Become a Creator today!Start creating today - Share your story with the world!
Start for free
00:00:00
00:00:01
Greg DeConciliis – Opening an ASC: Continuous Improvement
107 Plays1 year ago
Today is the final episode in our 9-part De Novo series! Last but certainly not least, Greg DeConciliis joins us again to discuss Continuous Improvement. You have officially opened your doors, and you can certainly celebrate, but what you cannot do is become complacent. So, Greg walks us through keeping physician and patient satisfaction high, the role of data and benchmarking, how to cultivate an environment of growth, and how to continuously improve, expand, and thrive.
In our news recap, we’ll cover the 11 ASCs in California recognized by CASA, why it’s essential to screen for cognitive impairment in your patients, the latest on noncompetes and the FTC, and, of course, end the news segment with a positive story about a new serenity lounge at Cedars-Sinai Medical Center.
Articles Mentioned:
CASA Awards 11 ASCs with the CASA Award for ASC Excellence
Cognitive Screening in Older Patients May Help Optimize Outcomes
Noncompetes are going extinct: 5 things to know
Cedars-Sinai Expands Nurse-Led Workplace Wellness Initiative with Serenity Lounge
Interesting in learning more about opening a new surgery center? Check out our related episodes:
- Michael McClain – Opening an ASC: Navigating Payer Contracts
- Wil Schlaff – Opening an ASC: Conducting a Comprehensive Feasibility Assessment
- Dawn Pfeiffer – Ask the Expert: Best Practices for Opening a New Surgery Center
- Beata Canby – Opening an ASC: Managing the Regulatory and Certification Process
- Gregory DeConciliis – Opening an ASC: Clinical Preparation
- Andy Berg – Opening an ASC: Finding Your Dream Team
- Wil Schlaff – Opening an ASC: Business Preparation
- James McClung – Opening an ASC: 30 Days from Your First Patient
Brought to you by HST Pathways.
Recommended
Transcript
Introduction to This Week in Surgery Centers
00:00:01
Speaker
Welcome to This Week in Surgery Centers. If you're in the ASC industry, then you're in the right place. Every week, we'll start the episode off by sharing an interesting conversation we had with our featured guest, and then we'll close the episode by recapping the latest news impacting surgery centers. We're excited to share with you what we have, so let's get started and see what the industry's been up to.
00:00:23
Speaker
Hi, everyone. Here's what you can expect on today's episode.
Guest Introduction: Greg DeConcilius
00:00:28
Speaker
Today is the final episode in our nine part de novo series.
00:00:32
Speaker
So last, but certainly not least, Greg DeConcilius joins us again to talk about continuous improvement. So you have officially opened your doors and you can certainly celebrate, but what you cannot do is become complacent. So Greg walks us through keeping physician and patient satisfaction high, the role of data and benchmarking, how to cultivate an environment of growth and how to continuously improve, expand, and thrive.
00:01:00
Speaker
In our news recap, we'll cover the 11 ASCs in California being recognized by CASA, why it's important to screen for cognitive impairment in your patients, the latest on non-competes and the FTC, and of course, end the new segment with a positive story about a new serenity lounge at Cedars-Sinai Medical Center. Hope everyone enjoys the episode and here's what's going on this week in surgery centers.
Running a Surgery Center: Insights and Operations
00:01:31
Speaker
Hi, Greg. Welcome to the podcast. Hi. Thank you for having me. Appreciate it. Yeah. Can you tell our listeners a little bit about yourself, please? Sure. My name is Greg De Consilius. I, my background is actually clinical as a PA working orthopedic surgery since 1999 and worked initially at a large orthopedic hospital, um, left there in 2004 to open up our surgery center where a multi-specialty surgery center located in the outskirts of Boston called Boston outpatient surgical suites. Um, we're in Waltham mass.
00:02:02
Speaker
We primarily do orthopedics, pain management, and some general surgery. So although we are considered the multi, we just primarily perform those three specialties. A fairly busy center, again, servicing the Metro West and Boston community, do about anywhere from 350 ortho cases a month per se, and a couple hundred other random cases as well from pain to general surgery, et cetera. So again, a fairly busy center, actually looking to grow to a eight OR center in the next 18 months.
