This Week in Surgery Centers: Katie Sypher – Thinking Outside the ASC Walls: Optimizing Clinical Operations

Katie Sypher – Thinking Outside the ASC Walls: Optimizing Clinical Operations

Here’s what to expect on this week’s episode. 🎙️

When most people think about clinical operations, they typically focus on the few hours the patient is at the surgery center for their procedure. However, those who have truly mastered clinical operations understand the process begins long before and continues long after.

Katie Sypher, Senior Consultant at LeftCoast Healthcare Advisors, shares on this week’s episode how vital it is to take a holistic approach and focus on the entire healthcare journey. Here are a few key takeaways from our chat:

➡️ The patient journey starts well before they step into a surgery center. Katie emphasizes the importance of a seamless experience from decision to post-surgery, advocating for comprehensive pre-surgery education and clear billing guidelines.

➡️ Collaboration with all stakeholders, including the surgeon’s office and schedulers, is crucial. Regular meetings and feedback loops can streamline workflows, reduce duplication, and improve outcomes.

➡️ The relationship between surgeons and anesthesiologists is vital. Establishing clear patient criteria and communication channels can prevent surgery cancellations and ensure a smooth operative experience.

➡️ To understand if your efforts are working, choose impactful, manageable metrics. Ensure data is accessible to avoid manual, time-intensive tracking and view metrics as a trend, not just snapshots, for long-term improvement.

➡️ Leverage technology to streamline processes and have a solid framework for evaluating emerging technologies to help you stay focused and put your goals first.

Find the full episode on Apple Podcasts, Spotify, or YouTube to hear all the details.

Episode Transcript

00:00.48
Erica Palmer / HST Pathways
Hi Katie welcome to the podcast. Yeah can you share a little bit about yourself and about left coast health care advisers with our listeners. Please.

00:05.23
Katie Sypher
Hi Erica thanks so much for having me.

00:15.72
Katie Sypher
Yes, of course so I’m a dietician that went back and got my MBA and the reason I did that was because I wanted to align clinical practice and the business practice and my experience has been in development sales. Patient care through starting co-starting to eating disorder clinics and then I was managing a health screening medical device sales as well as health care operations and currently I am the senior consultant at Left Coast Health Care advisors and we’re a consultant firm. That our mission is to bring your ambulatory strategy from your ambulatory strategy vision from concept to reality and we do that through working with you if you want to expand into a new location or you’re evaluating and want to improve your payer contracting. Or even streamlining your clinical operations and throughout my career. My focus has always been on improving the mental and physical. Well-being of those that I work with and work for so that they can operate and function at the top of their game.

01:23.90
Erica Palmer / HST Pathways
I love it. Yes and we just got done with a 9 part de novo series and we did have a few of your colleagues on in that series to talk through some of the regulatory stuff and expansion and um so I’m I’m super happy to have you on today. Um. Especially because we have not talked about clinical operations in depth yet and I think it’s incredibly important. Um, just the impact clinical operations can have on all ASC stakeholders and I think we’re in alignment here that when we say stakeholders we mean. Everyone so from the office scheduler to the patients and even their families to physician staff. Everyone so ah first to kind of kick us off. How do you define and characterize clinical operations within the context of a surgery center.

02:18.22
Katie Sypher
I’m really glad we’re starting with this question because I think it does lay the foundation for what we’re going to talk about today and I ah, we often think clinical operations as when the patient enters the door of the ASC until they leave. But so much happens. With that patient before they even get into the walls of that ASC and so for the purpose of today I want to define clinical operations as the entire journey. So starting with when that patient makes a decision to have surgery all the way through until they leave after their surgery is done. And want to view it as 1 continuous road.

02:56.30
Erica Palmer / HST Pathways
Love it. So let’s start with one of the most important stakeholders that you just mentioned the patient ah are there specific practices that prioritize the patient’s experience.

