4 Tips for a Postive Orthopedic Surgery Center Environment

Practice Management

Here are four tips for creating a positive environment and culture at orthopedic surgery centers.

1. Define your company's values. There are many different exercises you can do to define your company's values, says Thomas Jacobs, CEO of MedHQ. There are, however, three important rules to follow: 1) values must be defined and held by the top people in the organization (i.e., the CEO, the board of directors, etc.); 2) the leadership team, however that is defined (e.g., CEO together with direct reports, top administrative staff, etc.), must buy-in to the values; and 3) the values must be described in terms of the behaviors that demonstrate each of the values.

One of the best ways to develop your company's values statement, if you can arrange to do so logistically, is to have the entire leadership team spend a half or full day together working through a set of exercises that will flesh out the values statement. The key to this session is to capture the behaviors associated with the values, and by doing this step as a team rather than in the CEO's office, organizational buy-in can be assured.

Behaviors and values are inextricably linked. One way to show that your company truly adheres to its stated values is by identifying its actions that support the values — how your company prioritizes its time and resources should line up with the stated values. On the individual level, we recommend that each job duty listed in a job description be linked to one or more of the specific company values. These choices (or behaviors) are clear markers of what we truly value. How the organization promotes and manages these behaviors that support the organization's values is where the "rubber meets the road," or maybe more appropriately, where the "scalpel meets the skin," with respect to creating a great culture.

Because everyone in the corporation needs to be on board, this process will take a significant amount of time — as much as six to nine months before a company is ready to move to the next step. Leadership must take the time to communicate the meaning of the values to the other members of the company's staff so that the values can really become engrained in the fabric of the culture.

2. Emphasize teamwork. Although efficiency can be maintained in a wide variety of ways, at the heart of efficiency is collaborative teamwork and a staff with a high level of expertise. The culture of teamwork also should be incorporated and fostered in all other areas of a surgery, whether in an OR, patient waiting rooms or PACU. "If you ever watch an orthopedic surgical team work together during a surgery, it's always a team process that's occurring in the OR," Elaine Thomas, administrator at St. Francis Mooresville (Ind.) Surgery Center, says. "It's all about having a confident and detail-oriented staff so that the physician feels confident during the surgery as well."

3. Pay attention to business practices.
Busines practices, such as product standardization, are an ongoing process, says Adam Higman, manager at Soyring Consulting, a healthcare solutions company based in St. Petersburg, Fla. Product standardization can save money for the surgery center and the concept must become part of the center's culture. The first thing a surgery center should do is elect a staff member to follow-up with this process. "That individual then needs to make sure invoicing for contracted products are all correct, rebate checks are being properly received, physicians are uniformly using the same products and that everything a vendor promises is put down in writing," he says. "This individual also needs to track all the transactions and provide updates to the rest of the center. It's about setting up a culture and expectation that the road to savings is ongoing."

4. Encourage good infection control techniques. Staff buy-in is undoubtedly the most important step any surgery center can take toward building a robust infection control and infection prevention program. In order to achieve 100 percent staff buy-in, Linda Ruterbories, director of surgical services and program development at OA, says staff members at the OA Surgery Center are encouraged to take ownership and identify infection control concerns and make suggestions to improve infection prevention. Staff members are also reassured that there will not be any punitive action, such as terminations, if any mishaps with infection control occur. A culture of fear is counter-productive to the goal of identifying and fixing problems, says John Wipfler, CEO of OA – Centers for Orthopaedics.

"An ASC can have all the tips and tricks [to having excellent infection control], but those tips and tricks won't be particularly helpful without a culture of process, protocols and accountability," Mr. Wipfler says. "Those three things have to be on the top of every employee's list. Without any accountability or a sense of ownership, it's just a bag of tricks."

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