Continuous Improvement and Efficiency Strategies
00:02:32
Speaker
We currently have three ORs. And again, looking at the total explosion, if you will, of the outpatient joint and spine kind of market. So it's worked out pretty well. Yeah. Been here ever since. Yeah. And that's exactly why I'm excited to have you on today. Because for the last two months or so, we've been compiling all sorts of podcast episodes and content and industry advice on how to successfully open a new surgery center.
00:02:56
Speaker
And this episode today will be one of our last in the series. And I'm excited to pick your brain about this idea of continuous improvement, especially with the projects you have going on. After you've opened your doors and the dust has settled, there's still work to be done. So what does continuous improvement mean in the context of a surgery center? And why do you think it's so important for long-term success?
00:03:20
Speaker
Sure. And I guess I'll start with, we all think of continuous improvement differently. Obviously we look at outcomes and those types of things, but us doing a new surgery center, I think is continuous improvement because our ORs are packed full with our three ORs where there's no block time for about 15 or 20 surgeons who want to come in and use the facility. And so as a result, you have surgeon, I'm sorry, patients who are stuck, if you will, in the hospital systems backed up and they can't have surgery for two, three, four months.
00:03:49
Speaker
And our solution was to go out there and open this new facility, again, almost tripling our O-R capacity, allowing those new surgeons to come in, be a part of what we're doing, but in turn providing, again, more availability for high quality outpatient surgery. But back to your original question, you just made me think about that. Continuous improvements is an interesting thing. It's almost, if you will, a requirement. I think everybody feels like they do things very well. That kind of means they have good outcomes and et cetera.
00:04:16
Speaker
I feel like as part of the accrediting bodies that they come in and certify organizations, they require some sort of continuous improvement structure. But generally speaking, that's what it is. It's this kind of structured strategy, if you will, to either quarterly or even monthly to evaluate those outcomes and how you're doing things about your facility, your efficiencies, all your benchmarks, that type of stuff, and doing a systematic approach to make sure you're making constant improvements and get enhancing your outcomes and that type of stuff.
00:04:44
Speaker
Yeah, definitely. And so if we think about physicians really quick, so in your case of expansion, there's obviously more physicians looking to schedule cases at your facility. There was a patient need. What role does the physicians play with continuous improvement? And if you do want to expand, how do you approach recruitment and engagement and how do you keep physician satisfaction high? Sure. And I've been doing this for almost 20 years, so I've seen this kind of, this pattern.
00:05:14
Speaker
Back in 04 when we opened, there was a lot of surgeons who were looking to get out into the industry. The GI docs and the ophthalmologists, they'd already had done their stuff in the late 90s, early 2000s. Now ortho was the force of the forefront. We saw this kind of big flurry to folks to get to the outpatient setting. Then I felt like it was static a little bit. And then I feel like COVID, particularly in the ortho front, where the hospitals shut down appropriately and they weren't allowing any inpatient surgery.
00:05:41
Speaker
this kind of movement towards outpatient improved. And so I think we saw this, we're seeing this flurry again of a lot of surgeons, especially again in the ortho world, coming to be involved in a surgery center and kind of experience the benefits. And what are those? For us, again, we have folks, just cause we've been around for a while who knock on our door, but I always find meeting a new surgeon is always done best through a soft, warm intro from a, from another surgeon. And oftentimes there'll be a colleague they're working with who somebody at the hospital is frustrated from a,
00:06:10
Speaker
turnover time or they didn't have a certain device or whatever. And so they have conversations about the satisfaction they're achieving at the surgery center. And so this kind of warm intro occurs. And then my strategy is always to reach out to that surgeon. I provide them with some basic information in the facility and invite them out to the facility so they can actually look at and experience it and meet some of the folks and get a taste of kind of what we're all about. I think the sale is an easy thing in that sense. I think surgeons are simply looking for
00:06:39
Speaker
an efficient place to operate. They're looking for a place where they don't have a new staff member each time they operate who has to be retrained in the things they like and dislike. They know they're looking for the supplies and equipment they need to be on that back table and ready to be used. And so there's no secret sauce to it. There's no secret recipe. It's simply just being attentive to the surgeon. We always do it for the patients, right? That's where we're all in healthcare, but be attentive to the surgeon as well. Making sure early on we have a consistent staff with them so they get familiar with them.
