role and an ASC I have a business that
1:56
helps to develop and consult for ASC
2:00
I’m on the Executive Board of the state
2:02
Organization for AC’s of Texas and I’m
2:05
also on the triple HC expert content
2:08
committee deem status so a little bit of
2:11
experience amazing and all of that
2:14
experience is exactly why we needed to
2:16
have you on today for the last two
2:18
months we’ve been pushing out episodes
2:20
Focus mostly around the process of
2:22
opening up a new Surgery Center and
2:25
really trying to walk everyone through
2:27
step by step of how to successfully open
2:29
up a facility so with you today we’re
2:31
going to dive into what to do when
2:34
you’re 30 days out and make sure that
2:36
you’re Crossing all your teas and
2:38
dotting all of your eyes so the
2:41
discussion today will be bucketed by all
2:42
the major areas so let’s start with
2:45
compliance what final Regulatory and
2:48
compliance checks should be conducted to
2:51
guarantee everything’s in order for your
2:53
opening
2:55
day that’s a good question I did forget
2:58
to mention that I am currently the nurse
3:01
administrator of Memorial Ambulatory
3:03
Service Center and the reason why I say
3:05
that is because we were just inspected
3:06
by triple HC so I might bringing it up
3:10
as an example and I don’t want to
3:11
confuse anybody I would say is that
3:13
number one when you’re opening up a
3:14
center you need to have your closeout
3:17
documents from your general contractor
3:20
warranties preventive maintenance
3:22
preventive maintenance schedules more
3:24
importantly how to use the systems your
3:26
processes and procedures that are going
3:28
to go along with that equipment in those
3:30
systems with triple HC it’s about do you
3:35
do what you say you do right so they’re
3:38
very important um you also want to make
3:40
sure to have in place guidelines right
3:44
guidelines are huge when it comes down
3:46
to the specific temperatures are the
3:51
specific ways that you run your
3:54
sterilizer right um specific examples of
3:58
how you wash your hands and how long you
4:00
wash your hands right the metrics that
4:03
you’re looking for so those need to be
4:05
in place before you open up if all
4:08
possible and I will say is that is a
4:11
good example of why using someone that
4:14
has experience in help really leads to
4:16
quality insurance which is the biggest
4:19
problem that I see in
4:21
centers sure especially independent
4:24
mostly Independents but it’s done a
4:25
little bit differently everywhere so
4:28
yeah we’ve talked a lot about at what
Who to trust
4:30
point you get help and who do you get
4:31
help from and because I feel like
4:34
everyone opens tries to open up surgery
4:36
center with the best of intentions but
4:38
if it’s a group of Physicians that are
4:39
together and they’ve never done it
4:41
before then it’s really hard to know all
4:44
the little stuff that needs to be done
4:45
and things can get
4:48
delayed well what’s harder is who to
4:51
trust for example I’ve been several
4:53
different turnarounds where The
4:56
Physician Group
4:58
trusted individuals which they delivered
5:03
but there was certain discrepancies
5:05
between the work the general contractor
5:07
did and the approved plans of the
5:09
Architectural Review unit of the state
5:12
and usually typically that’s because of
5:15
cutting Corners right and the almighty
5:18
dollar so when I come in from the
5:20
physical aspect usually these are
5:23
scenarios that I see where the Physician
5:26
Group is having to replace a boiler
5:29
after three years which if taken care of
5:31
can last forever right or HVAC issues
5:34
where there’s dampers missing
5:38
or documentation missing on warranties
5:42
and and there could be liability issues
5:44
that arise from that yep that’s actually
Physical setup
5:47
the perfect segue are there other any
5:49
other examples or aspects of the kind of
5:52
physical setup in infrastructure that
5:54
should be
5:57
reviewed yes absolutely absolutely yeah
6:00
so all that I just said and there are
6:03
some specifics I included the Texas
6:05
department of uh State Health uh their
6:08
Architectural Review unit has a
6:09
checklist of closeout documents includes
6:12
Fire Marshal approval your uh building
6:15
inspection department approval which
6:16
means 100% inspection which means that
6:19
you are receiving your Co U which leads
6:22
to that 30 days that everybody talks to
6:24
talks about once you have your CEO then
6:26
you have 30 days where you can move in
6:29
and you want to open up 30 days after
6:31
that start those 10 cases and get
6:33
Medicare involved um our triple HC I
6:37
would highly suggest especially on
6:39
initial
6:40
surveys deem status is the way to go for
6:43
a news center that is not established
6:46
yet now for existing sers or our our
6:48
expansions the process is a little bit
6:51
different and and sometimes a little bit
6:53
smoother because you already have those
6:55
processes in place but to answer the
6:57
question is that you want to double
6:58
check the AR are you right it’s really
7:00
starts with a a punch list right because
7:03
you’re going through and making sure
7:05
that fire cocking is done the work that
7:08
the general contractor did it matches
7:11
the aru right I don’t think usually
7:13
official language is used like that but
7:15
that’s what you really are doing is
7:17
making sure that I’ve been in centers
7:20
where it called for the recessed
7:22
sprinkler systems but the general
7:24
contractors came in and put the non
7:28
recess sprink systems in there so it
7:31
does require someone to in my mind be
7:34
there throughout the process but that is
7:37
your last chance so making sure the
7:39
generator runs under 10 seconds that
7:41
kind of stuff so sure sure yeah and how
Equipment and Technology
7:45
else can you verify that all necessary
7:48
equipment and Technology are fully
7:50
functional well number one you have to
7:53
have biomedical come check them for
7:54
electrical safety right these are
7:56
contracts that you need to have in place
7:58
before you you open and then also in
8:01
Services the manufacturers right it
8:05
depends if you get the equipment from a
8:07
third party make sure that it’s a
8:09
certified third party or a reputable
8:12
third party right there’s a lot of
8:16
physician groups that I’ve seen that
8:19
have been upsold asked questions that
8:23
are important to ask the person that is
8:27
selling it to you are they upcharging
8:29
that equipment is that the most
8:31
necessary equipment for you do you need
8:34
that piece of equipment so that it
8:37
starts there but once you have the
8:39
equipment that person that you bought it
8:41
