If you're disenchanted with your lot in (professional) life, set your sights on advancing your career. OR nurses can become clinical coordinators, who can then become facility managers, who can then become VPs of operations or management consultants. Business staff can move into the administrator's chair by cycling through the collector, scheduler, biller and office manager positions. Here are thoughts on moving into management.
Clinical coordinators. To slide into an administrative role, you'll need to understand your facility's financial workings. You must grasp the difference between controllable and non-controllable costs, and study the responsibilities of the various jobs in the business office. Volunteer to serve on committees that deal with business office concerns.
Consider that the administrator has total responsibility for the operations of the center. You might have the clinical knowledge, but you'll also need to have enough credibility with the doctors, vendors and staff to take the lead in key decisions that will affect patient care and the facility's bottom line?
To prepare for that level of responsibility, take advantage of lulls in the surgical schedule or days off to train and learn the business side of facility management. Participate in materials management tasks. Learn how to order supplies and how much those supplies cost. Teach yourself to evaluate and recognize products or supplies that decrease case costs. Look at national benchmarks and what other facilities spend on supplies.
Administrator. To advance beyond your current responsibilities to a consultant or vice president position you'll need an extensive business acumen, and excellent interpersonal and computer skills. You'll also need to grasp reimbursement strategies, human resource regulations, national regulatory codes, accreditation standards, and legislative changes and updates.
If you run HOPDs in a large hospital, offer to serve as a troubleshooter for other facilities in your corporate chain or healthcare system. That will help you step beyond administrator duties by expanding your business and clinical skills, while also helping you to develop a global view of the ambulatory surgery industry.
How do you obtain this knowledge if you don't have access to it now? I see this a lot when interviewing prospects for consultant or vice president positions, especially when day-to-day tasks, such as billing and coding, are outsourced or handled by a central office. Expanding your skills demands a willingness to do whatever it takes. That's reality, not a clich??. Get your hands dirty and attempt to teach yourself the skills you need to move forward.
Work the phones and call payors to pre-verify insurance benefits. Call payors as part of your accounts receivable protocol. Contact patients about monies owed. That job is a lot harder than you imagine. Settle accounts payable. Review the financials. Load the inventory module and understand how it works. Knowing how to use the inventory module is an oft-ignored skill and one that will set you apart from the competition. I'll ask potential hires for the case costs of knee arthroscopy procedures at their current facility. The answer (or lack thereof) tells me a lot about their understanding of vital day-to-day operations.
Hard work pays off
Putting yourself in a position to advance your career sure sounds like a lot of work, doesn't it? Quite honestly, it is. But if you take the time and make the effort to match your skills to the requirements of your next professional challenge, you'll be ready to make the leap and never look back.
Doing Things Simultaneously Versus Sequentially Saves Time
Following the Lean Six Sigma book by Michael L. George, we do things simultaneously, not sequentially. Take the GI lab, for example. A patient came in, staff prepared the patient, took them into a room, hooked them up, gave them medications, then took them to the recovery room when they were done. Once we wrote out the steps on giant pieces of paper and pasted them on the walls, we looked at how the process could be done more efficiently.
So now, a pre-op nurse puts a blood pressure cuff on a patient as well as the EKG leads so that before the patient enters the room for surgery, she is ready to be hooked up. The procedure nurse uses the intercom system when the patient is ready for recovery. Then the recovery nurse goes into the room and gets the patient report while the pre-op nurse walks to get the next patient. We pared patient transfers from seven minutes to 90 seconds. The key is that the procedure nurse never leaves the OR. The recovery nurse takes the patient to recovery. The pre-op nurse brings each patient to the room and provides a report to the procedure nurse.
To improve OR turnover time, a "back hall" staff member waits outside the OR until a surgery is complete, at which point she turns over the room for the next patient. She immediately mops up a room after a patient goes to recovery and moves necessary equipment in and out of the room. We keep two tables in the room, allowing the tech to start preparing the empty table. The tech no longer has to leave the room to move equipment or dispose of trash. These changes cut OR turnover time from 25 minutes to between seven and nine minutes.
Sandy Beers, BSN
Ms. Beers ([email protected]) is clinical director of Surgery Center at Printers Park in Colorado Springs, Colo.