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Quick Tips for Managing a Rural ASC

Quick Tips for Managing a Rural ASC

By ASC Management, Leadership No Comments

Managing a rural ambulatory surgery center (ASC) presents unique challenges. In a limited demographic region, staffing, physician recruitment, and patient access can be problematic, especially if a well-formed strategy isn’t in place.

Here are several tips to help manage a rural ASC.

Staffing

In a remote (non-urban) region, there are typically a limited number of skilled professionals available to staff your rural ASC. While professionals in the area may possess the necessary medical credentials, they may not be equipped with firsthand ASC experience. If you require ASC experience as a minimum qualification, you will further limit your applicant pool. Therefore, it’s best to shift your focus to hiring qualified, motivated individuals who are willing to put in the time and effort necessary to achieve competency in the surgery center arena. Be prepared to spend adequate time onboarding and introducing new employees to the ASC model. It differs significantly from the hospital model where available staff may have gained much of their previous experience. A challenge faced by employees new to the ASC model is learning to perform multiple duties they were not likely required to complete in the hospital setting. Patience, consistent check-ins, and open communication with the preceptor are key in getting them up to speed.

Physician Recruitment

Physician recruitment can also be challenging for a rural ASC. Typically, there is only one hospital which employs physicians in the area. The ASC will either need to have a transfer agreement with that hospital or the physicians providing surgical and procedural services will need to have privileges at the local hospital.

If the hospital is not inclined to provide a transfer agreement to the ASC, physicians who only perform outreach medical services in the area may find obtaining medical staff privileges at the hospital burdensome. Because these physicians are not providing services to the rural community daily, they may be unable to meet the hospital’s case threshold requirements.

Take time to understand physicians’ relationships with the hospital prior to onboarding them to your ASC. In turn, ensure physicians you are recruiting to the ASC understand the steps they may have to take to secure the necessary relationship with the local hospital.

Patients

Patient access is limited in a rural area. Some patients may travel for an hour or more to receive medical services. Robust patient scheduling, admission, and discharge criteria are necessary to ensure optimal patient experience. Train your staff to ask your patients the right questions. Nursing staff need to supply patients with detailed post-operative instructions, as well as travel instructions to make sure patients are comfortable on their trip home.

Some patients may require longer recovery times to adequately prepare them for their extended post-op travel. Understanding these needs up front, will save your staff, physicians, and patients valuable time post-surgery. Provide patient satisfaction surveys, monitor the responses, and implement operational changes to enhance customer service.

The challenges encountered in running a rural ASC are different than those you may face in a surgery center located in a metropolitan area. Devise a strategy that considers staff, patients, and physicians. Focus on building and maintaining a high functioning ASC team. Create relationships that extend beyond the rural community. Focusing on these efforts will help you run a more successful rural ASC with the limited market and resources available.


Kelli McMahan, Regional VP of Operations

ASC Policies, Procedures, and Protocols, Oh My!

ASC Policies, Procedures, and Protocols, Oh My!

By ASC Governance, ASC Management, Leadership No Comments

Policies, procedures, and protocols are the lifeblood of an ASC’s operations. These critical guidelines should be clear, concise, and readily accessible to members of the workforce. Sometimes, despite the importance of these standards, locating a comprehensive listing of policies, procedures, and protocols is not easy. When staff members are unable to easily locate a policy for the guidance they need to complete their job duties, they are hampered in their mission to provide efficient and effective service to patients. Frustration arises when time is wasted working through inefficient processes. And, in a surgery center’s fast-paced environment, timeliness is critical to efficiency.

Policies and procedures are written to provide clear and concise context, which in turn promotes consistent performance across teams. Written policies are the guideposts which represent evidence-based practices to be applied in daily functions. When team members cannot locate a policy, mistakes can happen, and clinical care can falter.

The best policies and procedures are well-researched, carefully crafted documents that contain pertinent references. They should also be stripped of bulky words, keeping content current, consistent, and concise. No matter how well written the policy, it is meaningless if it is never read and applied to practice.

How do you know if your staff is knowledgeable of your surgery center’s policies and procedures?