from needs to make sure and you need to
8:43
hold them accountable to have it in
8:45
service the instructions for use right
8:48
and then also the other systems that are
8:50
you know feeding that piece of equipment
8:53
making sure that they are working
8:55
appropriately as well and what I mean by
8:58
that is for example the sterilizer the
9:00
boiler if your water softener is not
9:02
providing one part
9:07
per whatever The annotation is at the
9:10
end I can’t remember it’s like
9:12
milliliter yeah one part per milliliter
9:13
I think of hardness and it’s higher if
9:15
it’s hard water your boiler will go out
9:18
so you need to make sure that you’re
9:20
following the instructions for use and
9:21
that you have the appropriate PM
9:24
schedules those are set up that you have
9:26
a schedule a agreement for that and then
9:28
also so that they inservice you on how
9:31
to use it
9:32
appropriately gotcha yeah all that makes
9:35
sense Switching gears a little bit what
9:38
strategies could ensure that the
9:40
clinical and administrative teams are
9:42
trained and prepared for that first
9:44
patient to come
9:46
in yeah well one starts with a plan
9:49
right when you are a new center and you
9:52
have not opened up the center before
9:54
those processes are not in place and
9:56
that needs to start very early in in the
10:00
uh development process in my mind in
10:03
fact I have another tool that I created
10:05
uh for the last task conference it has a
10:07
timeline of the individual steps it
10:10
takes to develop a surgery center it
10:12
might have actually been included in our
10:14
last podcast I’m not sure but it gives
10:17
you a good indication of how long those
10:19
steps should take and that is a very
10:21
important one right because typically if
10:24
you are a practice and you are trying to
10:27
transfer patients from one Center to the
10:30
next there needs to be some type of
10:33
incentive for those patients to to move
10:35
typically because you don’t want their
10:37
experience to be effective right so
10:39
having those conversations setting up
10:40
those processes Discerning how you’re
10:43
going to pay your contracts right are
10:46
they in place yet are you just going to
10:48
offer cash pay to get those 10 cases
10:50
that requires to get the triple HC DM
10:52
status survey it’s a imperative process
10:55
that needs to be figured out before you
10:58
get to that 30 days
11:00
yes
11:02
absolutely and the LA for emphasis yeah
11:07
and what so with those teams do you
Training Tools
11:10
recommend that the like Surgery Center
11:13
leaders or physician owners really work
11:15
with those teams or do you rely on your
11:17
state AC associations just various
11:20
training tools any recommendations
11:24
there yeah one when it comes down to
11:26
education just make sure that you are
11:29
the accrediting body that you’re using
11:31
that you check their regulations on what
11:33
education is required right also there
11:37
are tools from experience that I have
11:40
gained or created reach out to your
11:42
neighbors don’t
11:45
just do not reinvent the wheel there are
11:48
so many people out there that are
11:49
willing to help there are ASA there’s
11:52
task in Texas there’s in cal every state
11:56
that I know of has a state organization
11:59
not to mention at least
12:01
on my middle level that there’s always
12:06
we need to stick together right and help
12:08
each other out to survive um nothing
12:11
that we do is a secret um and the only
12:15
way that it will get better is by us
12:17
sticking together so uh there’s so many
12:22
resources out there um you know I’m
12:25
pretty much I would have to say is that
12:27
I learned how to run an ASC
12:31
from
12:33
specifically more John Bob
12:36
Tom
12:38
Toms right Chris and
12:42
then resources right Joe alza wrote a
12:45
book on how to open up and develop a
12:47
surgery center I got that marked up
12:50
right asa’s Finance book asa’s forums
12:53
and Googling that and being involved in
12:56
it and actually replying so every one of
12:59
those people thank you because I
13:02
wouldn’t be here without you oh that’s
13:04
great to hear yeah I love the askap for
13:06
is huge I get the daily digest and all
13:10
the questions you can learn so much and
13:12
people share so much spreadsheets PDFs
13:15
handbooks like everyone is always quick
13:17
to respond and and help
13:20
out yeah just go don’t even don’t get me
13:23
wrong you should pay it for it and be
13:25
involved but yeah their library is
13:28
outstanding
13:29
yep I
13:31
agree all right so let’s talk about
Supplies
13:35
supplies meds and other necessary
13:37
resources what should you be doing just
13:39
to confirm that you’re all set in that
13:43
regard all right so James mcclung’s pet
13:46
peeve of 2020 actually it’s been a pet
13:50
peeve of mine forever well you
13:52
don’t you don’t increase the
13:55
responsibilities of asc’s by trying to
13:58
just add as much stuff as you possibly
14:00
can and just doing everything that other
14:04
facilities potentially would do we need
14:06
to maximize our efficiency within the
14:09
what we do have now the responsibilities
14:11
that we’re able to accomplish now and
14:13
and one of those that I feel like we are
14:15
not doing enough is Pharmacy I feel like
14:18
our Pharmacy Consultants that we
14:20
contract with are being sorely
14:25
underutilized and I will tell you is
14:27
that my first center that I devel on
14:29
very fortunate to be introduced to a
14:33
pharmacist that was looking to go out on
14:35
her own so from the very
14:38
beginning we learn together and I assure
14:42
you she’s the only pharmacist that I
14:45
know trust narcotics but I know that
14:48
she’s doing it right she’s involved in
14:51
quality improvement she orders narcotics
14:54
she looks for lookalike sound alike
14:56
drugs she helps in education and with
14:58
the crash cart organizing the crash cart
15:01
medication
15:03
utilization and also with anesthesia
15:06
making sure that they’re labeling making
15:08
sure that they’re following proper
15:11
etiquette and Industry standard when it
15:14
comes to patient care right she’s just
15:17
much more involved than just coming in
15:19
and doing chart audits and I feel that
15:23
is something that needs to be addressed
15:25
and improved across the board in our
15:27
industry yeah yeah
15:30
um is that Jones Amy Jones by any chance
15:35
I can’t think of her name but we had a
15:37
great pharmacist consultant come exactly
15:39
who it is
15:40
yeah she’s the only one I know
15:44
of that’s awesome good in my mind is
15:47
probably the only one you need to know
15:48
at this point
15:50
so that’s great sorry continue I just
15:53
like it had to be
15:54