00:07:09
Speaker
making sure their preference cards are accurate, making sure they have their equipment and supplies and need for the most part. And the efficiency is kind of built into the facility. And so they'll have a better day and know by the way, they get out probably two, three, four hours earlier, the same amount of volume or more. And again, it's what makes facilities such as ours really successful is that key piece. Surgeons want to bring their cases to our facility and operate there. So it works out pretty nicely.
Enhancing Patient and Physician Satisfaction
00:07:34
Speaker
Yeah. And I think that's such good advice too, because even if you don't have the reputation that your facility has and has built over the years, if you have physicians that are obviously in the hospital, ask them if you are looking to expand and grow, keep your ears open, let it happen organically, bring them on in and show them how positive the experience can be.
00:07:54
Speaker
And you had mentioned patients, which is the perfect segue. Obviously, keeping the physicians satisfied is one thing. Keeping patients satisfied is another. What strategies do you suggest people implement to measure patient satisfaction? And then the second piece of that would be translating that feedback into actual tangible changes.
00:08:16
Speaker
Sure. A couple of things we do. First off, I think we're all been, I say use the word benefited, but not that we all want to do it, but we've talked with the changes from regulations and that type of stuff. We've worked towards our computerized kind of assessment server, like a press gaming type thing, which is what we use because we know that we're going to be heading that way. And so most of us are already there. And so we utilize that. And I think the key with this is not just having the scores be reported out to you and reading them and then putting them aside.
00:08:43
Speaker
We make it a point of every single one of our staff meetings and every single one of our board meetings and our meetings with physicians to communicate those outcomes. And I think that's the biggest piece. That's the biggest piece is really just one of the keys to our success is we used to have board meetings monthly. And it was every, with every single surgeon who was at an ownership interest and was a part of that facility. And the same thing with staff meetings. I think the most successful centers are ones that have staff meetings monthly, not just quarterly.
00:09:10
Speaker
And they have a set agenda, and we talked earlier about continuous improvements, so again, a set strategy. And there's certain items on there, and one of them is patient satisfaction. And I think we always report about trends. And then again, most importantly, once we see things slip in some fashion, and again, the nice thing about some of these like press gamey, they put, they list the certain sections, for example, administration and check-in, recovery and discharge instructions, things like that. And so whenever we see those items start to slip a bit,
00:09:37
Speaker
We always put it on the staff's shoulders, if you will, and not in a negative way, but say, listen, what's changed? We're just busier? Are we just, was there new staff? Do we have to train? And we always put it upon them to come up with solutions. And most importantly, we remember those solutions and as myself and our nurse managers.
00:09:53
Speaker
And we report back to the staff on how things are doing. Are we improving? What can we do better and that kind of stuff. And so we've really spent a lot of time on this. And I will say transparently, and I don't know if it's just a Northeast thing, but we have, we don't have the best patient satisfaction scores. And I'm sure you might be listening to this and saying the same thing. You think you provide great care and you have great outcomes. And how can we do better in the patient satisfaction side? And we talk to our patients, we call them the next day and they're all doing great. That type of thing. But you have to look at the whole piece, but really dive down to those numbers again.
00:10:24
Speaker
don't just read them, read them, process them, communicate them with staff. And when look at the minutia of the different areas where you think you can approve, because I think it can really contribute to an overall higher scores. And that's how we approach it. Yeah. It's interesting. I'm in Connecticut. I totally get it. We are a complicated bunch in the Northeast, but it's interesting. I think patient satisfaction as a whole is interesting because there's so many elements that go into it that are actually
00:10:54
Speaker
sometimes out of your control. I don't know about your facility specifically, but it could be parking. It could be maybe the financial piece of it, things that they don't realize really aren't related to the surgery center directly, but it still added to their experience as a whole. And then it's really- It's very important. Ours is a location, finding it. And if they come in the door, frustrated at the start, it just starts that first impression of they don't forget it. So it's a really good point. Some things are out of your control.
