Consider these 8 areas to cut costs, boost morale
By Stephen W. Earnhart, MS
President
Professional Surgery Corp.
Dallas
I've got to tell you, the Same-Day Surgery Conference in Tampa was great. For the large crowd that attended and for me. It was a great opportunity to meet and discuss ideas. I, and many others came away with some great ideas. If you were among those who attended, you know what I'm talking about. If you couldn't attend this one, make every effort to catch the next one. Look in future issues of Same-Day Surgery for details.
As we talked about last month, this is the second in the "cost saving tips" series. Space just did not allow it to fit into one issue. Again, most of us have reached the point that we are not going to find areas where we can save tens of thousands of dollars per year in any one area. We need to now find several areas where we can save hundreds of dollars. With managed care biting us harder and more viciously, we need to look to areas that are not so obvious in saving dollars and time. You may want to examine the following areas to cut costs or boost morale. Many are obvious; some are not. Use what you can, and share those that have worked for you. (See editor's note at end of article.)
* Staff.
How much time, and therefore, money, are you wasting on unproductive personnel in your same-day surgery programs? Most programs have a "Sally." This is that passive-aggressive employee that blocks every initiative you try to adopt or put into place in your facility; the employee who goes crying to the surgeon when he doesn't get his way. The person who everyone complains about and who just doesn't pull his weight. The employee who you wish would just go away. Well, the time has come to cut these people from the pack. Get rid of them!
When I spoke these words at the conference, I was overwhelmed with applause from the attendees. Apparently it is a bigger problem than I had imagined. So many of you approached me after the conference and told me that you had a "Sally" that you wanted to get rid of -- but thought that you shouldn't. Chances are there are many hard working staff members at your center that are also fed up with these individuals. They just cost too much in time and effort. Spend those resources in other areas.
* Posted goals.
If you don't let your staff know what is expected of them, how can they help you? Post your goals for 1996 on paper, and share them with your staff. If you are looking to decrease your turnaround time, put it on graph paper and chart it. Post it in each OR. If you want to cut supply costs, list the dollar amount you want to cut each month and put it in the lounge. Let everyone know where you are headed.
As I have said so many times, one person cannot be all to all. You need help, and the best resources we have are our staff members. They want to help -- let them.
* People skills.
While increasing your staffs skills may initially cost some money, in the long run it will save you money. Don't cut back on educating your staff! There are great courses available at local community colleges in business, accounting, marketing, and management that can be available to your staff for very reasonable dollars. Offer to pay half the tuition if it will increase the efficiency or effectiveness of a staff member.
If you have a tuition reimbursement plan at your hospital, encourage your staff to take advantage of it. The more well-rounded your staff, the better able you are to cross train and utilize the valuable skills of your employees.
* Staff and MD lunches.
More than one-third of the Same-Day Surgery Conference attendees in the cost containment session stated they have a staff and MD lunch program in place. Is it abused? Are you still doing it only because you have always provided it? Many felt it was abused but difficult to control.
Some centers are now putting productivity requirements in place, i.e. if less than 10 procedures are performed for the day, no free lunch. Naturally you have to temper that with the time of the day the cases are performed.
Of those that do provide free lunches, they said it should include the entire department, not just the OR team. I don't agree. If non-clinical personnel are free to take a lunch break or have the time to go to the cafeteria or go outside the facility to have lunch, they should not be entitled to a free lunch. The purpose of free lunch is to provide nourishment to those staff members who are scrubbed or working with patients during the normal lunch hour or who are not in a position to leave the facility to purchase their meals. For the MDs it is the same reason; however, there is certainly a marketing twist in providing lunch for them.
Just on special occasions
Others provide free lunch on special occasions to the staff. This approach is best, I think. Select a day of the week or a particular day of the month to acknowledge the staff and physicians. On that day, lunch should be provided to the entire staff.
Don't fall into the trap of buying lunch for everyone on a regular basis just because it has always been done. It is just getting too expensive. If you are in a situation in which you cannot change the program, at least put a dollar amount per person per lunch in place.
I purchased an ambulatory surgery center where the program was completely out of control. The staff and physicians thought they had a right to have lunch provided to them even on days when the patients were gone before 10 a.m. They would order lobster, steak, the most expensive items on the menu, and then take it home! Needless to say, that practice ended quickly. Don't let your program take advantage of your good intentions.
* Entertainment.
What's happened to the fun in outpatient surgery? I remember working in a hospital in Boston where everyday the staff would get together and go out for a drink or throw together a quick party. We worked hard, but we also partied hard. I just don't see that anymore.
Have frequent, inexpensive staff parties, even if it is only once a month. These can be a tremendous morale builder for the staff. It just seems that we beat up our staff on hours, costs, and efficiency.
Have a little fun with the parties. It doesn't cost that much. They can be held at a local restaurant, or you can hold potluck dinners at the facility. Many times you can get your favorite vendor to sponsor several of these per year.
The parties don't have to be elaborate. Combine them with award or recognition events for employees. Have rewards for best uniform accessories, worst "hair day," or whatever. Make them fun. Everyone enjoys recognition, even when it is in jest. Ask your doctors to attend, and give them awards also. Make it an event that people can look forward to each month.
* Day care.
Several of the conference attendees offer this service, or it is offered through the hospital. Most of these programs were started during the nursing shortages several years ago as enticements to nurses. While not as popular today, they can still be a great benefit to your center, at a high price though. The regulatory and legal issues surrounding day care are not what they were 10 years ago. Instead of providing a center, most are now closing their programs and offering to pay a portion of the day care fee for a specified period of time, usually six to 12 months.
* Pharmacy dispensing.
I've never seen a program that actually makes money for the center. I have found the regulations and paperwork for these programs not to be worth the convenience or cost to the patients. Further, new managed care programs require patients to use a certain pharmacy, so most can't even take advantage of the service. Few if any of the attendees found these programs to be of benefit.
* Patient records.
What do you do with all these patient records? They pile up and generally become a major nuisance and problem. Regulations say that we have to keep them for up to 30 years (depending upon who you talk to). Space is just too expensive on-site. You can't afford to build new space to house them, and they look terrible sitting in boxes in your hallways and business office.
Consider storing them in off-site locations. There are many storage areas available to the general public that allow climate control and 24 hour access. Also, check out the building your center is located in. Often you can find cheap readily accessible storage space down the hall from you. Just don't let them clutter up your center, and do not build new space to house them.
(Editor's note: To suggest cost-saving ideas or provide feedback on this column, contact Earnhart at 5905 Tree Shadow Place, Suite 1200, Dallas, TX 75252. E-mail: [email protected].) *
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