her no it’s okay but within that though
15:57
look to the expert s Get Your Fire
15:59
Marshall well not Fire Marshall but like
16:02
your fire alarm company to come in and
16:04
show you how to do it set up with them
16:05
to do a fire drill once a quarter right
16:09
learn how the fire alarm contacts the
16:12
fire company how the EMS is contacted
16:15
contact EMS have them there for a code
16:18
learn how long it’s going to take for
16:20
them to get there know your neighbors
16:23
it’s not what you know it’s who you know
16:25
you have to relationships when it comes
16:27
down to running an appropriate Center
16:29
living in the now a big thing for me is
16:32
the timeline when it comes down to
16:34
compliance you live in the now right
16:37
that’s your goal right and then you
16:40
would look into the future and then the
16:42
past is it’s last right so if you’re
16:47
stuck in the past you’re just treading
16:49
your feet on a hamster wheel and you’re
16:51
not living in the now and the weight of
16:54
compliance could literally Crush you the
16:57
way you do that is by making
16:59
relationships staying involved getting
17:02
involved and not only looking to learn
17:05
how to do it but to make it better for
17:07
the ones that follow
17:09
you yeah that’s great I feel like we’re
17:12
this is very like philosophical today
17:14
we’re going deep so it’s because I’m at
17:17
a center it’s so like when I’m at a
17:20
center I’m more like Phil Jackson I’m
17:22
serious like I had the lights turn low
17:24
and I’m like everybody breathe
17:27
deep
17:29
I love it it’s about more of the why
17:31
than right than the what so yeah for
17:34
sure what advice do you have for
Contingency Plans
17:37
developing contingency plans to address
17:41
any and all un unforeseen
17:44
challenges yeah and so beyond quality
17:47
assurance where my my biggest goal of
17:50
2023 and one of the reasons why
17:53
Independents probably should unite is
17:55
quality assurance there’s been many
17:57
centers that that I have helped to
18:00
develop where it’s like a mix and match
18:04
of different manufacturers on the water
18:07
softener or another process the air
18:10
compressor right and the reason being is
18:13
because General Contractors don’t know
18:16
the difference right they don’t know why
18:18
we would want to have just a Steris
18:21
right or a colan water softener and so
18:24
they’re looking to save money right so
18:27
therefore it’s a little bit different
18:30
and those small differences add up
18:32
especially when you don’t have someone
18:34
that
18:34
doesn’t understand that concept but the
18:38
other concept that is big to me is
18:40
continuity of care and when I come into
18:43
centers a lot of times there’s probably
18:45
a lot of leadership turnover but more
18:49
importantly are I I wouldn’t say sadly
18:52
but concerning is that there is no
18:56
continuity of care there’s usually one
18:58
person or a few people that take on the
19:01
way of the world and then if they leave
19:05
or if they don’t leave no one else is
19:08
involved and so there’s a big giant
19:10
disconnect of how it was done before how
19:14
it’s being done now and then how it’s
19:16
going to be done in the future there’s
19:19
no continuity of care right and so how
19:22
you do that is by involving others right
19:25
performance
19:27
evaluations right looking at how others
19:29
have done it not Reinventing the wheel
19:32
including triple HC including your
19:34
Department of State Health stop living
19:36
in fear live in the now right it’s not
19:40
about where we’re at today right it’s
19:43
about where we’ll be at tomorrow right
19:47
and there will always be someone that
19:50
may have to fill that role even if um
19:52
you’re promoted or win the lottery right
19:55
so it’s all about patient care and
19:58
keeping that constant quality when it
20:00
comes down to Patient
20:02
Care great and I feel like you’ve shared
20:05
a lot of advice with us so far but any
20:08
final last words of wisdom um or
20:11
inspiration for those who are nearing
20:13
their opening date might be slightly
20:15
panicking but are are excited to open
20:18
any final words of
20:20
wisdom yeah uh you’re not alone right uh
20:24
the more that you can do up front the
20:26
better loading contracts into your emrs
20:29
loading the preference cards into your
20:31
emrs if you are finding yourself saying
20:34
we’ll do that later re-evaluate
20:39
that you’re not alone there are other
20:42
people that can help you to accomplish
20:43
those goals but once you get going and
20:46
you hit the ground running it’s much
20:47
harder to go back into the past yep
20:50
definitely cool thank you so much James
20:54
so we do this every week with our guests
20:56
what is one thing our listeners can do
20:59
this week to improve their surgery
21:01
centers no yeah we’ve talked about it
21:04
but quality assurance and continuity of
21:06
care cool Perfect all right James thanks
21:10
so much for coming on again we
21:12
appreciate it anytime thank you for
21:14
having
ASC Price Transparency
21:16
[Music]
21:19
me as always it has been a busy week in
21:21
healthcare so let’s Jump Right In ASA
21:24
released the results from their August
21:26
62nd survey
21:28
which asks questions all around price
21:31
transparency so as a reminder very very
21:34
quick history lesson here the push for
21:37
Health Care price transparency gained
21:39
traction with the Affordable Care Act
21:42
but things really started moving in 2019
21:46
when hospitals had to publicly share
21:48
their standard charges online and then
21:50
in
21:51
2021 a new rule was introduced demanding
21:54
hospitals be more transparent followed
21:56
by similar requirements for health
21:58
insurers the next year and then on the
22:00
ASC side as we know surgery centers must
22:04
provide a good faith estimate to
22:06
uninsured or self-paying patients under
22:08
the no surprises act and then just this
22:10
past September a bill titled lower cost
22:13
more transparency Act was introduced
22:16
suggesting asc’s should disclose their
22:18
standard charges though it didn’t pass
22:21
it does of course indicate this growing
22:23
interest in price transparency as a
22:25
whole so the timing of this survey is
22:27
perfect
22:28
all right so what did the survey results
22:30
entail so ASA had 160 respondents across
22:34
39 States and they shared that 70% of
22:38
their websites have a list of common
22:40
procedures but only 20% shared that
22:43
their website includes price information
22:46
for those common procedures so those
22:48
numbers are lower than I would have
22:50
liked to see but the positive is that
22:52
regardless of what is shared on their
22:54
websites 91% of respondents said said