00:11:22
Speaker
Yeah, that's tough. But the data to your point earlier is key. And also being able to share that with your staff and not saying, oh, I have this feeling that we're underperforming in this specific area, but being able to point to the actual comments you're getting from patients and the trends month over month is huge and could help catch something before it becomes a really big issue.
Technology and Benchmarking in Surgery Centers
00:11:43
Speaker
So let's talk more about that data collection and benchmarking. How does benchmarking, specifically against industry standards, help identify areas that need improvement? And what do you currently do in terms of data collection and benchmarking? Yeah, again, I think benchmarking is really key. It's one of those things where, as I mentioned earlier, I think we all believe that we're doing, we're providing great care. Again, we have good outcomes and that type of thing. But it's always nice to benchmark against others.
00:12:12
Speaker
And again, if our patient satisfaction scores were 89% or 85% overall recommendation. So that's pretty good. It's not 65, it's not 75, but I realized that the national average or the average for the area was 95%. Then again, it puts all your thoughts and your perspective into reality, into real numbers. And so for us, again, it's worked out really well. We have a management company and we're able to benchmark amongst all of those centers. And then of course, our national association
00:12:42
Speaker
has their industry standards as well. And I think benchmarks are important. And again, it level sets things even for again, I mentioned the staff and the surgeons they want to know, is 85 a good number? The national average is 86 or whatever, or 84 and then makes you, makes it seem a little bit better. And I think, I think particularly in the quality side and in the continuous improvement side, I think having an avenue to obtain benchmarking again nationally, but also regionally, we talked about some of those
00:13:08
Speaker
aspects already is really key. And fortunately, again, we have a national association that provides some of those benchmarks and certainly there's pharmacy consultants and local folks who can do the same thing. And so it's helpful. Yeah, definitely. How about QAPI studies? Have you, any tips there about QAPI studies you could focus on that kind of focus on or give tips for continuous improvement or any that you've seen that are really good that you'd recommend?
00:13:38
Speaker
Yeah, I think I actually think that sometimes we struggle to come up with good co-op study topics. And I think that benchmarking is a great start for it. So pick an area where maybe you're not meeting the average for the national or local benchmark and discover why. One of ours, again, I hate to keep beating a dead horse, but one of ours was patient satisfaction. And we spent a lot of, it's ongoing.
00:14:00
Speaker
We spent a lot of time on things like scripting and doing our own survey outside of the benchmarking and utilizing different technology we started using and trying to figure out what are the key pieces that kind of are contributing to a higher or lower scores in different areas.
00:14:16
Speaker
and attacking those scores. And so our quality study in that front, and the reason why it's ongoing is because we're not 100% yet, right? So we continue to come up with new solutions. We have different staff members who come in with different ideas and it's worked out pretty well. And so again, I always find, I always feel like that should be an annual study, not patient satisfaction, but anything where you feel like you're, whether it's cost or somewhere you're not, you have access to a benchmark score and a number of DVTs, number of infections, whatever it is, those quality benchmarks are a great place to start.
00:14:45
Speaker
Not only does it look good, but again, you're doing something good because you're trying to improve your patient outcome in some fashion. So it's a great place to start for a quality study. And again, it's tailor made for you, right? You already have the answer of where you need to be as far as that benchmark. And so you just try to figure out how to strive to get there.
00:15:03
Speaker
Yeah. And it's interesting because we have a couple speakers that talk about different topics and we're always doing webinars. And we had one last week or last year that was about just different QAPI study ideas. And it was probably one of our most well attended and requested topics because to your point, everyone's always looking for different ideas and something that's useful too, not just trying to check a box, but I think.
00:15:29
Speaker
looking at the data is the perfect source of inspiration for different ideas as to where you can improve. You had also mentioned technology. So with this bigger concept of continuous improvement at your surgery center, what role does technology play or can it play? Yeah, it's funny. I always feel like we were just getting with the times now. I think part of it was this move in one plan we were going to do and through partnerships and joint ventures, et cetera.