03:07.88
Katie Sypher
Yeah I think when it comes down to it. We’re all here for the patient but it’s really easy to get caught up in what my individual role is versus looking at how it fits in to that greater patient experience that greater patient Journey. And so taking a step back and looking at it from the patient perspective can help identify what opportunities you may want to adjust to create that Seamless road. So good questions to ask is is the patient receiving Pre-surgery Education. Who’s giving it is the Surgeon’s office giving it are you giving it if multiple people are giving it if no one’s giving it that can really impact how that patient is getting ready and prepared for that day of surgery you want to align on those Efforts. So that it really ideally the patient is getting information in one I’ll call it a packet that doesn’t have duplicated information and also doesn’t contradict itself and then another piece that can really help the patient is there’s so many questions that they have. List of questions or frequently asked questions and who do they contact we want to save time here if they’re calling the Surgeon’s office for a question that could be answered by the surgery center give that patient the list of who to reach out to for the questions that they have and then another.

04:32.83
Katie Sypher
Hot Topic I’ll say right now that we hear often is the billing and it can get so confusing for a patient because they can get billed from numerous different surgeons doctors locations and so give them a list hey this is what you should expect or who you should expect to get a bill from and I think at the end of the day. Taking the time to implement a joint patient readiness plan that clearly lays out the rules and responsibility help the patient feels like everybody is on the same page and working together to support them.

05:05.20
Erica Palmer / HST Pathways
Yeah I think that’s all really good advice I was just talking to 1 of our clients and I had asked them because I noticed their website was down and they said that it was causing so much patient confusion because the information they had on their site was so different than what the doctor had shared with them. That they yeah you know dead other issues with the site but there let’s just blow it up and start over because it it was too. It was more confusing for the patients um trying to do their own research without having to contact somebody. Um, so I thought that was just frustrating.

05:38.64
Katie Sypher
We see that more we see that I think more than we think we would.

05:45.19
Erica Palmer / HST Pathways
Yeah, Absolutely yeah, so I know and the transparency and the billing side of it. We could talk about for hours as Well. So I think that’s all really really good advice. Um, if we’re talking about stakeholders We We can’t forget the. Physicians office and the scheduler and I’m so glad you had brought this up because I often forget about the scheduler who is such a key piece um of making all of this run smoothly. So How can workflows be improved for them and and why is that important.

06:16.52
Katie Sypher
Yeah, and I’ll say first as a clinician anything that helped minimize duplication on my day to day actions was greatly appreciated and really helpful and so I think when we look at the Physician’s office in the scheduler. It comes down to the surgeon wants to perform surgery. They want to take their patients where it’s consistent. They know the staff. The staff is knowledgeable and so finding ways to work with the Surgeon’s office and the schedulers can be really helpful in. And making that easy for everybody and so having regular scheduled meetings which most people already do with the Surger center and their Surgeon’s office but take the time to talk about what’s working well and then discover what is what’s challenging from the scheduler’s perspective from the Surgeon’s perspective. And that gives you those starting points to say hey we might need to adjust or Tailor or create or stop a workflow that’s already in process but instead of you just doing it and thinking this will make a difference.. You’re really getting feedback from the people that are using it and.

07:25.13
Erica Palmer / HST Pathways
I like it.

07:27.94
Katie Sypher
Also feel. It’s ah important to remember that work with those are not meant to make life harder Now. There’s a learning curve often. It may be a little harder in the beginning but the goal is to either simplify a task to reduce duplication. And to improve an outcome.

07:45.74
Erica Palmer / HST Pathways
Yeah, yeah, all of that All of that makes sense and I would imagine being on the Clinician side. It’s just so nice when you have that seamless workflow and there’s a surgeon who wants to have a surgery somewhere and you know it’s going to be nice and simple. It’s like oh yes, I get to schedule with them First. You know the one. That’s maybe maybe a little more complicated. Um.

08:09.44
Katie Sypher
And that takes time and it takes intentionality in getting those 2 groups of people together to make a plan and evaluate an adjust if needed.