22:58
their facility has a standard workflow
23:00
for providing estimates to patients at
23:02
least prior to their
23:04
procedure and lastly 77% are using the
23:08
payer negotiated rate to calculate those
23:11
price estimates while 12% are using cash
23:14
prices and 7% are using procedure gross
23:17
charges now ownership does play a role
23:21
here which I think is really interesting
23:23
those who have Hospital ownership are
23:26
more likely to have a website but less
23:29
likely to provide
23:31
estimates and then those who have
23:33
physician ownership are less likely to
23:36
have a website at all but more likely to
23:39
have a standard price estimate workflow
23:41
so they’re kind of flip-flop there now
23:43
Alex Tyra and ASA did a great job
23:45
summarizing additional results from the
23:48
survey so as always we’ll link to the
23:50
article in the episode notes if you want
23:52
to kind of dive into these numbers
23:55
further and then sticking with our
23:58
transparency theme in a proposed rule
24:01
filed about two weeks ago the HHS the
24:04
Department of Labor and the department
24:06
of the treasury proposed hiking the
24:09
administrative fee to enter the no
24:11
surprises act independent resolution
24:14
process from $50 to
24:17
$150 the agencies also proposed
24:20
increasing the upper limit of the fee
24:22
range for certified IDR ENT entities by
24:26
20% for single determinations and 25%
24:30
for batch determinations and the
24:32
proposed rule of finalized would go into
24:35
effect on January 1
24:37
2024 so the agency’s project to spend
24:40
$70 million to implement the independent
24:44
dispute resolution process in 2024 on
24:47
Personnel costs certifying IDR entities
24:51
and completing investigations so
24:53
assuming 225,000 IDR disputes closed
24:57
next next year based on Trends observed
25:00
previously the proposed increase would
25:02
allow these agencies to recoup the costs
25:06
and as a reminder another little history
25:08
lesson the federal IDR portal was opened
25:12
between April 15th 2022 to March 31st
25:17
2023 and during that time
25:26
334,000 s had estimated and prepared for
25:30
hence why they’re anticipating that they
25:32
need all this additional funding to
25:34
manage the process
25:35
correctly Jim binski who’s the CFO of
25:39
WellStar Health System shared that he
25:42
had filed approximately 8,000 IDR
25:45
requests since the portal opened and of
25:48
those only 7% have been resolved so
25:51
though again the belief is that raising
25:53
the fees could provide agencies with
25:56
additional resources to address the
25:58
large dispute volumes now the kicker we
26:00
can’t raise the fees too much where it
26:02
becomes prohibitive for the average
26:04
person to be able to submit something
26:06
through the IDR process so that’s where
26:08
we have to find the balance here so we
26:11
will keep watching this bill and see
26:13
where it goes but just your usual
26:15
reminder to get ahead of all things
26:18
related to price transparency get those
26:20
automated workflows in place and get
26:22
ahead of the legislation that has come
26:25
your way and will just continue to come
26:28
your
26:29
way all right Switching gears a bit
26:31
Becker’s ASC asked a few Surgery Center
26:34
leaders the following question how have
26:37
you updated your strategy for success in
26:40
Outpatient Care recently so I’m just
26:43
going to summarize a few responses here
26:45
but as always I recommend uh checking
26:47
out the full article because there are
26:49
so many good tips um but here are a few
26:52
that stood out to me that I wanted to
26:53
share in no particular
26:56
order so the The Spine Center Spine
26:58
Center Atlanta has embraced
27:01
technological advances to streamline
27:03
communication and stay connected with
27:05
patients after the patients leave the
27:07
ASC they have also increased their
27:10
digital presence to stay connected to
27:12
patients through email and social
27:15
media Austin Orthopedic Institute
27:18
focused on critical metrics such as
27:21
patient outcomes patient satisfaction
27:23
efficiency and cost and post-operatively
27:26
they also have have been bringing in a
27:28
licensed physical therapist to help
27:31
mobilize patients before they even leave
27:33
the
27:34
facility spine and Orthopedic Center in
27:36
Florida is leaning into new technologies
27:39
and techniques that are allowing for
27:41
more opportunities for minimally
27:43
invasive spine
27:45
procedures they are also focusing on
27:47
patient education recognizing that
27:50
well-informed patients generally
27:52
experience better
27:53
outcomes and lastly Brentwood Surgery
27:56
Center is is completely focused on total
27:59
joints sharing that asc’s that have not
28:02
adopted or or are planning to adopt this
28:04
strategy are behind the curve and
28:06
missing out on the Great
28:08
Migration so just a few highlights there
28:11
but great insight into how some of the
28:13
leading surgery centers are planning for
28:15
the
28:16
future and to end our News segment on a
28:19
positive note nurse Lauren hver was at
28:22
the Notre Dame vers Nevada football game
28:25
when she noticed a man who appeared to
28:26
have dozed off so she had asked if he
28:29
was okay and then shortly after she
28:32
heard someone say I can’t wake Dad up
28:34
which is terrifying so she ran over to
28:37
the scene and as a cardiac nurse she
28:40
performed CPR until the First Responders
28:43
arrived and they were able to safely get
28:45
him to the hospital and today Mike Brown
28:49
is alive and well and he was recently
28:51
reunited with nurse hiver at a Notre
28:54
Dame football game again and that news
28:56
story officially wraps up this week’s
28:59
podcast thank you as always for spending
29:01
a few minutes of your week with us make
29:04
sure to subscribe or leave a review on
29:06
whichever platform you’re listening from
29:08
I hope you have a great day and we will
29:10
see you again next
29:19
week
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]
0:27
to hi everyone here’s what you can
0:30
expect on today’s episode we are in the
0:33
home stretch of our nine-part denovo
0:36
series and James mclung joins us this
0:39
week for part eight to walk us through
0:42
what you should be doing when you are 30
0:44
days from your first patient so it’s
0:46
critical that you are crossing all your
0:48
tees and dotting all your eyes so we’ll
0:51
go through your final Regulatory and
0:53
compliance checks necessary equipment
0:56
Tech Supplies contingency plans
0:58
preparing your clinical at
1:00
administrative teams and so much more
1:03
and in our news recap we’ll cover the
1:05
results from asa’s Price transparency