00:15:58
Speaker
Now that we've sorted out which direction we're going, we're jumping back to the technology such as EMR, which is an easy one and all the aspects of EMR that, that different add-ons and things you can do with it. Technology to me is so fantastic because it improves so many of your processes and outcomes, but at the same time, it's scary as hell because there's such a cost to it. It does eat away at your bottom line, so to speak, but I think it's, I think the challenges
00:16:25
Speaker
not getting overwhelmed with a number of different technologies that are out there, a number of different companies, but finding companies that can streamline a lot of them have more bigger bang for your buck that are cost effective for what you're doing. And again, overall improve outcomes. I mentioned for us patient satisfaction. Here we go again. But I feel like part of the patient satisfaction
00:16:43
Speaker
is their family members and what they experience because the patients are most of the time they're out and they're out of it. And they, as long as they wake up and they feel better, like they're happy, but the family members are the ones who are waiting and who may be not beginning a great amount of communication. Us employing some technologies in terms of communicating with family members, kind of trackers on where patients are throughout the facility. I think have really been helpful. We've done that over the last few months. And again, there are technologies for every single aspect from
00:17:10
Speaker
everyone's dreaded credentialing, you know, to managing employees, to time management, to, you know, staffing, to, again, of course, all the other aspects of patient management and that type of stuff. And so, again, it can be overwhelming. Anybody who attends a trade show or the national conference, head into the vendor room, there's 99,000 of them. Again, it's a matter of, I think, utilizing your colleagues, networking, that type of stuff, finding out which great ones are out there, how people's experiences have been, and evaluating them for yourself. I think that's been helpful for us.
00:17:40
Speaker
Yeah, I always suggest that as well. If you have a good relationship with the surgery center down the street and they're using a technology you're interested in, go ask if you could go watch them, use it for an hour or so, or have that candid conversation with them. Because it really can be overwhelming, especially if you haven't started down the journey yet. It's where do we start and everyone's telling you they have the best software. So it's, I get it.
Fostering a Continuous Improvement Culture
00:18:04
Speaker
bigger picture, how can you cultivate an environment where everybody, not just leadership or the board, is focused on continuous improvement? Yeah, again, I think I mentioned this earlier, so it's a little bit of a repeat, but I think when we've had the biggest issues, if you will, with staff and kind of staffing, staff being disgruntled, or which is not a great environment overall, it's when we've gotten to the point where we got away from our monthly meetings, it's very easy to do that because
00:18:33
Speaker
You become very busy and even though you've, my recommendation would always be to schedule like ours, the fourth Tuesday of every month. We meet at 6 30 in the morning. It's the OR staff to start because they usually start early seven o'clock, all your staff. So you're not repeating the basic stuff like benefits and the type of thing. And then 7 30 is our PACU staff because that way the OR staff can get off, get the day going. And then by the time the patients come out, you're done there. And that's the way we've done it. We start the ORs at seven o'clock. And so it just, it's worked out well. But again, I think the key piece though, is again, making sure you're
00:19:04
Speaker
Stick into that meeting schedule. It should be monthly, I think, because things pop up constantly. And then again, it's not just meetings. Okay. You check the box, you're meeting and I got coffee for the staff. I got some bagels and I'm sitting down and I'm talking to them, but engaging with them. I talked about the patient satisfaction piece, finding solutions. And you can't do it all. You and your management staff, you're the administrator, your clinical management, et cetera. We all have different knowledge base. We all have different experiences, experience in the industry. And so.
00:19:30
Speaker
by opening up the floor, if you will, and trying to get some feedback and communicating, be listening to what they're talking about, their ideas are. I think that's really the key. But then again, that could all be just talk if you're not actually acting on it. So again, one of our keys is trying to get feedback from staff and then actually doing something about it. That way they don't feel like they're just talking and it falls on deaf ears. And so for us, it's worked out well. Anytime we've ever had a challenge on
00:19:58
Speaker
Any time a continuous improvement plan or a process or whatever, we've oftentimes gone to the staff and communicated with them and looked for solutions. And they often have them and it makes your job a lot easier. Engaging them is really key, I think. Yeah, that's great advice. Have you ever been your quest for continuous improvement? Are there any challenges that you've been faced with that you've had to overcome or any kind of major hurdles?
