To Brent Lambert, turning around a moneylosing surgery center is a simple matter. “If staffing costs are 40 percent of revenues, I know we can turn the center around,” says Lambert, co-founder of ASCOA. “In money-losing centers, staffing is usually the biggest offender.”
According to estimates from McGuire Woods, more than one-third of all ASCs break even or lose money. Lambert says ASCOA continues to see an increasing number of broken centers. “Staffing costs across the industry are about 32 percent,” he says. “And we see some centers at 50 and 60 percent of revenues.”
“Our centers average 20 percent of revenue for staffing because we developed a model that blends strong management, respect and appreciation for hard work and a tremendous emphasis on efficiency,” says Lambert.
Today, ASCOA owns and manages more than 25 surgery centers across the country.
Lambert stresses that the key to a great staff comes from the people you hire – and how you manage the staff. His keys to successful staffing:
Hire the right people and give them a stimulating, fast-paced work environment.
“We hire high energy people who like to work,” Lambert says. “These are people who get bored standing around working at a hospital. They work hard, they inhale their lunches and keep going. But they also don’t have to work nights, weekends or holidays, and they aren’t on call either.”Run lean.
Typically, ASCOA puts only a few full-time people on its payroll. The scheduler, for example, also serves as the receptionist. The billing department consists of two to three people. “We use a lot of PRN people we can pull in quickly,” says Lambert. The other advantage: Lambert says his people often do the work of one-and-a-half people. By employing mostly part-time staff, ASCOA also avoids many holiday, vacation and sick day issues. “We recently looked at investing in a center that gave its employees eight weeks of paid vacation time,” Lambert recalls. “The owners of the center wanted to protect these people and their benefits, so we walked away from the deal.”Hire part-time staff that desire flexibility.
Lambert says ASCOA centers employ mostly part-time staff to keep costs down and provide highly skilled employees with a flexible work schedule. “Take a mom with kids. She gets someone to watch the kids two days a week, she gets out of the house and keeps her sanity,” he says. “It’s a great arrangement. They’re paid well.”Compress the schedule.
Many ASCOA centers operate only two or three days per week from early morning to mid-afternoon. “Our operating rooms run non-stop. We just schedule everything back to back, so no one can be late, including the surgeon. There’s no lunch break per se—often the nursing coordinator scrubs in so others can take a break—and we just keep going,” says Lambert. “When the cases are done, we turn out the lights and go home. So you’re only paying people for time they work. No overtime, no downtime.”Make work enjoyable.
“We like to run a friendly place and treat staff and patients with the greatest respect. We like to have a sense of humor too,” Lambert says, adding that ASCOA pays an annual bonus to staff members. “There’s a queue to work in our centers.”Reward leadership.
ASCOA administrators fulfill the role of CEO, CFO and COO, so hiring a great leader and empowering the administrator to run the center is critical to ongoing success. “Our administrators share in the success of the center. We have never had a doctor complain because the center runs efficiently.” Lambert says.
At ASCOA, staffing the center—and the costs associated—drive efficiency and profitability. And there is an added bonus: staff stability. Lambert says ASCOA’s retention rates are considerably higher than the industry average. “When we go in to fix a center, we’re very clear about all the ways we can help turn a center around,” says Lambert. “Staffing is the big one, and we’re very clear that by driving down costs we can also improve productivity—and morale—and return the center to health quickly.”