08:21.43
Erica Palmer / HST Pathways
Yeah, it might have been um maybe Michael or or 1 of your coworkers who had said to um, like don’t forget them around the holidays and if you’re you know you’re sending and thank you baskets or whoever don’t forget the scheduler at the physician’s office as well.

08:37.67
Katie Sypher
Um, yeah.

08:39.30
Erica Palmer / HST Pathways
Um, so along with the rest of the industry. We’ve been talking more and more lately about anesthesia and really trying to bring your anesthesia group into the fold more and truly think of them as a partner um not a third you know not a third party but someone that is that is a stakeholder.

08:55.65
Katie Sypher
Are.

08:58.34
Erica Palmer / HST Pathways
Um, so what advice do you have for streamlining clinical operations to strengthen that relationship.

09:05.33
Katie Sypher
I love that we’re talking about this because it does fall right in line with that continuous path and anesthesia plays such a huge role in. How the actual let’s say the time of the surgery. How the patient is set up in that whole experience and so the people that do it the best have really great I’ll say alignment and communication between the surgeon and the anesthesiologist and what we what I would recommend is first. A line on patient criteria have the surgeon and the anesthesia anesthesia team work together who is an appropriate candidate patient for having their surgery at the surgery center. And this especially what’s true if anesthesia doesn’t see them until the day of surgery because the last thing that anybody wants is a canceled surgery because the patient isn’t fit that the anesthesiologist says hey they’re not. They’re not fit for surgery and so that throws everybody into a loot into a chaos and. Also increases frustration so really working together to align and say these are the right types of patients with these criteria that we all feel comfortable with and then the pre-op screening who’s going to be doing the pre-op screening is the surgeon going to do. It is anesthesia making sure that you’re aligned on number one who’s doing it and that the patient.

10:26.85
Katie Sypher
Clearly knows where they’re going to go for that pre-op screening and that the questions that are going to be screened for everybody agrees upon and that if anything arises in that screening. There’s a communication channel so that everybody knows because if the surgeon finds something and then Anesthesia doesn’t know then that causes frustration. And vice Versa. So I would say to summarize create communication opportunities that build trust and rapport with the Anesthesia anesthesiologists the team and the surgeons will go a long way in and building that relationship and creating seamless.

11:03.95
Erica Palmer / HST Pathways
Yeah, and I think the having that criteria set up front will take away any feelings of oh they and this Anesthesia anesthesiologist would have done it this one wouldn’t have or vice versa and it’s like there’s no room for gray area here’s a agreed upon criteria.

11:04.90
Katie Sypher
Experiences for everybody.

11:22.32
Erica Palmer / HST Pathways
It’s very tried to make it black and white.

11:23.19
Katie Sypher
Yeah, especially in surgery centers that operate at such a fast cadence the goal you know surgery is okay we we were a well oiled machine if you don’t have that agreed upon Criteria It really can slow down your process.

11:40.18
Erica Palmer / HST Pathways
Yep, yeah, and again, it’s like I know people are really struggling with with staffing. Ah um, anesthesiologists and and getting the groups in that getting everybody there. So again, just strengthening that relationship and in having that trust in 1 another. It’s It’s really the only option. Um, okay, so you’re putting in all of this work to kind of improve your clinical workflows.

11:59.15
Katie Sypher
Angry.

12:07.80
Erica Palmer / HST Pathways
But obviously we want to be able to track and measure all of the efforts. So how can ASCs evaluate if their efforts are paying off.