00:20:23
Speaker
What I think about over the years are besides the aforementioned ongoing trying to make patients and their family happy is things like when you bring a new surgery in or a new surgeon, that type of stuff, trying to, trying to make them happy and make sure that you're providing great care to that patient is really key. I'll use an example. We, again, I mentioned we do orthopedics and pain management since 2004, but a few years ago, we had a general surgeon come aboard and since he's hired another partner.
00:20:49
Speaker
And as she's added procedures on, particularly like he was doing open her and he is now she does lap her and he is. So she's been doing here probably for six months. We have another in-service tomorrow morning at 6.30 because you can never ever be satisfied. She had a bad day one time, she had some newer staff and she just didn't have all the things she needed. And it was the day dragged out a little bit and that type of thing. And so we put it on her and that kind of key staff member that works there a lot to come up with a solution. And one of them was doing in-service. And so we're doing that again tomorrow.
00:21:19
Speaker
The point there is we all, there's new equipment that comes in or again, a new surgeon and new procedure, that type of stuff. Again, don't just think you have the answer on how to start, implement the whole process. Again, involve staff, involve the surgeons and come up with a good plan to roll out and make sure that everything runs smoothly. And again, reevaluate it. Like I just mentioned, we're reevaluating it and we're acting again tomorrow. And so.
00:21:43
Speaker
It's just, you just never can be satisfied. We all get in a rut at some point. We, we feel like things going on. You're happy. And that's why I think strategic planning sessions as part of the, as part of my, my, I was too still there. My light went out. Strategic planning sessions as part of your community quality improvement is, is really key in analyzing things and making sure you don't just stay static is a key part of what your conditional improvement should be.
00:22:06
Speaker
Yeah. And it sounds like in that case, having that honest conversation, being transparent and collaboration was the key to, and being willing to continue to work together and figure out a solution was the key there. All right, Greg, last question. We do this every week with our guests. What is one thing our listeners can do this week to improve their surgery centers? Yeah, I think, and you've heard this as a theme already.
00:22:31
Speaker
And I think maybe it's a good time because if you listen to this and it's after the summer, it's the fall or before that we get busy again, is get in front of your staff, have a good, have a staff meeting with them, open the floor.
00:22:41
Speaker
Get some feedback on anything, pick something, pick from, again, efficiencies to your vacation plan, your value assigned vacation time or who gets their vacation off, some kind of area. But again, focus on the continuous improvement area and get the feedback from them and act on it. I think your staff will really, really appreciate that and feel like you're listening to them and that it's a nice place to work and they know they're heard and that kind of stuff. And I think when that happens and your staff is happier, I think your surgeons are then happier because they recognize the staff is happy.
00:23:11
Speaker
And obviously your patients are going to be happy because the staff is happy. They're enthusiastic. And again, that all leads to good outcomes. I would say that I think we all just talking to so many colleagues who just get busy and it just gets crazy constantly. And it's one of the areas where I think a lot of people sacrifice, but have that staff meeting. Maybe you do it out of the bar or at a restaurant in the area and get the company credit card and keep it under control, but do something that if it's a slower day in an afternoon and staff really appreciate that. And that would be one thing that I think
00:23:39
Speaker
has can have really monumental impact on your facilities. Perfect. That is great advice. Thank you, Greg. I really appreciate all your time and expertise today. No problem. Thanks for having me.
00:23:56
Speaker
As always, it has been a busy week in healthcare, so let's jump right
Recognition and Emerging Trends in Healthcare
00:24:00
Speaker
in. The California Ambulatory Surgery Association recently awarded 11 ASCs with the CASA Award for ASC Excellence. So according to CASA's website, the awards were established to acknowledge the fact that California ASCs are drivers of excellent healthcare and that they provide opportunities and solutions for healthcare reform.
00:24:22
Speaker
The program is built around five pillar categories, acknowledging facilities that exemplify best practices in the surgery center industry, plus actively promote and advocate for ASC excellence and inclusion in the healthcare delivery system. So certainly a tall order. And as always, we'll link to the article so you can see all of the surgeries who, surgery centers who were recognized.
