You can tackle any job that's handed to you, right? But trust me, outfitting an entire supply room from scratch, negotiating insurance contracts and shopping for a building's worth of capital equipment will test that bring-it-on gumption. Here are 9 indispensable tips I picked up watching my facility evolve from a small eye center that hosted 500 cases a year to a surgical hospital whose physician-owners perform 10,000 procedures annually.

1. Ask around. After helping to open three surgical centers — a single-specialty ASC, a multi-specialty ASC and a surgical hospital — without changing jobs, my biggest advice for those taking on a construction project is to network with colleagues who've done it before. I've been working in the industry for 20 years and still call around for advice. Ask. Listen. Ask again. Heeding the advice of experienced peers will prevent many headaches.

2. Read up. Another potential source for guidance: trade journals, including the one you're reading right now. Use published reports to augment the insights gained from site visits. After reading an article about what software vendors can offer, for example, seek out peers who are familiar with how each system works in practice.

3. Investigate every option. We're currently in the market for an upgrade to our IT system. A committee of 12 has thus far gone on four site visits over a six-month research effort. We're following the golden rule of shopping for supplies or capital equipment: don't jump at the first option you see. A lot of money has been wasted when purchases are made without intensive and thorough research.

4. Understand personalities. During our facility's infancy, I managed six full-time employees, many of whom were my close friends. We worked together for a few physician-owners. It was an intimate group and an easy one to look after. As the staff grew in conjunction with our steadily increasing caseload, new talents — and personalities — were added to the mix. I'm now responsible for 180 employees. Working with six of my close friends? That was pretty easy. Balancing the personalities of 180? Not so simple. The essentials, however, remain the same. Take the time to truly understand your staff, with a strong consideration of who works well together — and who doesn't.

5. Hire teammates. Delegation is the key to successful management, whether you oversee a staff of 10 or 100. Make your job easier. Hire clinical and business team members that buy into the notion that no one is above performing mundane tasks that might be below their level of education or work experience. That may seem like staff management 101, but there are still those in the industry who won't look beyond their job description when things get busy.

6. Be realistic. As your facility grows, so will the daily responsibilities of each employee. Having a nurse handle staff education and infection control in a single-specialty surgery center makes sense. Overloading a few employees with many job titles as your facility expands, however, is not good practice. With growth comes more responsibility. Greater responsibility demands greater time commitments to get the job done right. As you expand, hire quality full-time employees who can devote their efforts to important tasks instead of spreading too much individual responsibility across your staff.

7. Start slow? Don't be surprised if a famine precedes the feast. When you open a new facility, your ownership group won't see an immediate return on its investment. Set up your business plan to weather the storm of going without steady revenue for the first six months.

8. Embrace competition. Count on getting more attention from the competition as you gain more success and continue to grow your facility and services (see "Future of Specialty Hospitals Remains Dicey" on page 32). Surgery centers quickly become the object of close scrutiny by community hospitals. When we became a surgical hospital, however, the target on our doors became even bigger.

9. Share successes. Positive verbal recognition should be part of your daily routine but consider putting your money where your mouth is. Our physicians believe in revenue sharing, a policy that we've found keeps the entire staff focused on providing quality patient care in a fiscally responsible way. Including a bonus in an end-of-the-year payroll check works, but consider using profit sharing to build team unity.

Here's what I mean. We incorporate a segment of our year-end bonuses into our annual staff holiday party, an informal gathering during an afternoon in December. We give full-time employees $50 to spend on themselves; we divide employees into groups of four and give each group $100 to spend on clothes or gifts for needy families in our community. We deliver the groups' charity purchases to a local shelter that we've been working with for years. This year we donated $4,000 worth of clothing and essentials. Our staff appreciates the opportunity to help those in need.

The one caveat: employees run to the local mall during a break in the holiday party and must return later that day to showcase their purchases in front of the entire staff. We make them share because we want to ensure they use their bonus to pamper themselves instead of buying for friends or family. We've had some interesting reveals and more than a few laughs from new employees who were unaware aware they had to divulge their purchases.

Still digging
We're not done yet. Our hospital is now in the midst of its fifth construction project, one that will add 150 parking spaces in an underground garage. It's been quite a trip, filled with a fair share of growing pains. But the upside and satisfaction in starting your own facility or growing your current one makes it all worth it. Looking back over the last 15 years, I've learned a lot about myself as a manager. I wouldn't have had it any other way.