If your staff asks questions which are addressed in the policies and procedures manual, that can be an indicator that they are unfamiliar with your ASC policies and procedures. For example, do they ask, “What policy addresses cleaning point of care devices between patient use?” or “How often must relative humidity be monitored?” These questions indicate your staff either do not know best practices, or your ASC process, or they are unsure where to locate the information.

To address a lack of awareness of policies and procedures, begin by creating open dialogue with your staff. During this process, you may uncover a need for retraining or identify areas in your onboarding process that are insufficient. On the other hand, if your staff reveals competency in the areas where there were questions and they are solely looking for your center’s specific policy, take a step back to review the accessibility of your policies and procedures and determine if they are user friendly. There may be many reasons why staff members do not establish and maintain policy knowledge with ease; communicate with them to find out why.

Are Policies, Procedures, and Protocols Accessible?

Let’s explore the accessibility factor by looking at the history of policies and procedures. In the past, policies and procedures were paper based – typically housed in several large three ring binders. Often, these policy notebooks were strategically placed in the confines of a manager’s office – the person most often responsible for upkeep of written policies. In this model, the binders are not immediately available to the bedside nurse who may benefit greatly if they were in a more convenient, accessible location.

The communication breakdown here can be explained by competing priorities. A manager of a busy ASC is often overwhelmed by the demands of the day. The ongoing task of refreshing policies quickly can easily slip to a lower priority.

A practicing nurse knows to wipe down the gurney and put clean sheets on the bed before the next patient uses it. He or she did not need to read a policy to know this. However, does this same nurse know why only FDA approved disinfectant is used? How much dwell time is needed to kill microorganisms? Which point of care devices need to be cleaned? The answers to these infection prevention practices are critical to current infection control standards and are addressed in written policy. When the policy is read and executed, best practice is displayed by the entire team.

Poor practice, ineffective communication, and inadequate onboarding occur when the cleaning process is vocalized but not provided in written form during the orientation of a new hire. The orientee does their best to repeat what is heard and observed – but a breakdown in the consistency of the function can easily occur. If the employee does not receive enough guidance or resources, he or she may resort to performing the task in the way he or she knows how, relying on previous experience or observations of others. That performance might not adhere to the latest best practices. Alternatively, proper infection control processes are easily achieved as a repeatable task with initial and continuous education resources available.

Sustainable solutions to sharing protocols, policies, and procedures

As ASC leaders, our responsibilities include consistent, reliable management of information. Effective policies contain information that can be easily shared with members of the workforce. Leaders need sustainable solutions that improve how we share policies with staff members.

Here are four goals to consider:

  • Policies are readily available to end users.
  • Policies are accurate and current.
  • Policies are protected from erroneous editing.
  • Policy updates are communicated clearly and in a timely manner to appropriate personnel.

To select a communication platform designed to achieve these goals and secure utilization among all team members, consider the following questions:

  • Does the platform address your identified goals?
  • Can the facility afford the platform?
  • What training is required to launch and implement the platform?
  • What will be gained from using this platform?
  • How will leadership appropriately administer change management?

Not every ASC will be able to adopt the same method, hence the importance of identifying your own goals. Once goals are established, develop leading questions to identify the best tool or process for your surgery center presently and in the foreseeable future.

Is there a better way?

Pinnacle III’s managed facilities recently adopted a technology-based policy management system. This strategic move allows our ASCs to immediately gain access to our surgery center policy library. Placing a clickable icon on every workstation provides employees immediate access to policies. System administration ensures accurate and current content material, maintaining intellectual ownership. To protect policies from incidental tampering, all editing occurs via permissions and a prescribed work flow process.

To facilitate the change management process, staff training was provided upon implementation. Periodic in-services were scheduled following initial implementation. To progress staff adoption, a series of quizzes were prepared for personnel affording them opportunities to practice locating and reading various policies on the platform.

Implementation of this software has decreased employee frustration with inability to locate policies. The software provides a more efficient way to maintain and update policies. Our leadership team is more confident members of the workforce are following policies. This has enhanced the workforce’s ability to achieve compliance to practice standards and defined business operations. The leadership team’s repetitive message, “Let’s view the policy!” and “Did you read the policy?” makes consistency probable.

