Transcript
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 guests, 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.
Speaker: Hi, everyone. Here's what you can expect on today's episode. This week, we're joined by Dallas Fryer. Dallas is the administrator at Corpus Christi Outpatient Surgery and is the president of the Texas ASC Society. And she's here to share four tips to improve staff satisfaction at your surgery center. From innovative scheduling to changing management styles, Dallas has implemented these techniques at her own ASC and has seen the positive results firsthand.
Speaker: In our news recap, we'll cover lab grown red blood cells, robots performing microsurgeries, a recent successful cyber attack on an ASC, and of course, end the news segment with a positive story about a 10 year old who delivered a baby. Hope everyone enjoys the episode and here's what's going on this week in Surgery Centers. Dallas, welcome to the show. Thanks.
Speaker: Dallas, can you tell us a little bit about the surgery center you run, Corpus Christi Outpatient Surgery? Our surgery center that's been open since 1998, we have five operating rooms and currently we are focused on musculoskeletal surgeries. So we do quite a bit of orthopedic, some pain management, and some podiatry. Great. And about how many cases do you see a month?
Speaker: Currently we're doing about 425 cases a month. We're going to be relocating the first quarter of next year and we'll have six ORs. And so we're certainly planning on growing from there. Fantastic. And so I wanted to hit kind of hit right in on one of the topics that everybody seems to be discussing in the industry lately. And that is staffing. What's been your experience, you know, over the last couple of years, last 24 months or so,
Speaker: regarding staffing at your center. Burnout and what trends do you see within your center?
Speaker: Wow, that is a really timely topic because it's probably the thing that I struggle with the most and the thing that's changed the most for my surgery center over the past couple of years. Prior to COVID, recruiting to the surgery center was a little bit easy because we were the only place in town that offered Monday through Friday, no weekends, no holiday, no call, and people were willing to maybe
Speaker: not have that call paid, not have the big sign on bonuses that the hospitals were offering in exchange for having a nice balance between work and personal life. But since COVID and since just the huge increase in sign on bonuses and the competitive nature to get nurses just to work in the non COVID related fields, it's been a real challenge.
Speaker: And so we've certainly had to rethink our strategies of hiring and retaining our nurses. Yeah, it seems like there's two sides of the coin there or there's the, you know, actually going out and recruiting new staff and the opposite side of the coin, you know, probably retaining existing staff and staff satisfactions probably.
Speaker: more important than it's been in a while. And so, how do you think about balancing those two? Are you more focused on one side versus the other?
Speaker: No really you have to pay equal attention to both I think because it's one thing to be able to go out and get staff and everything that you tell them about how great it's going to be to work here but if you can't bring them into a facility that does those things routinely and that your staff that they're going to work with on day one says oh yeah it's a great place to work then you're just going to keep having a revolving door
Speaker: And then your current staff are going to be looking and seeking other jobs because they're certainly bombarded with advertisements every day. Sure. Do you guys track staff retention? What's that looked like over the last 12 months?
Speaker: We do and fortunately we've tracked that for a number of years. And so I feel like some facilities are just starting to look at it and they really don't have something to compare it to. So our run rate for this year, we're running about 18 % staff turnover. And that's compared to prior to COVID, we were down around 12%.
Speaker: And last year we were upwards of 24, 25%. That's when it was at its worst. Got it. So it is regressing a little bit closer to the mean, but you're not there yet in terms of the pre -COVID levels. Right. And it's taken a lot of work and a lot of intention to get there. Sure. Okay, great. And I'd love to...
Speaker: to talk about that intention a little bit. One of the things that we discussed with you prior to recording this episode was, it sounds like you've got a set of really good management, best practices and tips and tricks around your staff that you employ at Corpus Christi. And so we'd love to touch on a couple of those. Can you tell us a little bit about your shift method and specifically the 12 versus 10 versus eight hour shift method that you've used?
Speaker: Sure. And that's something that's relatively new to us over the past year. One of the things that we found when I couldn't even get anybody to interview was people did not want to come to work and work five days a week. They've kind of really gotten into this. Well, I work 12 hours at the hospital and then I'm off for four days.
Speaker: And it's just not anything that we had ever offered before. So I really had to sit down and do it by hand on paper figuring out how can I offer 12 -hour shifts? How can I offer 10 -hour shifts? And really look at the best practices regarding the 12 -hour shifts and make sure that you weren't going to be setting yourself up for
Speaker: for more burnout on a daily basis and how to manage those types of shifts. But we've put together a different model for each department. In recovery, I have several people working 12 -hour shifts. And in my operating room, I only have one person working 12 -hour shifts. But I have three people working 10 -hour shifts.
