Larry Parrish, MBA, administrator of Illinois Sports Medicine & Orthopedic Surgery Center in Morton Grove, Ill., makes eight points about scheduling cases in an ambulatory surgery center.
1. Don't take scheduling requests verbally. Illinois Sports Medicine & Orthopedic Surgery Center's scheduling office doesn't take scheduling requests over the phone. Verbal requests might result in incomplete case information and leave the facility unprepared when surgery is supposed to start. "Even if the surgery scheduler scrupulously asks for and enters all the required information known at that time, the surgeon's office staff may forget to include an essential specialty item needed for the case," Mr. Parrish says. To avoid this problem, the center requires surgeons’ offices to fill out an electronic surgery scheduling request form, which includes all essential patient demographics, insurance and procedure information, as well as needs for any special instrumentation, equipment and implants for each case.
2. Use a digital request process. The surgery scheduling request form has evolved with changes in technology and become more effective. The original request forms were in paper format, to be completed and faxed to the surgery scheduling office. However, a surgeon's office sometimes inadvertently left portions blank, requiring a series of back-and-forth phone calls to obtain essential case information. Now the form is in digital format, to be completed and submitted on a secure, HIPAA-compliant website. Required fields must be filled out before moving to the final step in the process. For example, if the requestor does not put in the patient's date of birth, the request cannot proceed.
3. Help surgeons schedule outside their block times. Whenever surgeons or their office staff members want to schedule a case outside of their ASC block time, Mr. Parrish's surgery center makes a concerted effort to accommodate the request. Frequently, the center e-mails news of a voluntary block release to all surgeons and encourage them to fill it with their own case.
4. Contact offices with unused block time. Officially, blocks will not be released until 72 hours before surgery, but when surgeons have unfilled block time as the 72-hour limit approaches, the surgery scheduler often calls the surgeon's office and asks if they plan to add any additional cases before the official release. If a request necessitates an earlier or later start time for the block-holder, Mr. Parrish or his business office manager, Kari Sroka, call the surgeon to ask for a favor. "This demonstration of the center's willingness to make an extra effort to accommodate a special request helps to keep our surgeons happy," Ms. Sroka says. If a surgeon is unable to accommodate a special request, the center will ask other block holders or look for an acceptable alternative day and time. "It involves a bit of negotiating," Ms. Sroka adds. "But in most instances we're able to fulfill everyone's needs. We're very careful not to ask for too many favors from any one surgeon."
5. Reward surgeons who release block times. If the physician agrees to release the block, the center's managers and staff make sure to be extra attentive to the needs of accommodating surgeons and their patients. Patients are prepped and ready to go to the OR, the perioperative team is standing by with all of the necessary instrumentation and equipment at the ready, and room turnaround for the next cases is timely and efficient.
6. Surgeons running late need to contact the ASC. When surgeons are running late, it is often due to factors beyond their control, but it can have a cascading effect on scheduling. The next cases will be delayed and there will be staffing challenges for both nursing and anesthesia. If the surgeon knows that there will be a significant delay and notifies the surgery center promptly, the patient will not be brought into the pre-op area. "It's far more comfortable and less stressful to stay in the waiting room with family then lying on stretcher in a patient gown with an IV running," Mr. Parrish says.
7. Let patients know about the delay. Delays can be very frustrating for patients. "The patient might be anxious and hungry, having fasted since the previous evening, so you can't offer them food or a beverage to calm them," Mr. Parrish says. "The best you can do is to keep the patient and family informed and help them to wait it out."
8. Tell patients how long the delay will be. If the surgeon is running late at the office, the delay is usually no more than 30 minutes to an hour, but if the surgeon is coming from the hospital OR, it can be as much as three hours. "On rare occasions, usually due to child care issues, a patient who is still in the waiting room may opt to reschedule the case and go home," Mr. Parrish says. Prepped patients, on the other hand, are usually willing to stick it out. "It's a tough situation and there's not a whole lot the surgery center's staff can do about it except to keep the patient informed and give them and their family members as much comfort as possible," he says.
Learn more about Illinois Sports Medicine & Orthopedic Surgery Center.
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3 Tips on Running a Successful Surgery Center in a Small Space
7 Lax Habits of Otherwise Highly Effective Surgeons