A technology-based platform may not be the answer for your ASC. However, it is important to understand the pain points and efficiency issues that occur in your center. These critical components are directly tied to patient care. No matter what your solution, make sure you are addressing your policy, procedure, and protocol goals. After all, the best policy ever written is the policy which is accessed, read, and applied to daily practice!


Jean Day, Director, Clinical Education

ASC Marketing and Sales: Keeping Up in an Evolving Industry

ASC Marketing and Sales: Keeping Up in an Evolving Industry

By ASC Development, ASC Management, Leadership No Comments

Marketing your business isn’t easy. Having a comprehensive marketing strategy is especially important in dynamic markets where change is the norm. In health care, and especially in the ASC industry, effective leaders tend to focus on concrete operational and administrative items that keep the doors open for business. Surgery centers often operate with a precise number of staff designed to support the current client base. An all hands-on deck culture leaves limited time to consider, let alone implement, a robust ASC marketing and sales strategy. Some stakeholders may argue a robust ASC marketing and sales strategy is not vital – after all, physician practices drive business to the site of care. While this is true, environments change. Those who are committed to tactics that have worked well in the past may soon find they have been left behind.

What is an effective way to go about marketing an ASC? Here are some strategies to consider.

Selling – Manipulation v. Persuasion

It is said, “Any successful business sells well.” What does that mean exactly and how does it apply to surgery centers?

As an administrator in a health care entity, it may be difficult to imagine yourself selling as one does, let’s say, in a retail store. When we think of health care in a typical clinical environment, we picture sick patients, caring providers, medical equipment, medicines, and other related items. It can be difficult to imagine selling in the health care arena. In fact, it almost feels wrong – perhaps because most health care isn’t elective. However, I would venture to say this is true only if you consider the old school perception of selling. What do I mean? The old mindset of selling embodies characteristics of manipulation which, by definition, entails, “artful, unfair, or insidious means.” There is a much stronger ethical consideration in health care than in many other industries. Artful, unfair, and insidious means go against the ethics of medical practice.

Shifts towards globalization and mainstream use of technology have allowed for greater sharing of consumer insights. Consumers in turn have become more savvy. Selling now focuses more on persuasion. Persuasion means to move by “argument, entreaty, or expostulation to a belief, position or course of action.” Selling deals with intent, purpose, and an end goal. If the end goal is to rip people off, then, yes, selling feels terrible. That is manipulation. However, health care leaders can expect to feel something different when their selling mindset moves toward persuasion.

The Norwegian word for sell is “selje,” which directly translates to, “to serve.” As a business operator, if you believe you are there to serve the marketplace, customers will find ways to buy your services because you are serving them. With this shift in perspective, selling becomes more palatable for our surgery centers, right?

Understand Your Customer

The best way to attract customers – new patients or physicians – is to understand your prospects. Health care providers ask leading questions to understand the root cause of a health problem. The same practice holds true with your customers.

Let’s say you want to recruit a spine surgeon who just moved into your market. What are your next steps?

How about a visit to the surgeon’s practice, bringing his or her favorite lunch and dessert, to entice the surgeon to stick around while you rave about how great your surgery center is for his/her cases? This represents the old way of selling. And many physician recruiters would feel good about this method because you walked in with intent, purpose, and an end goal. But you would be doing yourself, the physician, and the surgery center a huge disservice if you didn’t take the time to understand the real needs of the physician. The favorite lunch and dessert will only satisfy for a short while. The positive statements in favor of the surgery center will only maintain impact until the physician experiences a negative event that doesn’t measure up to these claims. Even though this sales approach may provide immediate success, it is wiser to invest more effort in understanding the physician’s needs.

Taking time to get to know the physician and asking the right questions will create and sustain a longer-term relationship with them, which should be the real end goal. Another reason to ask the right questions is to assist customers articulate their needs. Your exercise may help get them to a place where they feel better about taking a step forward with you. Conversely, you may encounter a physician who has his or her defenses up because they have run into someone who sold, manipulated, and ripped them off in the past.