Speaker: And it's worked out really well. I'm applying the same methodology to pre -op. And being able to advertise that we're hiring for a 12 -hour shift or a 10 -hour shift has really increased the ability to get those applicants in the door to even to interview. And then it's really seen a big change for our current staff.
Speaker: You know, they're finally, some of them were working 12 hours just before, but they were just doing it four or five days a week. And that is not good for anyone. So being able to offer something very routine gives them a great sense of accomplishment, but still being able to balance with doing things at home.
Speaker: I like that. It sounds like it's a nice value prop you can recruit to on the new talent acquisition side. It sounds like it's increasing satisfaction of your existing staff. It does sound like it might be more complicated to track and juggle the schedule. Are you using a spreadsheet for that? Is it a marker board? Do you have a software tool? How do you best manage that? It's really basic. I have it just handwritten on a piece of paper.
Speaker: And really, it's accomplished by getting the feedback from the current staff. And I found that the more I can let them kind of self -schedule with some guidance, the better it works. So, you know, they'll trade shifts, they'll trade weeks around each other, and they'll make sure that if they need time off that they kind of get it covered amongst themselves.
Speaker: Um, because they really have a good ownership of making sure that everything gets accomplished and it doesn't miss a beat. So it's hard not to micromanage it, but in the long run, it really benefits everybody. Great. Um, what about management style and management techniques of your, of your frontline managers? What have you seen to be effective there as it relates to employee morale and employee satisfaction?
Speaker: Well, you know, that's another thing that we've really focused on over the past few years is engaging with the frontline staff. And, you know, you're in the surgery center, you don't have a lot of middle managers, but you need to empower people to be that and give them the tools and the training of how to do that.
Speaker: how to have a conversation with the frontline staff of what are the challenges and ask them how they would fix them and then be open to what they say and follow through. If it's no, we can't do that or we're looking at it, how can we modify it and tweak it? That's very similar to what we came up with these schedules and just having them be
Speaker: accessible and open -minded with the front -end staff and not be well that's nice but we haven't been doing that here and and that that's good that it worked over there but not here. Sure sure and in terms of you know management style you know techniques have you found that it's a one -size
Speaker: fits all proposition or do different frontline staff members require different management styles and different approaches.
Speaker: Absolutely. We all kind of learn and hear about the five love languages. I kind of teach my managers to think similar ways with their frontline staff and to try to figure out what motivates somebody so you know what type of rewards are important to them. Some nurses are going to want to be able to work very independently and be asked their opinions.
Speaker: where other nurses or other staff members will see that as like, oh my gosh, she doesn't know how to tell me what to do. They want a very structured environment. And so even if you have the same message or the same question to ask, being able to tailor that to the staff member is very important.
Speaker: But again, you don't know what works with that individual staff member unless you're just having daily conversations with them and being engaged with them and being able to pair them with each other that complement one another. You know, you may hire somebody thinking that they're going to be great in one department working with one manager and then you actually find that, you know what,
Speaker: given your personality or given your skill set or given what you want to learn, it may be work better in another area of the facility. Sure, that makes sense. And if you found a lot of people talk about
Speaker: generational differences and maybe how Gen Z staff like to go about things as opposed to millennial staff. I tend to see that sometimes it's more personality profile and you can have different types of personality profiles with it. So it's less around how old they are or what generation they're in and more just getting to know them and getting to know their personal style. What have you seen? Do you bind to the concept of
Speaker: It's a generational thing and all Gen Z needed to be managed a certain way or is it more unique to the individual? It's absolutely unique to the individual and it's really about tapping into what makes them satisfied. You know, is it independence? Is it being able to
Speaker: be very social at work. Some people find that disrespectful. Some people find a joking environment to be unfocused. And then the whole one thing that you do hear about very often with the Generation X is immediate
Speaker: um, satisfaction, right? And they want immediate feedback. So doing an evaluation on somebody, you know, once a year, giving them feedback, but it's not great no matter what generation you are, but being able to immediately identify, yes, you did a good job today. Thanks. Or, but on the flip side of it, if you want something improved, you have to tell them immediately, but that's good management style with any generation and any employee.
Speaker: I think we've just gotten away with it for a long time. I agree. I agree. What about transparency? Where does this fit into your management philosophy?