1:08
survey provide an update on the no
1:10
surprises act share how as’s are
1:13
adapting for success and of course and
1:16
the new segment with a positive story
1:18
about a nurse who reunited with a man
1:20
whose life she saved hope everyone
1:23
enjoys the episode and here’s what’s
1:25
going on this week in surgery
1:28
centers
Compliance
1:32
hi James welcome back to the podcast hi
1:35
thank you in case our listeners missed
1:38
your episode with us last year can you
1:40
share a little bit about
1:44
yourself yeah my name is James mclung
1:46
I’m a registered nurse bachelor’s
1:48
registered nurse I have been a
1:51
administrator and pretty much filled any
1:53
role and an ASC I have a business that
1:56
helps to develop and consult for ASC
2:00
I’m on the Executive Board of the state
2:02
Organization for AC’s of Texas and I’m
2:05
also on the triple HC expert content
2:08
committee deem status so a little bit of
2:11
experience amazing and all of that
2:14
experience is exactly why we needed to
2:16
have you on today for the last two
2:18
months we’ve been pushing out episodes
2:20
Focus mostly around the process of
2:22
opening up a new Surgery Center and
2:25
really trying to walk everyone through
2:27
step by step of how to successfully open
2:29
up a facility so with you today we’re
2:31
going to dive into what to do when
2:34
you’re 30 days out and make sure that
2:36
you’re Crossing all your teas and
2:38
dotting all of your eyes so the
2:41
discussion today will be bucketed by all
2:42
the major areas so let’s start with
2:45
compliance what final Regulatory and
2:48
compliance checks should be conducted to
2:51
guarantee everything’s in order for your
2:53
opening
2:55
day that’s a good question I did forget
2:58
to mention that I am currently the nurse
3:01
administrator of Memorial Ambulatory
3:03
Service Center and the reason why I say
3:05
that is because we were just inspected
3:06
by triple HC so I might bringing it up
3:10
as an example and I don’t want to
3:11
confuse anybody I would say is that
3:13
number one when you’re opening up a
3:14
center you need to have your closeout
3:17
documents from your general contractor
3:20
warranties preventive maintenance
3:22
preventive maintenance schedules more
3:24
importantly how to use the systems your
3:26
processes and procedures that are going
3:28
to go along with that equipment in those
3:30
systems with triple HC it’s about do you
3:35
do what you say you do right so they’re
3:38
very important um you also want to make
3:40
sure to have in place guidelines right
3:44
guidelines are huge when it comes down
3:46
to the specific temperatures are the
3:51
specific ways that you run your
3:54
sterilizer right um specific examples of
3:58
how you wash your hands and how long you
4:00
wash your hands right the metrics that
4:03
you’re looking for so those need to be
4:05
in place before you open up if all
4:08
possible and I will say is that is a
4:11
good example of why using someone that
4:14
has experience in help really leads to
4:16
quality insurance which is the biggest
4:19
problem that I see in
4:21
centers sure especially independent
4:24
mostly Independents but it’s done a
4:25
little bit differently everywhere so
4:28
yeah we’ve talked a lot about at what
Who to trust
4:30
point you get help and who do you get
4:31
help from and because I feel like
4:34
everyone opens tries to open up surgery
4:36
center with the best of intentions but
4:38
if it’s a group of Physicians that are
4:39
together and they’ve never done it
4:41
before then it’s really hard to know all
4:44
the little stuff that needs to be done
4:45
and things can get
4:48
delayed well what’s harder is who to
4:51
trust for example I’ve been several
4:53
different turnarounds where The
4:56
Physician Group
4:58
trusted individuals which they delivered
5:03
but there was certain discrepancies
5:05
between the work the general contractor
5:07
did and the approved plans of the
5:09
Architectural Review unit of the state
5:12
and usually typically that’s because of
5:15
cutting Corners right and the almighty
5:18
dollar so when I come in from the
5:20
physical aspect usually these are
5:23
scenarios that I see where the Physician
5:26
Group is having to replace a boiler
5:29
after three years which if taken care of
5:31
can last forever right or HVAC issues
5:34
where there’s dampers missing
5:38
or documentation missing on warranties
5:42
and and there could be liability issues
5:44
that arise from that yep that’s actually
Physical setup
5:47
the perfect segue are there other any
5:49
other examples or aspects of the kind of
5:52
physical setup in infrastructure that
5:54
should be
5:57
reviewed yes absolutely absolutely yeah
6:00
so all that I just said and there are
6:03
some specifics I included the Texas
6:05
department of uh State Health uh their
6:08
Architectural Review unit has a
6:09
checklist of closeout documents includes
6:12
Fire Marshal approval your uh building
6:15
inspection department approval which
6:16
means 100% inspection which means that
6:19
you are receiving your Co U which leads
6:22
to that 30 days that everybody talks to
6:24
talks about once you have your CEO then
6:26
you have 30 days where you can move in
6:29
and you want to open up 30 days after
6:31
that start those 10 cases and get
6:33
Medicare involved um our triple HC I
6:37
would highly suggest especially on
6:39
initial
6:40
surveys deem status is the way to go for
6:43
a news center that is not established
6:46
yet now for existing sers or our our
6:48
expansions the process is a little bit
6:51
different and and sometimes a little bit
6:53
smoother because you already have those
6:55
processes in place but to answer the
6:57
question is that you want to double
6:58
check the AR are you right it’s really
7:00
starts with a a punch list right because
7:03
you’re going through and making sure
7:05
that fire cocking is done the work that
7:08
the general contractor did it matches
7:11
the aru right I don’t think usually
7:13
official language is used like that but
7:15
that’s what you really are doing is
7:17
making sure that I’ve been in centers
7:20
where it called for the recessed
7:22
sprinkler systems but the general
7:24
contractors came in and put the non
7:28
recess sprink systems in there so it
7:31
does require someone to in my mind be
7:34
there throughout the process but that is
7:37
your last chance so making sure the
7:39
generator runs under 10 seconds that
7:41
kind of stuff so sure sure yeah and how
Equipment and Technology
7:45
else can you verify that all necessary
7:48
equipment and Technology are fully
7:50
functional well number one you have to
7:53
have biomedical come check them for
7:54
electrical safety right these are
7:56