12:16.26
Katie Sypher
I think everybody knows that tracking and measuring is really important in all every type of business especially health care. We want to say hey is it working but it is hard. It’s time consuming and it’s one of those. I’ll say tasks that can easily get stuck to the bottom of the barrel of work that needs to happen and so when you’re choosing something to measure you’re choosing to implement something new. My experience is it’s best to start small and be really intentional about what you’re trying to measure. So start with something you want to improve on. You don’t want to track up your if you’re you’re tracking 1 thing you don’t want to all sudden track 20 things and so hey, what are we working to improve is it patient satisfaction is it. Staff satisfaction is it decreasing same day cancellations. And if you don’t know where to start there are benchmarks and I know we’ll get to that in just a minute. Um where that has regional and national benchmarks to to measure be the mg ask ah as a great or great resources for that so you can always start there but just choose 1 or 2 metrics. To start with and the key is to make sure you have the ability to measure it and what I have found is a clinician I’m like I want to measure this and you go to the data person and said we don’t have that information readily available. You’re going to have to manually do that which takes a lot of time and so when you decide hey we want to measure and track this.

13:43.60
Katie Sypher
Make sure that you have the ability to measure and track it else. You’re going to spend a lot of time trying to pull all the pieces together to evaluate that. Um you want to align across all of all the people that we’ve been talking about if your surgeon’s office is measuring something the serger center. Need to also measure work with them to say hey can I get those results and add that in don’t duplicate your efforts and I think the big I would say when you’re doing deciding to measure celebrate your wins and your successes with your whole team. Everybody’s working so hard to try something new and to evaluate something new. Take the time to sell. Right? And to say hey we’re doing a great job look at how we’ve improved on Xy and z but keeping with the journey theme avoid looking at metrics as a snackshot like a point in time because metrics we want to look at the trend we want to say hey what? what was happening before. We implemented this. We’re measuring it and now we’re doing how are we doing after but it is also a journey and so you want to avoid getting caught. This is how we’re doing today. But what is the trends over time and then it does sound elementary but choosing metrics. We’ve already said this is choosing metrics that are impactful and measurable can be hard so you finding that data person or that data guru in your office that can really help guide and say we have access to Xy and z it’s an easy pool is a great person to a ball involved in this conversation.

15:16.22
Katie Sypher
To make sure that it will make your life easier and that you can continue to track and measure without spending hours doing it.

15:24.90
Erica Palmer / HST Pathways
Yeah, all great advice and we I mean I’m going to sound like a broken record here. But we’re all like without software I don’t know how anybody could track and and measure these things, especially you know trending over time. It’s 1 thing to do it for a quick quappy study. Um, but if you’re really looking to improve in these areas go to the you know the power user of who with your software or your data team or whatever resources you have and say here’s what we want to track. How can you? How can you get me there.

15:57.32
Katie Sypher
And you know one other point that I would add is once you’ve said hey I’ve reached my target. We’re We’re highly Compliant. We’re doing great figure out how to continue to keep that high level of success going. While you start to add in new metrics but don’t just bombard yourself with everything reach your goals figure out how to maintain it and then continue to add on from there.

16:24.77
Erica Palmer / HST Pathways
Yeah, and I think starting with 1 or 2 is is great advice because it can get it can get overwhelming. Are there. You mentioned benchmarks but are there specific ones that you would recommend. Ases can start with or should be using to kind of assess and improve the quality of their clinical operations.

16:44.93
Katie Sypher
There are definitely I’ll say benchmark standards that are out there so patient falls in the ASC medication errors consent errors prolonged anesthesia recovery time. There’s also ones that would. Be a little bit harder to measure like e visits one day post discharge I think when it comes to the benchmarks. What do What’s your goal. What are you trying to do and so looking.

17:05.97
Erica Palmer / HST Pathways
Prison.

17:16.50
Katie Sypher
Sort of what certifications. Do you Ah, do you have or what certifications are you looking to have and then what metrics are they going to require for you to get that certification is a really good place to start because it can get overwhelming when you go to them and say hey we’re going to measure everything but really start with what are we trying to improve on and what. Kind of certifications. Do we want and then build it out from there I think the other important piece to keep in mind is EHRs especially if you’re looking to measure or capture data for care. That’s provided outside of your walls. For example. Um, the Ed Ed visits after a surgery that’s harder information to get so if that is something that’s important for you to benchmark, especially talking to your surgeons or if you’re a marketing and or trying to get a certification. Prioritize figuring out how to incorporate or get interconnected sources so that you can get that data.

