Administrator: Jim Van Etten
Nurse manager: Pam Neiderer, RN, BSN
Surgeries: Cataracts, retina, orthopedics, laparoscopic hernia and gall bladder, GYN, ENT, endoscopy, podiatry, pediatric general surgery and oculoplasty.
Staff: 21 full-time staff members: 17 RNs, 3 certified scrub techs, 1 LPN and several part-timers.
Procedure rooms: 1
ORs: 4
Operating surgeons: 40
Monthly case volume: 430
Years in operation: 13
Ownership: The center is owned by Memorial Hospital and is part of Memorial Health Systems.

Joker's wild
A program called "joker's wild" recognizes and rewards staff who go above and beyond the call of duty. Here's how it works. Each month, administrators select from among a list of nominated employees (the surgical staff submit the names and deeds of others they catch doing something right) the one person who went the furthest out of his or her way to do good. For example, one month the winner was the billing clerk who took time to help a wandering patient find her way to the right medical office on the second floor. At lunch, the monthly winner pulls a card from a deck: A 5 is worth $5, a 10 is worth $10 and a face card is worth $15. If a joker is drawn, the facility gets a pizza party.

Cooperation, not competition
The Surgical Center of York is a freestanding facility that benefits from good relationships with the hospital that owns it across the street and the larger surgery center that competes with it 10 minutes up the road.

Surgeons typically perform cases (lumps and bumps) that don't require an anesthesia provider in the hospital outpatient department and all of their other cases at either or both of the town's surgery centers. Surgical Center of York shares instruments with the hospital and swaps supplies (cataract lenses and ThermaChoice balloons, for example) with the surgery center. "If they have what we need, all we have to do is drive across town and pick it up. We swap back and forth and charge each other," says Pam Neiderer, RN, BSN, the team leader of clinical services.

Pros and cons of the health system
Being part of a health system helps the center save on supply costs through a group purchasing agreement. But because the hospital has priority when it comes to anesthesia staffing, the facility often can't get enough CRNAs to cover its four ORs and can only open three.

Anesthesia providers are hospital-employed. They rotate to and from the surgery center and the hospital in three-week shifts. "It's nice for them, because they don't get stuck doing big or little cases all the time," says Ms. Neiderer. And, of course, in those rare instances when the surgery center has to admit a patient, the hospital is right across the street.

- Kristin Royer