ADD CASES ALL THE TIME (left to right) Scheduler Lisa Shope, Purchaser Debora Shirley and Business Office Coordinator Lauren Ball are all instrumental in bringing cases to the Gainesville (Ga.) Surgery Center

Growing surgical volume is an incredibly important part of your job, and essential to the financial success of your center. But it isn't easy. It requires constant attention and effort, and loads of time to figure out how to keep your ORs humming. Follow these 4 tips to ensure your efforts are focused and effective.

Leverage physician credentialing
Build solid relationships with surgeons as soon as they receive their credentialing packets. Your director of nursing and materials manager also need to meet new surgeons early on to learn about their preferences regarding OR staff, supplies and instruments. The materials manager can also begin to research how to best acquire additional equipment surgeons might request, while the director of nursing can determine if your current staff will need specific training to use it.

The credentialing process is a great time for physicians to tour your facility, meet with key staff members, familiarize themselves with equipment and seek answers to questions they might have. These visits also let the director of nursing and the business office manager walk physicians through your clinical and billing processes. The initial visits are also great opportunities to discuss and negotiate block times.

When adding new procedures — and related new instruments or equipment — ask the central sterile staff to review any changes to your current reprocessing standards. Finding out the type of procedures surgeons will perform will help ensure you have time to turn over needed instrument trays in order to maintain scheduling efficiencies and prevent immediate-use sterilization.

Bottom line: You want surgeons to be confident with your processes, from the business office to the reprocessing room, and comfortable bringing cases to your center. Having them visit before their first surgeries eliminates last-minute misunderstandings and ensures a smooth start.

Schedule for satisfaction
Building physicians' confidence in your ability to care for their patients starts with the scheduling process, so your business office must be available, reliable and accommodating when working with referring schedulers.

Develop rapport with physician schedulers by providing comprehensive patient care before the date of service. Ensure the pre-operative process (insurance verification, pre-op screenings, notifying patients of their financial responsibilities) goes off without a hitch. Any breakdown can result in delayed or canceled surgeries, which have a negative impact on your relationship with the physicians.

Be readily available and willing to accommodate surgeons' scheduling requests. Finding ways to fulfill their needs outside of regular block times will maintain their satisfaction with your scheduling process and flexibility. Yes, scheduling physicians' cases can be a balancing act. Your goal is to meet their requests as much as the schedule allows while maintaining an efficient staffing model. There are times when the 2 goals conflict. Scheduling to meet physician demand can create inefficiencies and have a negative impact on the surgery center's bottom line. But to build the desired relationships with new physicians and their schedulers, it's sometimes necessary to satisfy their unique requests.

Work in last-minute cases
This can be a challenge, but last-minute cases can also be a significant source of volume growth and surgeon satisfaction. The goal is be as accommodating as possible while maintaining a safe surgical environment. To accomplish these dual aims, your business office, clinical staff and anesthesia providers must be involved and supportive. Of course, they need to be empowered to say "no" when necessary, especially if potential add-on patients fall short of your clinical guidelines for safe surgery.

If staffing issues prevent you from taking on last-minute cases, consider consulting a seasoned nurse for solutions. They might see opportunities you might have overlooked. If a lack of manpower is inhibiting your volume potential, hiring from a staffing agency is better than routinely refusing last-minute procedures. Remember, saying "yes" to more cases is always good business.

Ask the right questions
Who on your staff spends the most face-to-face time with surgeons? The circulators and surgical techs do. It's important that these key clinicians are on board with the need for financial growth and actively participate in determining how the center can attract more cases. It's always easier to work with surgeons to grow your business when you have solid relationships in place. Spend time with physicians and their schedulers so you have healthy communication on a regular basis. Get together away from work for coffee or lunch. Continually ask, How we are doing and what can we be doing better? Also don't overlook asking surgeons for more cases. It seems minor, but the simple request often pays big dividends.