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Topic: Try to boost staff efficiency

Ambulatory Surgery Reimbursement Update, October 14, 2008

Manage your mix of employees and consider transitioning surgical technicians into your operations where possible.

“It’s becoming more common in our industry to use surgical techs and other technicians versus using registered nurses, who have much higher salaries and training, as much as possible,” said John J. Goehle, MBA, CASC, CPA, vice president of finance at Facility Development & Management, LLC, in Orangeburg, NY.

Review your payroll to determine the clinical and total hours in a given month, and calculate the clinical and total hours per case by dividing by the number of cases per month to evaluate staff efficiency. Goehle said that two benchmarks are 8–10 clinical hours, and 10-12 total hours, per case: the averages depend on your case load and mix. For example, you might be on the higher end of the averages for orthopedics but on the lower end for GI, pain, and ophthalmology.

Try cross-training your nursing staff members and technicians so that they can work in different specialties. If you have a light schedule on Fridays or you’re not able to get physicians in or certain procedures done during the afternoon, some nursing staff members may not be busy on those Fridays or off hours in the afternoon. So you might consider cross-training them in some of the clerical tasks from the business office or even cleaning areas of operations.

“I know this isn’t necessarily a popular opinion, but certainly, in an ASC that is small, we all have to pitch in and help out,” Goehle said. “If we can reduce the cleaning or clerical staff … that can certainly help reduce the costs and increase staff efficiency.”

It’s also a good idea to cross-train your staff so there is more than one person who is skilled at coding and accounts receivable management, said Susan Garrison, CHCA, PCS, FCS, CPC, CPC-H, CCS-P, CHC, CPAR, executive vice president at Magnus Confidential, Inc., in Dawsonville, GA, who also spoke at the audio conference.  If you have only one person trained in these tasks, and that person goes on vacation or decides to leave the facility, you will find yourself in a difficult situation. Plan ahead so that you have this support when you need it.

Editor’s note: This topic is from the October 2008 issue of Ambulatory Surgery Coding and Reimbursement Insider.

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