Skip to main content
Tag

Ambulatory Surgery Center Archives - Page 7 of 7 - Pinnacle III

What is Your Surgery Center’s Online Reputation?

What is Your Surgery Center’s Online Reputation?

By ASC Management No Comments

Trista Sandoval, Director of Business Development & Physician Relations, expands on an excerpt from PINNACLE III’s February 2017 White Paper “Looking Ahead: 10 ASC Trends to Watch in 2017.”

How is your online reputation management coming along this year? This question may seem intrusive. For those of us who have done nothing, it may seem flat out invasive. Many of us started the year with great intentions, perhaps even creating an initiative to develop an online reputation strategy, launch a program, or reach a target number of views or responses. For many, those objectives have fallen by the wayside, long forgotten whilst putting out day-to-day fires, onboarding new physicians, developing new service lines, or implementing new software.

Unfortunately, allowing online reputation to fall off our radar has negative ramifications. Why? Let’s start with what online reputation management is.

Online reputation management is the practice of crafting strategies that shape or influence the public perception of an organization, individual, or entity on the internet. It helps drive public opinion about a business and its services. Undeniably, it influences, and is influenced by, your overall reputation.

What happens when your reputation is tainted? Simply put, you lose business – and customers. In a market where the competition is high and physicians are known for being highly competent, experienced, certified professionals with proven track records, there is no room for a tainted reputation. Further, healthcare entities are beginning to favor models in which the patient experience is prioritized and continuously enhanced based on patient feedback.

Patients gravitate to their preferred provider through engaging websites, mobile-optimized scheduling features, healthcare portals where they can access their recent visit information, and pay-your-bill online features. With patients more responsible than ever for satisfying upfront co-pays and deductibles, they are more willing to research top healthcare options to obtain the highest quality, most cost-effective care.

In a study from Nielsen Report Global Trust Advertising and Brand Messages, consumers were asked to what extent they trust various forms of advertising. Ninety-two percent (92%) of individuals surveyed indicated they completely trust recommendations from people they know. Seventy percent (70%) responded that they completely trust consumer opinions posted online. This is significant, telling information on how our consumers perceive our brands and who influences their choices. It is no wonder healthcare organizations are prioritizing the patient experience and improvements based on patient feedback.

Every healthcare entity should be focused on learning how to better communicate with patients and how to better gain their trust when it comes to helping with surgical care needs.

If you find yourself in the category of most individuals who have completed little to no online reputation management efforts this year, or have put in limited effort, all is not lost. Start now!

First, identify what is being said about you. Managing reviews or creating operational changes that enhance your patients’ experience requires knowing exactly what your customers are relaying to others. Review top consumer resources – Google, Facebook, Yelp, etc. – to gauge the status of your online reputation. Take a moment to evaluate how your current online reputation differs, and aligns, with your online reputation goals.

Second, identify the platforms on which most of your patient reviews are being posted. This will be helpful in determining which platforms are most utilized and warrant efforts to improve your reputation as well as which platforms are under-utilized. You can then create your strategic initiatives based on how you want to tackle each platform.

Here are some helpful hints to remember when managing your online reputation:

1. Use Google Alerts to notify you when your brand is mentioned on the internet. You can also use the same method to alert you when your competition is mentioned to compare your popularity.

2. Respond timely to any negative reviews. Show customers you care about their experience and you value their input.

3. Remain factual. Ensure you carefully craft your responses.

4. Capitalize on bad reviews by improving your processes.

5. Avoid sharing protected health information (PHI), including pictures of patients or staff members.

6. Monitor your online platforms and identify potential pitfalls. If this is not your area of expertise, reach out to a trusted expert for guidance.


It is important you and/or your third-party advisor understand your market, industry, strategy, and goals. Define these in the early stages of your strategic planning.

Online reputation management is a process. There is no better time than now to start protecting and enhancing your brand in the digital world.

To uncover more ASC Trends in 2017, visit our white paper page.


Trista Sandoval, Director of Business Development & Physician Relations

Leadership Defined – Best Qualities of an ASC Leader

Leadership Defined – Best Qualities of an ASC Leader

By ASC Management, Leadership No Comments

Jennifer Post’s article, 11 Ways to Define Leadership, published in the leadership section of Business News Daily on March 29, 2017, listed qualities of highly effective leaders alongside relevant quotes from current leaders and business founders. I found many of the viewpoints on the definition of leadership useful for the ambulatory surgery center (ASC) industry. The author’s main point also struck a chord. She maintains leadership is subjective, but its foundation is formed from one thing – the ability to build consensus and establish a following among individuals and teams.

