Same-Day Surgery Manager
Staff incentives that work for ASCs or hospital-based facilities
By Stephen W. Earnhart, MS
President and CEO
Earnhart & Associates, Dallas
You budget staff hours, and they put in the time and do their jobs. Easy, and it works. But cases still run over, and surgeons are still upset that they cannot get their rooms started until late in the day or early evening. Patients don’t like elective surgery at 7 p.m. They thought they would be home by then. Anesthesia is going to be upset with running rooms late because they have fewer resources as personnel becomes harder and harder to find.
What do you do?
Call me crazy, but incentives for staff do work. I fly all over this country and work hard because I have the incentive to do so. The trick is to find the right incentive button to push for your staff.
Health care workers have advantage
We are living in extraordinary times. Those of us in health care are experiencing job security that is the envy of all the other industries combined. Not only are our jobs secure, but we have the unique ability to choose where we work and under what conditions. Try explaining that to your spouse who came from a dot-com company. So, we as a group are also becoming harder and harder to please and to motivate.
So how can we provide incentives to our staff in this job market? By becoming creative and individualizing incentives. I guarantee that what motivates me will not work for all — so sit down with each staff member, one on one, and find out what buttons are important to them.
Let me share with you what we are finding at Earnhart & Associates during countless staff interviews. We have found some commonalities that might save you some time with your staff. Surprisingly, what we have found will work for both ambulatory surgery center (ASC) and hospital-based surgery facilities. As we say in Texas, "If you want to make an omelet, you have to break some eggs," so think out of the box with me.
Remember our scenario: cases running later and later into the day and the staff, anesthesia, the surgeon, and the patient rightfully complaining about it. As a staff member, what is my incentive to bust my butt to track down the patient, the surgeon, and the paperwork to get the case started and to move it forward? What is my reward (outside of personal satisfaction and professionalism — yeah, yeah, I hear you) to turn that room over and safely take the patient to the post-anesthesia care unit? I get the next case!
No, no, no. That is not an incentive. That is a disincentive! You have to do better than that. That is old-school thinking and will not fare well in this new job market.
Do this if you want to get my attention: When the last case of my room is complete, send me home — with full pay! And why not? You budgeted the money anyway, right? So why not pay me for expediting my room? I made the facility look good, the surgeon is happy, the patient is safe and recovering, so why not give me that incentive?
Motivating different age groups
I know enough of you to know that some of you are thinking, "He just came on at 3 p.m. and finished his last case at 5. Am I going to pay him six hours to go home?" Yes, yes, and yes! Stop thinking the old way. We need to increase our physician satisfaction to keep them from going elsewhere (and they are — in increasing numbers). We need to start marketing to them. They are our clients, and every patient they bring to the hospital or ASC has part of our paycheck in their pocket.
OK, our experience has shown that the "older" staff (people like me!) want to go home with pay because time is more valuable to us than it typically is to a "younger, more ambitious staff." Precisely why you need to individualize this group of staff by paying a new differential to staff members who want to stay on through their shifts and do the "other work" like pulling cases, cleaning, patient phone calls, etc. — now the other teams have gone home.
If you cannot get consensus on who will stay late or go home, rotate the teams daily or weekly so everyone gets the same opportunity. The differential pay to the "late" staff should come out of the money you used to pay in overtime. Should you do this for every member of the department or ASC? No. Only the people who are directly involved in or can expedite the cases should have this opportunity. Clerical staff and instrument room personnel are not affected and should not be included.
I suggest you try this for a month and see if it works for your facility. Remember, your goal is not to reduce your staff budget. That budget is unchanged. Your goal is to finish the surgical list faster and with higher physician, patient, and anesthesia satisfaction by providing the staff with a time/financial incentive.
This is a marketing thing and not a money thing. Motivate me!
(Editor’s note: Earnhart and Associates is an ambulatory surgery consulting firm specializing in all aspects of surgery center development and management. Earnhart can be reached at 5905 Tree Shadow Place, Suite 1200, Dallas, TX 75252. E-mail: [email protected]. Web: www.earnhart.com.)
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