How can you engage physician recruitment prospects in deeper conversations about their needs? Here are some examples of focused questions to get you started in better understanding your customer.

  1. “I understand you just moved into the area. Where would you like to see your practice go in the next 3-5-years?” or “What are your goals for you and your practice in the next 3-5 years?”
  2. “What are your current patient demographics? Are there any additional cases or services you would like to start performing?”
  3. “Are there any special equipment needs for your surgical cases?”
  4. “Have you worked in an ASC before?” If yes, “What are some of the best or worst things that have shaped your ASC experiences? What things do you wish you could have changed? What things have you enjoyed?”

To accurately gauge if you are asking the right questions, determine if you are simply selling to your customer or truly servicing them. Servicing your customer entails understanding their needs first, rather than presenting to them what you think they want.

When you ask better questions of your customer, you get better responses about pain points and aspects your customer expects from your service. These answers can help you pinpoint how your ASC stands out from competitors. Sometimes your ASC is a better site of care for a physician; sometimes it’s not. Not being able to serve every client’s needs is okay. Develop your strategy, then focus on servicing your clients if it makes sense for you, your staff, and the business. Avoid being stagnant. Communication about your customers’ needs allows you to uncover hidden opportunities for business growth which can yield untapped profit.

Understand Customers’ Preferred Channels of Communication

Once you obtain the answers you need from your customers, work to understand how your customers want to receive future information and communication. Do they prefer phone calls, texts, emails, or paper communication? Do preferences change depending on the content? Identify when it is appropriate to send out a mass form of communication to all clients and when to communicate with clients on an individual basis. When you communicate with clients one-on-one, tailor your messaging and communication channel to fit their communication preferences. The best way to find out is to ask!

Making Every Sale Count

The last tip in marketing your surgery center is to make every sale count. Air Force veteran and “sales whisperer” Wes Schaeffer claims, “To make any sale, you must make every sale.” He goes on to explain: “Suppose you are going on a date. You would brush your teeth, dress up nice, approach with a smile, and perhaps pay for dinner. All these little gestures are viewed as little sales along the way, contributing to a larger sale.”

The same holds true for your surgery center. Some of the little sales to consider as part of your larger ASC marketing and sales strategy are:

  1. Is your pre-registration pamphlet easy for patients to read and understand?
  2. Can patients easily navigate your website? Is your website enticing to patients? Do they get a good feel for the care they will receive at your facility?
  3. Do patients receive any form of communication prior to their procedure to ensure they are ready?
  4. Do front desk personnel warmly greet patients and/or friends and family when they arrive?
  5. Do your nurses and providers explain all necessary steps and set up expectations throughout each patient’s episode of care?

This is just an example of some of the mini-sales opportunities that occur when providing service to patients. There are many more touch-points in the patient journey. Each of these touch-points allow an opportunity to complete a mini-sale.

What works for your surgery center today, may not work for your surgery center tomorrow. Opportunities to improve customer experience occur with technology updates and patron preferences. The customer experience should be monitored, updated, and modified over time. The best way to identify the quality of your customers’ experiences is through patient satisfaction surveys and online reviews. Identifying how your customers navigate through your supply chain, including all the mini-sales touch-points, lends itself to better customer experiences and opportunities to retain customers long-term.

Effective ASC Marketing and Sales Drives Business

ASC marketing and sales requires an unceasing commitment. Customer needs are your number one priority in providing services, whether that customer is a physician or patient. Ensure you prominently address those needs in your strategic plan.

Effective ASC marketing and sales expresses your story. Never forget, your sales pitch should reveal your passion – to provide the highest quality service to consumers. As every consumer and every industry is different, so too is every business and every sales pitch. When you embrace the unique direction your customer base is encouraging you to move in, customer loyalty and unique service offerings will drive your business growth.


Trista Sandoval, VP of Business Development & Physician Relations

Effective Health Care Marketing Goes Beyond Driving Business

Effective Health Care Marketing Goes Beyond Driving Business

By ASC Management No Comments

Health care regulations and policies are constantly changing, which makes health care marketing dynamic and challenging. Most marketing focuses heavily on targeting the right audience and delivering a tailored message to that audience. If the message is successfully transmitted, it drives demand for the health care service and consequently increases business and revenue. However, more nuanced effort is required to effectively market your surgery center and drive revenue growth.