I have been fortunate to learn from highly effective ASC leaders. Those I admire possess a variety of styles, but at the core, they all build momentum around common clinical and business-related goals.

In evaluating the day-to-day behaviors of these effective surgery center leaders, I identified the things they did that were most inspiring to me. I paired each tenet of a good leader with relevant quotes on leadership from Ms. Post’s article. I created the following as a guide for myself in hopes I can integrate these leadership traits into my daily interactions with my surgery center teams.


Step 1: Care

Leadership is about people serving people, inspiring people, and caring about people. You must show you care through your daily actions.

Our surgery centers often lean on staff to be excellent in a fast-paced environment, which is what we are known for. However, this can leave staff feeling the pressure to keep up. It is important to provide our presence, support, education, and creative tools so staff feel equipped to deal with the day-to-day operations of their departments.

“Leadership is serving the people that work for you by giving them the tools they need to succeed . . . [Team members] should be looking forward to the customer and not backwards, over their shoulders, at you . . . [Give] genuine praise for what goes well and lead by sharing in the responsibility early and immediately if things go bad.” –Jordan French, founding CMO, BeeHex, Inc. 3D Food Printing

Step 2: Communicate

When a leader does not communicate well, team members don’t feel valued. Good communication involves listening, truly understanding, and respecting others’ opinions. ASC staff members must be critical thinkers and doers. Impromptu conversations with staff member about problems in the center can result in some of the best ideas to resolve them. This requires leaders to have conversations, ask for input, listen, and think before throwing out an idea.

“Any time you work with a group you should expect disagreement. You should embrace dissent. Teamwork isn’t about going along. It’s about hearing all views, admitting mistakes, and sharing risks and rewards jointly.” – Gary Kelly, CEO, Southwest Airlines

“In my experience, leadership is about three things: to listen, to inspire and to empower. Over the years, I’ve tried to learn to do a much better job of listening actively making sure I really understand the other person’s point of view, learning from them, and using that basis of trust and collaboration to inspire and empower.” –Larry Garfield, president, Garfield Group

Step 3: Have Character

Over-prepare, admit weaknesses, and allow others to assist you. This builds a culture where team members feel valued and fulfilled.

“Adversity does not build character, it reveals it.” –James Lane Allen, novelist

“Leadership is the ability to see a problem and be the solution. So many people are willing to talk about problems or can even empathize, but not many can see the problem or challenge and rise to it. It takes a leader to truly see a problem as a challenge and want to drive toward it.” –Andrea Walker-Leidy, owner, Walker Publicity Consulting

Step 4: Be Competent

Effective leaders know their business and their team. A competent leader is reflected in a competent team. Encourage and help your team gain certifications or specialized training that will make your facility better by providing staff members with gratification and betterment of themselves. Promote from within your organization to your leadership roles. Create your own OR nurses using peri-op 101. Hire clinical directors with the intent of nurturing them in ways that will allows them to assume administrator roles.

“To me, leadership is about playing to strengths and addressing weaknesses in the most productive and efficient way possible. It’s about knowing your team and yourself, and doing your best job to set both up for success.” –Samantha Cohen, co-founder, Neon Bandits

Step 5: Have Courage

As many times as things go right, they go wrong. Leaders need to be the ones sitting in front of a board owning up to mistakes made. However, if a leader can take the situation, apply corrections, and discuss that process, blame is removed so the problem can be fully dissected. If we look at every issue as a potential opportunity to prevent its recurrence, people stop avoiding the issues.

“A leader is someone who has the clarity to know the right things to do, the confidence to know when she’s wrong, and the courage to do the right things even when they’re hard.” –Darcy Eikenberg, founder, RedCapeRevolution.com


Every leader has his or her own style and strategy, and every company its unique challenges. Recruiting and retaining talent in healthcare is a financial and intellectual investment. Effective leadership helps ensure we get the most out of the time and money we spend finding and training team members, because effective leaders build and retain top talent.

“There is no one-size-fits-all approach, answer key or formula to leadership. Leadership should be the humble, authentic expression of your unique personality in pursuit of bettering whatever environment you are in.” –Katie Christy, founder, Activate Your Talent


Jovanna Grissom, Vice President of Operations

1Business News Daily article March 29, 2017 11 Ways to Define Leadership

Managing difficult employee behavior

Help! My Employees are Keeping Me Awake at Night!