00:24:46
Speaker
But I did want to call out 90210 Surgery Medical Center. So in addition to winning the CASA award for ASC excellence, they also won the prestigious CASA ASC of the year. So the staff at 90210 Surgery Medical Center hosted four tours at both the congressional and state level.
00:25:06
Speaker
They participated in the Ask a DC Fly-ins. They have committed to the CASA safe opioid pledge. They provide free surgeries to underprivileged children in the greater LA area. And as if all of that was not enough, they also coordinate a crucial initiative to provide supplies to Ukraine. So congrats to everyone who was recognized and thank you for all that you do for your communities.
00:25:34
Speaker
Switching gears, a recent study reveals the pervasive issue of cognitive impairment among older adults undergoing surgery. So those with cognitive impairment, which spans from mild cognitive issues to severe dementia, experience an increase in post-operative complications and further cognitive decline. And so cognitive impairment can negatively impact things like memory, language, and decision-making.
00:26:01
Speaker
So, if it's undetected, you can imagine how difficult it can be for them to smoothly go through a surgical procedure. It affects communication, it increases the risk of surgical site infections, and then can hinder patient involvement in pre and post-op care.
00:26:19
Speaker
So spotting any potential signs during the pre-assessment process is key, and there are proven screening tools that only take 10 to 15 minutes for patients to complete that can help identify patients at risk as early on as possible. So if you're not already screening for something like this, identifying and managing cognitive impairment pre-surgery could help lower risks, optimize care, and ensure that the surgery and recovery process goes smoothly.
00:26:47
Speaker
In our third story, according to Becker's ASC, non-competes appear to be going away. So this story is a bit of a follow-up to one that we had reported on back in July, and here are a few of the latest things to know.
00:27:03
Speaker
So the Federal Trade Commission proposed a rule that would actually ban non-competes nationwide, but there's still a long road ahead. So the FTC will vote on the rule in this coming April, and numerous small business groups and the US Chamber of Commerce have submitted letters in opposition.
00:27:21
Speaker
In the meantime, states are taking things into their own hands regardless of what's going on at the federal level, and they're trying to make non-competes harder to enforce. California recently passed laws declaring non-competes void in the state, even if they were entered into outside of state lines.
00:27:40
Speaker
Minnesota, North Dakota, and Oklahoma have also banned non-competes, and New York recently passed a bill that would outlaw non-competes. It's just waiting on the governor's signature. And then in Colorado and Washington, D.C., they both recently passed laws limiting non-competes to employees who make a certain pay threshold.
00:28:00
Speaker
And if you haven't picked this up already, in general, courts have grown increasingly skeptical about employers' need for non-competes except in cases when employees have access to truly sensitive information.
00:28:14
Speaker
This will be very interesting to see how this plays out. This will be a huge change for the healthcare industry. And when it comes to healthcare, the argument is that non-competes actually depress worker wages, limit competition, and result in higher healthcare costs. And it's estimated that by eliminating non-competes, it opens up a potential
00:28:36
Speaker
annual healthcare cost savings of up to $148 billion. Now they gave no insight into how they calculated that number, so please take that with a grain of salt. The FTC votes in April, so we will have to wait and see how it goes, but we will certainly be providing an update once there is one.
00:28:55
Speaker
And to end our new segment on a positive note, Cedar Sinai has expanded a nurse led workplace wellness initiative by adding in a serenity lounge. So two nurses found an underutilized locker room and equipped it with massage chairs, aromatherapy oils, artwork.
00:29:14
Speaker
and other amenities to provide nurses and staff with a much deserved break. And in a study recently published in the American Journal of Nursing, Cedars-Sinai nurse investigators found that nurses who used a massage chair in a quiet room for as little as 10 minutes experienced mental and emotional relief, allowing them to return to patient care better equipped to handle the stress.
00:29:39
Speaker
So kudos to the two nurses that took this initiative to improve the workplace for themselves and for their colleagues. And that news story officially wraps up this week's podcast. Thank you as always for spending a few minutes of your week with us. Make sure to subscribe or leave a review on whichever platform you're listening from. I hope you have a great day and we will see you again next week.