Lynn S. Feldman, RN, MBA, administrative manager of Eastwind Surgical, a two-OR ASC for spine surgery and pain management in Westerville, Ohio, provides six best practices for spine in ASCs.
1. Address lack of case diversity. "In a spine-only ASC, there is a danger of lack of diversity of cases," Ms. Feldman says. Only a select few spine surgeries are performed on an outpatient basis. Pain management is a good companion procedure to keep the ASC running. But when pain and spine procures are going on at one time, extra staff members are often a necessity.
2. Patient education is critical. Patients can be nervous about undergoing a procedure that is usually performed on an inpatient basis. The preoperative phone call should clearly spell out what will happen to the patient and approximately what time he or she will be leaving.
3. Spinal staff members are hard to find. "You need to find staff who can hit the ground running," Ms. Feldman says. Since spine surgery only recently became an outpatient procedure, staff will have to come from hospitals. One silver lining in the current recession is that talented spine-surgery staff members are easier to find. When the ASC recently added another nurse of the recovery area and two more per diems, it had a wide range of applicants.
4. Staff must tolerate bumpy schedules. A hospital is a very structured work environment, but spine surgery in an ASC in particular has variable hours. Spine surgeons may come in and do five cases in one day and then not come back for many days. "You work when they want to work," Ms. Feldman says.
5. Let candidates know challenges upfront. Applicants should be told upfront that hours will be unpredictable. They need to know they may need to stay into the evening or even through the night if the patient has to stay overnight.
6. Give staff incentives for the variable hours. One incentive for employees to be flexible is to give them quarterly profit-sharing. This gives them a reason to welcome the extra cases.
Learn more about Eastwind Surgical.
Read more about spine surgery:
- 7 Steps Spine Surgeons Should Take to Prevent Infections
- Spine Surgery in 2011 and Beyond: 7 Points About the Future of Spine Surgery
- 10 Steps to Take to Add Spine to an Existing Orthopedic Surgery Center