contracts that you need to have in place
7:58
before you you open and then also in
8:01
Services the manufacturers right it
8:05
depends if you get the equipment from a
8:07
third party make sure that it’s a
8:09
certified third party or a reputable
8:12
third party right there’s a lot of
8:16
physician groups that I’ve seen that
8:19
have been upsold asked questions that
8:23
are important to ask the person that is
8:27
selling it to you are they upcharging
8:29
that equipment is that the most
8:31
necessary equipment for you do you need
8:34
that piece of equipment so that it
8:37
starts there but once you have the
8:39
equipment that person that you bought it
8:41
from needs to make sure and you need to
8:43
hold them accountable to have it in
8:45
service the instructions for use right
8:48
and then also the other systems that are
8:50
you know feeding that piece of equipment
8:53
making sure that they are working
8:55
appropriately as well and what I mean by
8:58
that is for example the sterilizer the
9:00
boiler if your water softener is not
9:02
providing one part
9:07
per whatever The annotation is at the
9:10
end I can’t remember it’s like
9:12
milliliter yeah one part per milliliter
9:13
I think of hardness and it’s higher if
9:15
it’s hard water your boiler will go out
9:18
so you need to make sure that you’re
9:20
following the instructions for use and
9:21
that you have the appropriate PM
9:24
schedules those are set up that you have
9:26
a schedule a agreement for that and then
9:28
also so that they inservice you on how
9:31
to use it
9:32
appropriately gotcha yeah all that makes
9:35
sense Switching gears a little bit what
9:38
strategies could ensure that the
9:40
clinical and administrative teams are
9:42
trained and prepared for that first
9:44
patient to come
9:46
in yeah well one starts with a plan
9:49
right when you are a new center and you
9:52
have not opened up the center before
9:54
those processes are not in place and
9:56
that needs to start very early in in the
10:00
uh development process in my mind in
10:03
fact I have another tool that I created
10:05
uh for the last task conference it has a
10:07
timeline of the individual steps it
10:10
takes to develop a surgery center it
10:12
might have actually been included in our
10:14
last podcast I’m not sure but it gives
10:17
you a good indication of how long those
10:19
steps should take and that is a very
10:21
important one right because typically if
10:24
you are a practice and you are trying to
10:27
transfer patients from one Center to the
10:30
next there needs to be some type of
10:33
incentive for those patients to to move
10:35
typically because you don’t want their
10:37
experience to be effective right so
10:39
having those conversations setting up
10:40
those processes Discerning how you’re
10:43
going to pay your contracts right are
10:46
they in place yet are you just going to
10:48
offer cash pay to get those 10 cases
10:50
that requires to get the triple HC DM
10:52
status survey it’s a imperative process
10:55
that needs to be figured out before you
10:58
get to that 30 days
11:00
yes
11:02
absolutely and the LA for emphasis yeah
11:07
and what so with those teams do you
Training Tools
11:10
recommend that the like Surgery Center
11:13
leaders or physician owners really work
11:15
with those teams or do you rely on your
11:17
state AC associations just various
11:20
training tools any recommendations
11:24
there yeah one when it comes down to
11:26
education just make sure that you are
11:29
the accrediting body that you’re using
11:31
that you check their regulations on what
11:33
education is required right also there
11:37
are tools from experience that I have
11:40
gained or created reach out to your
11:42
neighbors don’t
11:45
just do not reinvent the wheel there are
11:48
so many people out there that are
11:49
willing to help there are ASA there’s
11:52
task in Texas there’s in cal every state
11:56
that I know of has a state organization
11:59
not to mention at least
12:01
on my middle level that there’s always
12:06
we need to stick together right and help
12:08
each other out to survive um nothing
12:11
that we do is a secret um and the only
12:15
way that it will get better is by us
12:17
sticking together so uh there’s so many
12:22
resources out there um you know I’m
12:25
pretty much I would have to say is that
12:27
I learned how to run an ASC
12:31
from
12:33
specifically more John Bob
12:36
Tom
12:38
Toms right Chris and
12:42
then resources right Joe alza wrote a
12:45
book on how to open up and develop a
12:47
surgery center I got that marked up
12:50
right asa’s Finance book asa’s forums
12:53
and Googling that and being involved in
12:56
it and actually replying so every one of
12:59
those people thank you because I
13:02
wouldn’t be here without you oh that’s
13:04
great to hear yeah I love the askap for
13:06
is huge I get the daily digest and all
13:10
the questions you can learn so much and
13:12
people share so much spreadsheets PDFs
13:15
handbooks like everyone is always quick
13:17
to respond and and help
13:20
out yeah just go don’t even don’t get me
13:23
wrong you should pay it for it and be
13:25
involved but yeah their library is
13:28
outstanding
13:29
yep I
13:31
agree all right so let’s talk about
Supplies
13:35
supplies meds and other necessary
13:37
resources what should you be doing just
13:39
to confirm that you’re all set in that
13:43
regard all right so James mcclung’s pet
13:46
peeve of 2020 actually it’s been a pet
13:50
peeve of mine forever well you
13:52
don’t you don’t increase the
13:55
responsibilities of asc’s by trying to
13:58
just add as much stuff as you possibly
14:00
can and just doing everything that other
14:04
facilities potentially would do we need
14:06
to maximize our efficiency within the
14:09
what we do have now the responsibilities
14:11
that we’re able to accomplish now and
14:13
and one of those that I feel like we are
14:15
not doing enough is Pharmacy I feel like
14:18
our Pharmacy Consultants that we
14:20
contract with are being sorely
14:25
underutilized and I will tell you is
14:27
that my first center that I devel on
14:29
very fortunate to be introduced to a
14:33
pharmacist that was looking to go out on
14:35
her own so from the very
14:38
beginning we learn together and I assure
14:42
you she’s the only pharmacist that I
14:45
know trust narcotics but I know that
14:48
she’s doing it right she’s involved in
14:51
quality improvement she orders narcotics
14:54
she looks for lookalike sound alike
14:56
drugs she helps in education and with
14:58
the crash cart organizing the crash cart
15:01
medication
15:03
utilization and also with anesthesia
15:06
making sure that they’re labeling making
15:08
sure that they’re following proper
