3-part philosophy cuts OT and costs
$10,000 saved with ultrasound purchase
Specialty Surgical Center in Sparta, NJ, has used a three-part philosophy process to achieve significant savings, including a drastic reduction in overtime for preop nurses and a $10,000 savings in an equipment purchase.
Their secret? Stay on top of technology, examine your profit & loss statements on a monthly basis, and engage your staff in the cost-saving process.
"The goal is to get as much technology in place as possible, in anticipation of all the [health care reform] rules coming out," says Bonnie Brady, RN, CNOR, the administrator of Specialty Surgical Center. "You never have any space for [paper] files, so you want to get away from that as much as possible."
Technology has had a dramatic impact on the time their preoperative nurses spend making calls to patients, Brady says. Formerly, the center had to pay each preop nurse an average of 12 hours overtime. "We had preop nurses here late at night to do the preop phone call," Brady says. "Sometimes they couldn't reach patients, and they would have to call three or four times." Patients would spend large amounts of time giving histories that often included insignificant details, she says.
The center invested in SourceMedical Vision software, with the addition of the One Medical Passport piece. The software allows patients to submit their medical history online, Brady says. Surgeons' offices give patients bright yellow cards with information about the secure web site. The card tells patients in a step-by-step process how to complete the process of submitting their history. (For more on the software, see resources, below.)
The software guides patients down pathways, depending on the information they submit. For example, if patients say they are diabetic, it asks whether they have juvenile or adult-onset diabetes.
"Nurses come in in the morning, download histories, and review it," Brady says. Rather than focusing on unimportant details, they can focus on any problems the patient has, she says. The nurses still make a preoperative phone call, but the call is more defined, Brady says. "Sometimes there's no problem, and the nurses just call and tell them when to stop eating," she says.
Now, the overtime in the preoperative area is "almost negligible," Brady says. In addition to dramatically decreasing the amount of time spent on the phone, the software has increased the quality of the call nurses make to patients, Brady says.
Patients can complete the process anytime instead of waiting on a phone call, so the system has been well-received by patients, she says. "I thought it would be problem with the elderly, but they're good," Brady says. "Ninety to ninety-five percent of our patients are using it, and they like it."
In fact, the process has helped improve the center's patient satisfaction scores, which are in the 90th percentile or higher, Brady says.
The center also added EdgeSurvey software from CTQ Solutions to measure patient satisfaction. This software allows patients to go home and complete their patient satisfaction survey online. "I never thought patients would use it, but they use it all the time," says Brady. In fact, 42-52% of patients are completing patient satisfaction surveys.
"They do all the work," Brady says. "Before this, nurses were handing out surveys. They had to collect them, collate them, and make a report out of it. This does it all for you."
The software allows you to benchmark against yourself, in terms of areas where you performed best and worst, and it also allows national benchmarking.
The center also has added a patient tracker system. Patients are assigned a symbol with their initials, which is visible on a screen to their friends and family in the lobby. Nurses move that symbol through the work areas. "Patients families can watch that [symbol] and know the patient is in preop, then moves to the OR, then moves to postop," Brady says. "They know where their family members are at all times."
Even the central service department has joined the technology age and is scanning manufacturers' instructions, quality assurance documentation, material safety data sheets (MSDSs), and other items into their computer. "The computer is streamlining a lot of processes," Brady says. (See information on getting your staff involved in cost cutting, below, and using an open house to educate staff and the community about prices, below.)
Sources/Resources
For more information on SourceMedical Vision or One Medical Passport software, go to:
- SourceMedical, Wallingford, CT. Phone: (800) 719-1904. E-mail: [email protected]. Web: http://sourcemed.net.
For more information on EdgeSurvey, contact:
- CTQ Solutions, Branford, CT. Phone: (877) 208.7605. E-mail: [email protected]. Web: ctqsolutions.com.
Engage staff in cost cutting Involve your entire staff in cost cutting, advises Bonnie Brady, RN, CNOR, the administrator of Specialty Surgical Center in Sparta, NJ. "They come to me with good ideas all the time," Brady says. For example, staff members examine every item at the center, from the smallest to the largest, to determine how money can be saved. "We get three quotes on everything," Brady says. "We play one [vendor] off the other." Even when the center has one preferred vendor, they obtain two more quotes and then go back to the preferred vendor to ask, can you beat this price? "Most of the time, they want your business, and they work something out," Brady says. "Never take the first number." Recently Stephen S. Espinosa, RN, BSN, CNOR, RNFA, director of nursing, saved $10,000 by negotiating prices for a new ultrasound. "A lot of vendors out there are willing to meet your price or lower their price to get your business," Espinosa says. Know beforehand what you're willing to pay and what quality you are expecting, he advises. Recently his center examined their 50 cc bottles of contrast media and realized they were paying more than $30 a bottle. Through its group purchasing organization, the center was able to obtain the "best price in its market" of $6.19 for the same product, Espinosa says. The center also uses auction sites, including Centurion Service Group (www.centurionservice.com). The site offers used instruments for less than half price, Brady says. "We look for good deals and bid," she says. "Sometimes we get it, and sometimes we don't." To ensure you obtain the instrument you are expecting, do your homework and look at photos of the instrument, Brady advises. The center also recently switched vendors for disposable arthroscopy shavers. "By switching companies, we saved at least $40 off of the old vendor," Espinosa says. The center also has realized success with contracts, which are examined annually. The center saved $3,000 per year by examining the emergency generator contract and changing vendors. The center's cost-cutting efforts are continuing. The center has managed to significantly drop expenses by looking at the profit & loss statement every month at the managers meeting. Each area of the center is examined, and goals where the managers want to see decreases are set for the next month. The center is saving with staffing approaches such as flexible work hours. Brady says they also have cross-trained staff "so we can utilize everyone." At the front desk, the center is using per diem staff to cover for staff members who are out, rather than keeping full-time employees for that purpose. Espinosa's advice to other managers who want to save money? "Have that attitude, always, that you spend like it's your own money," he says. |
Games educate staff and community The managers at Specialty Surgical Center in Sparta, NJ, have found an innovative way to educate their staff, as well as the community, on the cost of items. The center held two open houses as a way to celebrate National Ambulatory Surgery Center Week. The open houses were held after hours and were promoted through the local media. Staff members marked the prices of items throughout the center. "It was rather eye-opening," says Bonnie Brady, RN, CNOR, the administrator. "Now staff know what things cost." For example, many staff members didn't realize that a pack of sutures cost $22. During the open houses, the center held games such as displaying three products and having guests price them from the highest to the lowest price. In another game, the center had guests estimate the cost of everything in the room, which was well over a million dollars. "The general public has no idea what things cost," Brady says. Guests who guessed correctly put their name in a pot to win prizes such as gift baskets at the end of the night. The prizes were donated by local vendors. |
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