By ASC Management, Leadership No Comments

Lately, when faced with a work situation that taxes my emotional reserve and keeps me awake at night, I turn it on its head. I view the issue from a different perspective; change the tape that’s repeatedly playing in my brain by altering the order of the words.

For example, when I hear, “I’ve got a difficult employee and I don’t have a clue what to do,” I reframe the problem and respond with, “Let’s talk about the difficult behavior this person is exhibiting that is creating frustration for you in the workplace.” Shifting our dialogue to focus on the behavior rather than the person, creates a much-needed level of objectivity that allows for more effective problem solving.

Let’s face it, as leaders, we are bound to encounter employees who exhibit behaviors that are difficult to manage. An employee who simply fails to show up to work on time can create havoc in a facility. Being met with resistance when asked to perform a task in a specific way can derail a surgery center team’s attempts to ensure patient safety.

If you’re like most people, you don’t enjoy confrontation. So, you chalk the behavior up to “a bad day” or, when the behavior rears its ugly head consistently, excuse it with, “That’s just how Marianne operates. She’s not interested in hearing feedback.” But, it’s your job to deal with these behaviors effectively to minimize the ripple effects. The harsh reality is, if you don’t deal with difficult behaviors, the problems will only get worse. And, if you don’t document your actions, it is as if you never responded.

When you find yourself wondering why an employee is being so difficult, avoid succumbing to “stinkin’ thinkin’.” In other words, avoid personalizing the behavior.

Here’s an example. Tom, your receptionist/registrar, reports to the surgery center 10 to 15 minutes late every morning. He is responsible for checking patients in promptly. If he’s not there, patients either end up waiting for him to arrive or his co-workers must stop what they’re doing to perform his job. This is annoying enough on its own. But he has the nerve to saunter in with a Starbucks coffee in hand, jovially greeting everyone on the way to his workstation. The patients love him. They have no idea he’s the one who created the tension they sensed upon their arrival. As he settles into work, capably completing the tasks his co-workers have started for him, you overhear a steady stream of employees filing past your office muttering, “Really? He does this every day. Why does he insist on making everyone miserable? I’m tired of doing his job. Doesn’t he recognize we’ve got our own tasks to perform to ensure surgeries start on time?”

Tom, contrary to what is now popular belief, likely does not wake up every morning planning to upset everyone. He’s laid back – a strong suit when it comes to interacting with patients nervously anticipating their planned procedure – and approaches everything in stride, including sleeping through his alarm, a long line at Starbucks, and having to circle the parking lot three times to find an empty spot.

To deal effectively with Tom’s tardiness, it’s important to accurately identify the problem behavior. On the surface, it might appear the problem is slacking – showing up late because Tom wants others to perform his job. After all, that’s what his co-workers have surmised. However, after talking with Tom, you realize he is on a completely different wavelength. He truly is unaware his behavior negatively impacts the start of everyone else’s day.

Now that you’ve identified the true difficulty, you can effectively manage Tom’s future behavior by having a conversation with him. People who are on a different wavelength, need clearly defined communication that outlines expected results.

Your conversation may proceed along these lines. “Tom, I need you to be at your workstation ready to check in our first patient on time each morning. I expect you to clock in at 5:45, then immediately report to your desk to ensure you are prepared for 6:00 a.m. arrivals. Adhering to this regimen will serve our patients well. The value you bring to our organization will be enhanced when your co-workers realize they can rely on you to greet patients and get them checked in promptly. Our physicians will recognize a change in how quickly they are able to get started each morning. I’m going to document our conversation today as a coaching session. Now that you recognize how important it is for you to be on time to perform an essential requirement of your job, I’m confident you will figure out how to report to work promptly every day.”

I recognize this is only one example of dealing with a difficult behavior. And, more importantly, I’ve assumed the conversation went well. You talked to Tom, he saw the light, he altered his behavior, and being late to work is not something that occurs anymore. I’m aware, however, that’s not always the case.

My point is this: when you separate the person from the behavior, accurately identify the problem, and promptly address with the employee how their behavior impacts the organization, you have a much greater chance of achieving a successful outcome. Those successful outcomes will not only lead to a happier, more united facility, they will allow you to sleep much better at night!


