Academic medical centers, which are just beginning to embrace ambulatory surgery centers, face special challenges as they set up ASCs, according to Joan G. Dentler, president of ASC Strategies in Austin, Texas. Ms. Dentler recently assisted NYU Langone Medical Center and Dartmouth-Hitchcock Medical Center in building their first ASCs, and the facilities opened to rave reviews from surgeons and patients. Here she offers five tips for academic medical centers setting up ASCs.
1. Recruit from the ASC world. At least the ASC leadership should come from the surgery center community rather than the medical center's inpatient ORs. Leadership has to have the ability to create a culture reflecting the ASC community and not academic medicine.
2. Get surgeons involved. From the time planning starts, there should be an advisory group representing surgeons who will use the ASC. The advisory group can recommend ways to make the center more surgeon-friendly, support initiatives to make it more efficient and act as role models. Surgeons who show up on time, help with turnovers and introduce other efficiencies will be a good example for others.
3. Limit research activities. Research activities are crucial to academia and cannot be entirely barred from the ASC, but they slow down turnover and thus need to be limited. "The academic center can keep its culture without sacrificing the goals of the ASC," Ms. Dentler says.
4. Bar first-year residents. First-year residents should learn the fundamentals of surgery in the hospital OR, where operations are much slower, rather than the ASC, which needs to stay efficient. However, it is crucial to have more senior residents work in the ASC. By the time they graduate, they need to know how to function in this environment. "A rotation through the ASC will expose residents to the real world, where they will have to be faster, more efficient and more cost-effective," Ms. Dentler says.
5. Spread changes to rest of AMC. Ms. Dentler advises making the ASC a beta site for changes throughout the organization. Efficiencies can spread from the ASC across other parts of the medical center. The question, she says, will be: "If you can do it here, why can’t you do it elsewhere?" The surgery center will also give the medical center new capabilities to partner with other providers in the region, she says.
Learn more about ASC Strategies.
1. Recruit from the ASC world. At least the ASC leadership should come from the surgery center community rather than the medical center's inpatient ORs. Leadership has to have the ability to create a culture reflecting the ASC community and not academic medicine.
2. Get surgeons involved. From the time planning starts, there should be an advisory group representing surgeons who will use the ASC. The advisory group can recommend ways to make the center more surgeon-friendly, support initiatives to make it more efficient and act as role models. Surgeons who show up on time, help with turnovers and introduce other efficiencies will be a good example for others.
3. Limit research activities. Research activities are crucial to academia and cannot be entirely barred from the ASC, but they slow down turnover and thus need to be limited. "The academic center can keep its culture without sacrificing the goals of the ASC," Ms. Dentler says.
4. Bar first-year residents. First-year residents should learn the fundamentals of surgery in the hospital OR, where operations are much slower, rather than the ASC, which needs to stay efficient. However, it is crucial to have more senior residents work in the ASC. By the time they graduate, they need to know how to function in this environment. "A rotation through the ASC will expose residents to the real world, where they will have to be faster, more efficient and more cost-effective," Ms. Dentler says.
5. Spread changes to rest of AMC. Ms. Dentler advises making the ASC a beta site for changes throughout the organization. Efficiencies can spread from the ASC across other parts of the medical center. The question, she says, will be: "If you can do it here, why can’t you do it elsewhere?" The surgery center will also give the medical center new capabilities to partner with other providers in the region, she says.
Learn more about ASC Strategies.