18:17.84
Erica Palmer / HST Pathways
Yeah, the more data sources the better and can just give you that bigger picture too and not just you know be siloed to the data points that your your ASC collects. Um, we’ve talked about.

18:24.83
Katie Sypher
Yeah.

18:31.75
Erica Palmer / HST Pathways
Tech a little bit here or there but are there any current or emerging technologies that you believe will have an impact on clinical operations.

18:39.72
Katie Sypher
So I’m going to answer this question just a little bit different because technology is a huge huge buzzword and there are so many emerging tools that promise to simplify your life make it easier make it fast or maybe just even make you a little cooler.

18:42.80
Erica Palmer / HST Pathways
Um, sure. Yeah.

18:57.50
Erica Palmer / HST Pathways
Here.

18:59.56
Katie Sypher
But what I would say on the technology front is that work on creating a framework to evaluate emerging technology in the market so you want to you want to consider what problem are we trying to solve with this technology. How is it going to make my day-to-day easier. Who is it going to impact and have that person involved in the evaluation process because they’re the ones that would impact the most is it going to what’s it going to do to your bottom line and is it going to reduce duplication and decrease variability. Because technology is forever changing if I was to suggest something today or tomorrow in six months that could be obsolete or something new could be coming and so I think it’s more I would recommend to focus more on having the framework with as your. Surger center and your surgeon’s office. So as new technology emerges emerges. You have the ability to use that framework to help you make a smart choice.

20:00.46
Erica Palmer / HST Pathways
I think that’s great. Ah advice and kind of goes back to that that idea of of having that black and white um decision making skills where you know to your point something like 1 of your surgeons goes to a conference and sees something shiny and comes back and wants it and. Like no we we went through the process and you know here’s where we landed on the other side. Um I think that’s really great advice. Ah, the only thing I would add to it is um, peer review or um, ah, talk to your peers and see you know if you are.

20:20.15
Katie Sypher
Film.

20:31.56
Katie Sypher
Um, yeah.

20:34.27
Erica Palmer / HST Pathways
Um, evaluating technology talk to other people either locally regionally through your association state associations and see if they’ve used it too because to your point there I was just at the New York state show and there’s so many new vendors there and I’m trying to walk around like what do you do.

20:45.23
Katie Sypher
Or for.

20:51.73
Erica Palmer / HST Pathways
You know, trying to to learn myself so it is it can certainly certainly be a lot all right last question for you Katie we do this every week with our guests. What is 1 thing our listeners can do this week to improve their surgery centers.

20:54.00
Katie Sypher
Um, talking.

21:10.14
Katie Sypher
Thought a lot about I I knew this question was coming so I did think a little bit about it. But what I would say is walk in the shoes of your patients I’m going to tie this all the way back to how do we really work towards creating a positive patient Experience. Have a non-clinical staff member start at the parking lot and go through the and take the journey that the patient takes talk to the people that the patient talks to sit where they sit go to the or rooms and really pretend that they’re a patient and. What they what you may find is there are some simple changes that could be adjusted that are cost free that could make a huge impact for that patient experience and I’m going to give you an example, It’s probably the educator and Dietician in me, my husband was in the emergency room for Kidney Stone and. Was sitting in the room with him and I looked at the light boom above where he was sitting. It was coveredbbard and dust like Dis gross and doctors come in nurses come in staff administrator but they don’t sit where the caregiver sits. They’re never sitting at the chair looking up and so. As simple as letting your maintenance staff know hey clean the top of those lights could be the difference between a negative social media post and a positive social Pdia post and so I would say take the time to walk through see what the patient sees and you may be surprised that the simple changes could make a huge impact.

22:40.81
Erica Palmer / HST Pathways
That is awesome advice Katie thank you and thanks so much for coming on I learned a lot I know our listeners will as well. So we appreciate it.

22:50.85
Katie Sypher
Thank you.