Kim Woodruff, VP of Corporate Finance & Compliance

ASC Infection Control Program

How to Develop an ASC Infection Control Program

By ASC Management No Comments

Surveillance, prevention, and control of infection in ambulatory surgery centers is a frequent deficiency cited in state, Medicare, and accreditation surveys. ASCs are required to have an infection control program that outlines purpose, goals, specific risks, methods of data collection, and strategies used. The program also must identify how and when the infection control program is evaluated. Because most centers do not have a full-time infection control nurse or officer solely dedicated to this role, this requirement can seem daunting. With some luck, the Infection Control Officer (ICO) might get to a meeting once a year and complete the training required to hold this position.

The purpose of infection prevention is to protect the patient, health care workers, visitors, and others in the health care environment. In an ASC especially, it needs to do so in a cost-effective manner. How can you effectively and efficiently ensure infection prevention in your setting?

1. Start by setting infection control program goals.

  • Identify and reduce the risk of endemic and epidemic facility-associated infections.
  • Report appropriate information to internal surgery center leadership and public health authorities.
  • Develop communication linkage between professional and health care workers, patients, families, public health professionals, and the community.
  • Create plans to respond to emerging infections and bioterrorism.
  • Promote a zero tolerance of hospital acquired infections (HAIs).

2. Explain how infection control is embedded in your organization. Spell out how the ICO integrates with committees, the reporting structure, and the sources utilized for evidence-based practices. For example:

  • The ICO is part of the Continuous Assurance Committee and oversees the infection control program.
  • Under the direction of the Medical Director, the ICO investigates all suspected outbreaks. This occurs in collaboration with the appropriate medical and administrative staff.
  • Using the most correct and useful statistical process, data is collected, analyzed, and reported.
  • The ICO has access to comparable community data to determine if rates within the center are above or below those in the community.
  • The ICO develops this plan using data from CDC/NHSN/NNIS.
  • The board of managers approves the infection control program, types and scopes of activities, and training materials. They review this plan at least annually to evaluate its effectiveness in the center.

3. Create a prioritized risk assessment. The risk assessment should focus on internal and external factors. This helps form a complete picture of the risks that exist. Prioritize the identified risks based on the potential impact, probability, and the organization’s preparedness. This is your base for determining what activities you should perform and at what intervals.

  • External: Consider patient populations and cultural reactions to health care. Examples are community issues, such as high rates of TB. These factors are not fixed. As situations arise in the community, a new risk assessment may be necessary.
  • Internal: Focus on your high volume/high acuity cases. Think about instrumentation and the associated cleaning problems (i.e., long, luminated). Consider the physical plant in which you provide care. Are there risks? Do you have a water feature in your lobby?

4. Identify and summarize your activities.

  • Remember to take credit for activities you already perform. This can include monthly and 90-day SSI surveillance, prophylactic ABO administration tracking, and bloodborne pathogen exposure monitoring/reporting and outcomes.
  • Based on your risk assessment, you may track things like monthly monitoring of SPD logs, environment of care items, and hand hygiene. Ensure each one of these activities has a summary explaining the process, frequency of tasks, and documentation undertaken.

5. Spend time discussing and documenting the strategies you will use.

  • A good general statement is “TJC, AAAHC, OSHA and pertinent federal, state, and local regulations pertaining to infection control are being implemented and followed.”
  • Include items such as staff training on PPE, TB, hand hygiene, and cleaning. In addition, list the local, state, and federal contacts and reporting requirements, as well as communication with other health care facilities and providers in your community.

It is important to formally evaluate and revise your goals and program, or portions of the program, at least annually and whenever risks significantly change. Make sure your evaluation addresses the assessment of the success or failure of interventions for preventing and controlling infections and responds to concerns raised by leadership or others. The evaluation should always address how relevant infection prevention and control guidelines are based on evidence and have evolved. In the absence of evidence, cite expert consensus.

Oftentimes, daunting tasks are made less so when you have a framework to follow. Once you get the ball rolling, you are more likely to find an internal champion to serve in the ICO role. Ensure you support your ICO as they tackle program specifics by allocating the funds necessary to secure appropriate training and advance program goals. Before you know it, you’ll have a thriving program and your ASC will significantly reduce the likelihood of being cited for an infection control related deficiency.