15:11
etiquette and Industry standard when it
15:14
comes to patient care right she’s just
15:17
much more involved than just coming in
15:19
and doing chart audits and I feel that
15:23
is something that needs to be addressed
15:25
and improved across the board in our
15:27
industry yeah yeah
15:30
um is that Jones Amy Jones by any chance
15:35
I can’t think of her name but we had a
15:37
great pharmacist consultant come exactly
15:39
who it is
15:40
yeah she’s the only one I know
15:44
of that’s awesome good in my mind is
15:47
probably the only one you need to know
15:48
at this point
15:50
so that’s great sorry continue I just
15:53
like it had to be
15:54
her no it’s okay but within that though
15:57
look to the expert s Get Your Fire
15:59
Marshall well not Fire Marshall but like
16:02
your fire alarm company to come in and
16:04
show you how to do it set up with them
16:05
to do a fire drill once a quarter right
16:09
learn how the fire alarm contacts the
16:12
fire company how the EMS is contacted
16:15
contact EMS have them there for a code
16:18
learn how long it’s going to take for
16:20
them to get there know your neighbors
16:23
it’s not what you know it’s who you know
16:25
you have to relationships when it comes
16:27
down to running an appropriate Center
16:29
living in the now a big thing for me is
16:32
the timeline when it comes down to
16:34
compliance you live in the now right
16:37
that’s your goal right and then you
16:40
would look into the future and then the
16:42
past is it’s last right so if you’re
16:47
stuck in the past you’re just treading
16:49
your feet on a hamster wheel and you’re
16:51
not living in the now and the weight of
16:54
compliance could literally Crush you the
16:57
way you do that is by making
16:59
relationships staying involved getting
17:02
involved and not only looking to learn
17:05
how to do it but to make it better for
17:07
the ones that follow
17:09
you yeah that’s great I feel like we’re
17:12
this is very like philosophical today
17:14
we’re going deep so it’s because I’m at
17:17
a center it’s so like when I’m at a
17:20
center I’m more like Phil Jackson I’m
17:22
serious like I had the lights turn low
17:24
and I’m like everybody breathe
17:27
deep
17:29
I love it it’s about more of the why
17:31
than right than the what so yeah for
17:34
sure what advice do you have for
Contingency Plans
17:37
developing contingency plans to address
17:41
any and all un unforeseen
17:44
challenges yeah and so beyond quality
17:47
assurance where my my biggest goal of
17:50
2023 and one of the reasons why
17:53
Independents probably should unite is
17:55
quality assurance there’s been many
17:57
centers that that I have helped to
18:00
develop where it’s like a mix and match
18:04
of different manufacturers on the water
18:07
softener or another process the air
18:10
compressor right and the reason being is
18:13
because General Contractors don’t know
18:16
the difference right they don’t know why
18:18
we would want to have just a Steris
18:21
right or a colan water softener and so
18:24
they’re looking to save money right so
18:27
therefore it’s a little bit different
18:30
and those small differences add up
18:32
especially when you don’t have someone
18:34
that
18:34
doesn’t understand that concept but the
18:38
other concept that is big to me is
18:40
continuity of care and when I come into
18:43
centers a lot of times there’s probably
18:45
a lot of leadership turnover but more
18:49
importantly are I I wouldn’t say sadly
18:52
but concerning is that there is no
18:56
continuity of care there’s usually one
18:58
person or a few people that take on the
19:01
way of the world and then if they leave
19:05
or if they don’t leave no one else is
19:08
involved and so there’s a big giant
19:10
disconnect of how it was done before how
19:14
it’s being done now and then how it’s
19:16
going to be done in the future there’s
19:19
no continuity of care right and so how
19:22
you do that is by involving others right
19:25
performance
19:27
evaluations right looking at how others
19:29
have done it not Reinventing the wheel
19:32
including triple HC including your
19:34
Department of State Health stop living
19:36
in fear live in the now right it’s not
19:40
about where we’re at today right it’s
19:43
about where we’ll be at tomorrow right
19:47
and there will always be someone that
19:50
may have to fill that role even if um
19:52
you’re promoted or win the lottery right
19:55
so it’s all about patient care and
19:58
keeping that constant quality when it
20:00
comes down to Patient
20:02
Care great and I feel like you’ve shared
20:05
a lot of advice with us so far but any
20:08
final last words of wisdom um or
20:11
inspiration for those who are nearing
20:13
their opening date might be slightly
20:15
panicking but are are excited to open
20:18
any final words of
20:20
wisdom yeah uh you’re not alone right uh
20:24
the more that you can do up front the
20:26
better loading contracts into your emrs
20:29
loading the preference cards into your
20:31
emrs if you are finding yourself saying
20:34
we’ll do that later re-evaluate
20:39
that you’re not alone there are other
20:42
people that can help you to accomplish
20:43
those goals but once you get going and
20:46
you hit the ground running it’s much
20:47
harder to go back into the past yep
20:50
definitely cool thank you so much James
20:54
so we do this every week with our guests
20:56
what is one thing our listeners can do
20:59
this week to improve their surgery
21:01
centers no yeah we’ve talked about it
21:04
but quality assurance and continuity of
21:06
care cool Perfect all right James thanks
21:10
so much for coming on again we
21:12
appreciate it anytime thank you for
21:14
having
ASC Price Transparency
21:16
[Music]
21:19
me as always it has been a busy week in
21:21
healthcare so let’s Jump Right In ASA
21:24
released the results from their August
21:26
62nd survey
21:28
which asks questions all around price
21:31
transparency so as a reminder very very
21:34
quick history lesson here the push for
21:37
Health Care price transparency gained
21:39
traction with the Affordable Care Act
21:42
but things really started moving in 2019
21:46
when hospitals had to publicly share
21:48
their standard charges online and then
21:50
in
21:51
2021 a new rule was introduced demanding
21:54
hospitals be more transparent followed
21:56
by similar requirements for health
21:58
insurers the next year and then on the
22:00
ASC side as we know surgery centers must
22:04
provide a good faith estimate to
22:06
uninsured or self-paying patients under
22:08
the no surprises act and then just this
22:10
past September a bill titled lower cost
22:13
more transparency Act was introduced
22:16
suggesting asc’s should disclose their