Although patients may arrive at the specialist’s or ASC’s doorsteps through effective advertisements or physician referrals, there is no guarantee patients will stay to receive treatment for the same reasons.

For effective long-term business growth and retention, patients need to view your ASC as a reliable, trustworthy, and competent place to receive care. This is not fulfilled through marketing alone; it requires commitment from your entire organization.

Building Trust with Patients

Health care fits into the service industry category, where trust is translated into currency. Patients seeking care are already experiencing some vulnerability and stress related to their health. From the moment your patients walk through the door, and even before this point, they are assessing how your ASC responds to their needs and the quality of service they can expect to receive. In other words, can they expect your ASC to live up to the expectations set forth by your marketing campaign?

Long gone are the days when companies were able to unilaterally control their marketing message. Nowadays, patients are doing the marketing for providers, whether the providers agree or not. Technology has provided a platform for consumers to express their feelings and experiences online about the businesses with which they interact.

One study by the Local Consumer Review has indicated positive online reviews make 73% of consumers trust a local business more.[1] It is crucial to understand how patient experience and brand reputation go hand-in-hand in an increasingly digital world.

Focusing on Patient Experience

Strong marketing strategies focus on optimizing patient engagement to enhance positive brand reputation. That engagement starts with the initial marketing, but it solidifies through the patient’s experience at the ASC.

Here are some ways to improve patient experience:

  1. Set expectations through patient education.

Offer patient education through different platforms to establish patients’ expectations for their care. Patients get frustrated when there is a lack of information about their procedure, which sets the stage for unintended miscommunication. By being proactive in creating simple, relevant guides, you will contribute to your patients’ overall perception and experience.

  1. Invest in customer service education for your staff.

Your staff is the “face” of your organization. Patients tend to care more about how they are treated than the facility’s appearance. Educate your staff on how to engage with patients in positive ways, and how to ask patients to provide feedback about their experience. You may also consider giving staff a simple flyer or cut sheet to hand to patients which outlines how to leave an online review for your ASC. Evidence shows that 70% of consumers will leave a review for your business when asked.[1]

  1. Invest time in communicating with your customers.

Technology has changed consumers’ expectations about how businesses communicate with them. Be aware of what patients are saying about your organization and be proactive in responding to what they are relaying. Let your patients know you are open to feedback, whether it’s good or bad.

Also, it is important to understand where to communicate with your patients. Although a recent study shows Yelp & Facebook are local consumers’ most trusted review sites,[1] other platforms are being used for consumer reviews. One of the services Pinnacle III provides to its facilities is managing each ASC’s online reputation. We foresee demand for patient interaction expanding, not decreasing.

  1. Have a service recovery plan.

This applies to both patients and referring physicians. As a physician, you value your relationship with your patient. As a surgeon, you value the trust other physicians place in you when they refer their patients to you. What if a mishap occurs that could potentially tarnish those sacred relationships?

It is wise to prepare your staff members to handle an unhappy patient or referring physician partner. By focusing on customer loyalty versus attempting to gain new ones, you may realize more positive benefits in the long run. Frederick Reichheld, author of the Loyalty Effect, stated that a five-percentage point increase in customer retention increases profits by more than 25 percent.[2]

Better Business at Your ASC

Targeting potential consumers with tailored marketing messages can help lead patients to your health care door, but their arrival is only half the battle. Comprehensive and results-driven health care marketing also incorporates the patient experience when they seek treatment at your physician office and/or ASC. Stay in-touch with the ever-changing health care market to make sure you are providing the best possible service for your patients’ needs. Seek to build trust with patients and you will be rewarded for your efforts. Recognizing and prioritizing each patient’s overall experience ensures health care marketing results in long-lasting, loyal relationships.


Alice Beech, Physician Liaison


[1] https://www.brightlocal.com/learn/local-consumer-review-survey/

[2] Reichheld, Frederick F., and Thomas Teal. The loyalty effect: the hidden force behind growth, profits, and lasting value. Harvard Business School Press, 2008.