Jovanna Grissom, VP of Operations

Everyone Sells

Everyone Sells

By ASC Management, Leadership No Comments

I have been in sales nearly my whole life. As a kid during the summer, my friends and I sold lemonade, snow cones, or our old toys from a stand in the neighborhood. From the ages of twelve to fifteen, I rented a table at comic book conventions to buy and sell to other collectors. At the age of sixteen, I had to sell myself in a job interview. When I graduated from college with a degree in physical therapy, I “sold” patients on my ability to assist them in recovering from a variety of physical ailments. To ensure the most optimal outcome, I needed them to “buy” into how important it was for them to be actively involved in their own recovery process. As I moved into formal management and leadership positions, my sales challenge progressed. I was charged with getting my teams or clients to buy into the vision or direction I was “selling.” And, as a business owner, I’ve sold my company’s services to prospects.

Yes, I’ve been selling a long time. That’s what got me excited about a recent Harvard Business Review article by Rebecca Knight titled “How to Improve Your Sales Skills, Even If You’re Not a Salesperson.”1 In it, she quotes Thomas Steenburgh, professor at the University of Virginia Darden School of Business, who states, “Selling is moving somebody else to action.” As managers and leaders, that’s what we do every day. Ms. Knight then proceeds to provide fantastic advice regarding how to think about sales and make oneself more comfortable with the thought of selling.

Although Ms. Knight’s article was focused on actual sales, I viewed it from the aspect of managing and leading people. The principles are the same. Effectively selling your team or clients on your vision and implementation strategy requires the same four tools Ms. Knight identifies as those required to effectively sell products or services.

Reflect.  Look back on the great leaders you’ve worked with in your career. How did they inspire you or your team to achieve more? I always say, management is getting people to do what they are supposed to do, but leadership is helping them achieve more than they thought they could. I had a boss who was great at providing what I needed. He broke down bureaucratic obstacles in the organization that kept me from being successful. Once he paved a path for me, I understood he expected me to deliver results. I’ve tried to adopt a similar leadership style.

On the flip side, reflecting back to poor leaders allows us to learn what not to do as well as what types of behaviors to avoid. I had another boss who was ruthless. She actively sought out weaknesses. The more vulnerable the victim the better, especially if that person reported directly to one of her subordinates. My takeaway from that experience was to make sure my team members were always prepared. Furthermore, I made it clear I would always stand with them.

Put yourself in your counterpart’s shoes. I appreciate the old saying, “To truly know someone, you need to walk a mile in their shoes.” Empathy is the action of understanding, being aware of, being sensitive to, and vicariously experiencing the feelings and thoughts of another. A leader may be able to fake empathy once or twice. However, the people you are leading will quickly identify whether you are truly empathetic or just paying them lip service.

Understand what motivates your group. Tie the motivations of individuals to your vision to accomplish your goals. I once worked for a senior VP who desperately wanted to expand his territory. He asked what my goals were. I told him I wanted to become an area manager. He replied with, “Then build an area.” He proceeded to provide me the resources, encouragement, and, when necessary, the interference, to build an area. The result was both visions were realized.

Plan, prepare, and practice. You only have one chance to make a first impression. If you’re trying to sell your team on a shared vision for success, obtain buy-in by preparing an initial “pitch” to get them on board. Not being successful the first time doesn’t doom the plan or idea for the future. However, being ill-prepared during the initial roll-out seriously reduces the chance of success going forward.

  • Plan: Identify objections you may encounter ahead of time. Know the people you are preparing to lead or motivate.
  • Prepare: Know your facts. Understand your data. Do your research.
  • Practice: Find a friend or family member with whom to practice your presentation. Or, at the very least, pitch it to yourself in front of a mirror.

Stay calm and don’t brag. Staying calm is especially important if you don’t receive the response you expected. If there is resistance to your plan when initially presenting it to your team, keep your wits about you. You may find additional research is required. Sometimes, you need to work through the plan with your team gradually. Generally speaking, losing your temper or panicking will make things worse.

Bragging or making the project or vision about you is a sure path to difficulty. I have seen managers try to motivate staff or physicians to get behind a vision but these individuals were so ego-centric it was clear to their audience the plan was really about the manager, not the team. Generally, “me” based managers fail.

Again Ms. Knight quotes Thomas Steenburgh, “Very few parents say they want their kids to grow up to be a salesperson.” If these parents truly understood the versatility of the sales skill set, they would appreciate that a sales career can prepare their kids for a life of leadership.


Robert Carrera, President/CEO

https://hbr.org/2017/05/how-to-improve-your-sales-skills-even-if-youre-not-a-salesperson