Speaker: So, you know, probably one thing that I've been accused of throughout my entire career is being too transparent. You know, but I very much in the type that the more I want my staff to be just as knowledgeable about as of everything as I am, because then they can come up with the better solutions than often I can.
Speaker: Um, and so I think transparency, especially when it comes to hiring and training staff, if, if they don't know how hard it is to hire somebody, then they just think, you know, we don't want to fill the positions. Well, it's completely different when, you know, four years ago, you'd have 30 people apply for a job and now you're lucky if you get one.
Speaker: You know, and I think that you have to be very transparent with your current staff for that and help them help you create the environment where everyone not only wants to stay, but maintains your reputation as being a great place to work. Sure. And where do you feel like that concept of transparency really resonates?
Speaker: in terms of staff satisfaction? Is it transparency around and being vulnerable around, hey, here's what we've heard, here's what we've maybe gotten negative feedback on, and here's what we're going to do to improve it? Is it transparency around the overall center goals and objectives? What are some areas in particular? It's kind of all of that. What I found
Speaker: It's about what's important to that individual. Some people may care about the center goals, and some of your staff may really not. But it's transparency about what we can and can't do. If somebody's consistently asking me,
Speaker: We need another staff member here. We need another this or we need another widget. And I know that I can't do it either because it's just not in the budget or it's really not needed.
Speaker: I've got to be able to tell them and explain to them, give them a no, you know, and the reason why, but basically be very transparent with, yeah, we can't do that. And for whatever reason, instead of just, you know, continuing to lead them on thinking that, oh, maybe someday, maybe next month, maybe next year, when in reality, you know that it's not going to happen. I like that. I think sometimes,
Speaker: It can be easier to say, hey, that's a good idea. We'll think about that. We'll come back to that. The problem will be that you don't come back to it for a long time. So I like that just kind of being up for on if it's not possible and explain that early. Yeah. And I think, you know, as we, as we changed our focus from becoming a, we were a multi -specialty facility and becoming focused and orthopedic and starting to do total joints and
Speaker: and more complex surgeries. There was a lot of anxiety from the staff around that and just being transparent and owning that, you know, Hey, we're going to have to learn this together, but we're going to do it in the best and safest way possible. Um, and that there's nobody better to take care of patients than we are, you know, and, and we're all, we're all here for the same reason. Absolutely.
Speaker: You touched on earlier, Dallas, kind of management in a surgery center, and you mentioned, hey, there's not a lot of
Speaker: mid -level managers. It's not like in a hospital or a bigger setting. How do you make sure that the frontline staff does have someone to talk to? How do you make sure that the managers that you do have, although you run lean, have time to keep up with their staff members and get to know that unique style and personality that you mentioned is so important?
Speaker: you know, that's probably the biggest challenge there is. And I think that it's, for me, it's about not micromanaging and it's about allowing them extra time in the mornings or extra time in the afternoon and not a lot of time, but instead of just, okay, don't come in until five minutes before your patient's going to get here, you know, just allowing them that networking time and encouraging it, you know,
Speaker: Bringing donuts and bringing tacos and not us always mean the person doing it But you know telling hey, why don't you bring donuts for your department? You know and just creating those moments where they can get together and talk And and as upper management, you know My boss told me just the other week, you know
Speaker: We've got to constantly be looking to see if our next manager is modeling the same behavior as we are. And if they are, is that what we want them to be doing? So that gives us a check of the behavior we're modeling, but also gives us the opportunity to make sure that that's what our frontline staff are seeing.
Speaker: Because your next manager is a direct reflection of yourself. And is that the reflection that you want to see? Right. And are they cascading the culture that you'd like the center to have overall? Exactly. Because they are. They're casting the culture. You just want to make sure it's the right culture. That's right. That's right. OK, Dallas, final question for you here. And we do this every week with our guests.
Speaker: What is one thing our listeners can do this week to improve their surgery centers? Ask your most important person in each department what their biggest challenge is and listen to their answer, whether it's something personal or whether it's something work related. You don't have to fix it, but just listen for the answer. Listen and learn.
Speaker: Fantastic. Well, Dallas, this was great. We got some really actionable tips here. I heard, you know, flexible staffing schedule, flexible management style, a focus on transparency and understanding individuals' personal styles and what they respond to from a management perspective, and also, you know, making sure to allow time for
Speaker: networking, team to team interaction, manager to individual contributor interaction. So this is great. It's a hot topic. It's top of mind. I have no doubt our listeners are gonna get some good nuggets from listening to this one. Well, thanks so much for putting this together. I think it's just so exciting to be able to have this for leaders of surgery centers. It's not something we've had before and very excited for it.