22:18
standard charges though it didn’t pass
22:21
it does of course indicate this growing
22:23
interest in price transparency as a
22:25
whole so the timing of this survey is
22:27
perfect
22:28
all right so what did the survey results
22:30
entail so ASA had 160 respondents across
22:34
39 States and they shared that 70% of
22:38
their websites have a list of common
22:40
procedures but only 20% shared that
22:43
their website includes price information
22:46
for those common procedures so those
22:48
numbers are lower than I would have
22:50
liked to see but the positive is that
22:52
regardless of what is shared on their
22:54
websites 91% of respondents said said
22:58
their facility has a standard workflow
23:00
for providing estimates to patients at
23:02
least prior to their
23:04
procedure and lastly 77% are using the
23:08
payer negotiated rate to calculate those
23:11
price estimates while 12% are using cash
23:14
prices and 7% are using procedure gross
23:17
charges now ownership does play a role
23:21
here which I think is really interesting
23:23
those who have Hospital ownership are
23:26
more likely to have a website but less
23:29
likely to provide
23:31
estimates and then those who have
23:33
physician ownership are less likely to
23:36
have a website at all but more likely to
23:39
have a standard price estimate workflow
23:41
so they’re kind of flip-flop there now
23:43
Alex Tyra and ASA did a great job
23:45
summarizing additional results from the
23:48
survey so as always we’ll link to the
23:50
article in the episode notes if you want
23:52
to kind of dive into these numbers
23:55
further and then sticking with our
23:58
transparency theme in a proposed rule
24:01
filed about two weeks ago the HHS the
24:04
Department of Labor and the department
24:06
of the treasury proposed hiking the
24:09
administrative fee to enter the no
24:11
surprises act independent resolution
24:14
process from $50 to
24:17
$150 the agencies also proposed
24:20
increasing the upper limit of the fee
24:22
range for certified IDR ENT entities by
24:26
20% for single determinations and 25%
24:30
for batch determinations and the
24:32
proposed rule of finalized would go into
24:35
effect on January 1
24:37
2024 so the agency’s project to spend
24:40
$70 million to implement the independent
24:44
dispute resolution process in 2024 on
24:47
Personnel costs certifying IDR entities
24:51
and completing investigations so
24:53
assuming 225,000 IDR disputes closed
24:57
next next year based on Trends observed
25:00
previously the proposed increase would
25:02
allow these agencies to recoup the costs
25:06
and as a reminder another little history
25:08
lesson the federal IDR portal was opened
25:12
between April 15th 2022 to March 31st
25:17
2023 and during that time
25:26
334,000 s had estimated and prepared for
25:30
hence why they’re anticipating that they
25:32
need all this additional funding to
25:34
manage the process
25:35
correctly Jim binski who’s the CFO of
25:39
WellStar Health System shared that he
25:42
had filed approximately 8,000 IDR
25:45
requests since the portal opened and of
25:48
those only 7% have been resolved so
25:51
though again the belief is that raising
25:53
the fees could provide agencies with
25:56
additional resources to address the
25:58
large dispute volumes now the kicker we
26:00
can’t raise the fees too much where it
26:02
becomes prohibitive for the average
26:04
person to be able to submit something
26:06
through the IDR process so that’s where
26:08
we have to find the balance here so we
26:11
will keep watching this bill and see
26:13
where it goes but just your usual
26:15
reminder to get ahead of all things
26:18
related to price transparency get those
26:20
automated workflows in place and get
26:22
ahead of the legislation that has come
26:25
your way and will just continue to come
26:28
your
26:29
way all right Switching gears a bit
26:31
Becker’s ASC asked a few Surgery Center
26:34
leaders the following question how have
26:37
you updated your strategy for success in
26:40
Outpatient Care recently so I’m just
26:43
going to summarize a few responses here
26:45
but as always I recommend uh checking
26:47
out the full article because there are
26:49
so many good tips um but here are a few
26:52
that stood out to me that I wanted to
26:53
share in no particular
26:56
order so the The Spine Center Spine
26:58
Center Atlanta has embraced
27:01
technological advances to streamline
27:03
communication and stay connected with
27:05
patients after the patients leave the
27:07
ASC they have also increased their
27:10
digital presence to stay connected to
27:12
patients through email and social
27:15
media Austin Orthopedic Institute
27:18
focused on critical metrics such as
27:21
patient outcomes patient satisfaction
27:23
efficiency and cost and post-operatively
27:26
they also have have been bringing in a
27:28
licensed physical therapist to help
27:31
mobilize patients before they even leave
27:33
the
27:34
facility spine and Orthopedic Center in
27:36
Florida is leaning into new technologies
27:39
and techniques that are allowing for
27:41
more opportunities for minimally
27:43
invasive spine
27:45
procedures they are also focusing on
27:47
patient education recognizing that
27:50
well-informed patients generally
27:52
experience better
27:53
outcomes and lastly Brentwood Surgery
27:56
Center is is completely focused on total
27:59
joints sharing that asc’s that have not
28:02
adopted or or are planning to adopt this
28:04
strategy are behind the curve and
28:06
missing out on the Great
28:08
Migration so just a few highlights there
28:11
but great insight into how some of the
28:13
leading surgery centers are planning for
28:15
the
28:16
future and to end our News segment on a
28:19
positive note nurse Lauren hver was at
28:22
the Notre Dame vers Nevada football game
28:25
when she noticed a man who appeared to
28:26
have dozed off so she had asked if he
28:29
was okay and then shortly after she
28:32
heard someone say I can’t wake Dad up
28:34
which is terrifying so she ran over to
28:37
the scene and as a cardiac nurse she
28:40
performed CPR until the First Responders
28:43
arrived and they were able to safely get
28:45
him to the hospital and today Mike Brown
28:49
is alive and well and he was recently
28:51
reunited with nurse hiver at a Notre
28:54
Dame football game again and that news
28:56
story officially wraps up this week’s
28:59
podcast thank you as always for spending
29:01
a few minutes of your week with us make
29:04
sure to subscribe or leave a review on
29:06
whichever platform you’re listening from
29:08
I hope you have a great day and we will
29:10
see you again next
29:19
week
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