Speaker: As always, it has been a busy week in healthcare, so let's jump right in. In an article by Pharma News Intelligence, the first humans in the world were transfused with lab -grown red blood cells during a randomized controlled clinical trial. So let's start with the trial itself. The trial is a joint initiative between a couple different organizations, the NHS Blood and Transplant, the University of Bristol, and the University of Cambridge, and all of those are across the pond in the UK.
Speaker: And also, it's important to note that the trial is funded in part by the National Institute for Health and Care Research. So today, only two participants have been transfused with lab -grown blood. And the researchers shared that they have both tolerated the transfusion well and without any side effects. So assuming everything continues going well, the study will transfuse 10 participants twice, at least four months apart, just to continue testing.
Speaker: I'm sure you can assume why this is a huge breakthrough, but according to the United States Red Cross, someone in the US alone requires blood every two seconds, which means 29 ,000 units of red blood cells are needed each day.
Speaker: And I don't know about you, but I get texts from the Red Cross probably every week telling me there's an emergency blood shortage and encouraging me to make an appointment. So if they can be successful in pulling this off, we could start to rely on lab -grown blood rather than donors, and it could really ease the burden and also revolutionize care for patients with long -term blood disorders.
Speaker: In our second story, according to Outpatient Surgery Magazine, the first robot -supported microsurgical operation was recently performed on humans. So between the lab -grown blood cells and robots performing surgeries, this new section is kind of starting to sound like an episode of Black Mirror, but I promise these are all real stories with real potential to change healthcare.
Speaker: Two doctors in Germany recently performed the first completely robot -supported microsurgical operation on humans. The robot mimics human hand movements with an electromagnetic field and joysticks. And using tiny surgical instruments, the surgeon's movements are reduced in size by up to 20 times, which eliminates the shaking that may naturally present in human hands.
Speaker: Five operations have been successfully performed and more are set to follow. According to the doctor who performed the procedure with the robot, procedures can be performed with a greater degree of precision, increasing patient safety, and allowing patients to recover faster. So those are the benefits for the patient. But for the doctors, it allows them to perform surgeries with better ergonomics and less fatigue.
Speaker: And while this type of robot won't be widely available for a long time, unfortunately, it does show us where the future of microsurgeries is headed. So we would love to know what you think. Would you try it? Do you see the benefits? Head over to HST Pathways LinkedIn page and leave a comment on this episode. I'm really curious about how the industry is feeling about these sorts of technological advancements.
Speaker: In our third story from Becker's ASC, a surgery center in North Carolina shared that their patient data was unfortunately leaked after a successful email phishing attack. According to the report, two employees were targeted during an email phishing cyber attack and a thorough investigation showed that the unauthorized party, the attacker,
Speaker: had access to emails from February 14th to May 10th, which is almost a full three months. During that timeframe, patient names, social security numbers, driver's license numbers, health insurance information, medical history, dates of service, and a bunch of other data points were compromised. And the ASC did have to notify patients of the breach just a couple weeks ago on October 31st.
Speaker: Now, I share this story not to shame anybody because, unfortunately, we are all under cyber attacks on a daily basis and these attacks are getting smarter and smarter and more human -like every day. But this is just a reminder that following recommendations from your IT department is non -negotiable.
Speaker: So install your patches, reboot the computers, don't click any suspicious links, change your passwords, and we'll include a few extra links in the episode notes with useful tips and reminders for how you can protect yourselves and your patients from these never -ending cyber attacks because unfortunately, they'll just be ramping up.
Speaker: But to end our new segment on a positive note, a 10 -year -old girl helped her mom deliver a baby at home when her mom very quickly went into labor three weeks early. So Miracle is the 10 -year -old's name. And when she realized what was going on, she did the right thing and called 911.
Speaker: And the dispatcher did an amazing job at keeping her calm and coaching her through it before the ambulance could even arrive. So to put it in perspective, the call itself was only a total of 11 minutes long. And during that timeframe, Miracle got her mom all set up, delivered the baby, cleared her baby sister's mouth and nose, checked the umbilical cord, and performed a couple other life -saving measures to make sure her mom and her new sister were okay.
Speaker: So thankfully everyone is doing just fine today and a huge thanks to Miracle and the 911 dispatcher for making it happen. 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'll see you again next week.
