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Andy Berg – Opening an ASC: Finding Your Dream Team
107 Plays1 year ago
Andy Berg, Director of Clinical Staffing at MedHQ, joined us for the sixth installment of our De Novo series to discuss the intricacies of assembling the ideal team for a new surgery center. Regardless of whether you're opening an ASC, the episode is filled with invaluable insights on staff recruitment, flexible hiring strategies, identifying leadership qualities, and ensuring your existing team is actively engaged in the interview process.
In our news recap, we'll cover the gigification of the healthcare industry, ASCA's official comments in response to Medicare's 2024 proposed payment rule, the nurses' strike still going on at Robert Wood Johnson University Hospital, and of course, end the news segment with a positive story about a new 'nuclear' prostate cancer treatment that is improving lives.
Articles Mentioned
The Gigification of Healthcare
ASCA Submits Comments on 2024 Payment Policies (Recap)
ASCA Submits Comments on 2024 Payment Policies (Full)
‘It is time to settle the strike’: RWJUH nurse work stoppage hits 40th day
A ‘nuclear’ treatment brought hope to people with prostate cancer
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
Brought to you by HST Pathways.
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Transcript
Introduction to Surgery Center Weekly
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 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.
00:00:28
Speaker
Hi, everyone. Here's what you can expect on today's episode.
Finding the Dream Team for New Surgery Centers
00:00:32
Speaker
Andy Berg is the Director of Clinical Staffing at MedHQ, and for the sixth episode in our de novo series, I had a chance to sit down with him to chat about how to find your dream team when you're opening a new surgery center. Now, even if you aren't opening an ASC,
00:00:50
Speaker
There's a ton of great tips throughout the episode about how to recruit staff, flexible hiring options, qualities to look for in a leader, and how to make your current team feel included in the interview process.
News Recap: Healthcare Gigification & Medicare Changes
00:01:04
Speaker
In our news recap, we'll cover the gigafication of the healthcare industry, ASCA's official comments in response to Medicare's 2024 proposed payment rule, the nurses' strike still going on at Robert Wood Johnson University Hospital in New Jersey, and of course, end the news segment with a positive story about a nuclear prostate cancer treatment that is improving lives.
00:01:29
Speaker
Hope everyone enjoys the episode and here's what's going on this week in Surgery Centers.
From Baseball to Healthcare: Andy Berg's Career Journey
00:01:38
Speaker
Hi, Andy. Welcome to the podcast. Hi, Erica. Thanks for having me. Can you share a little bit about yourself and about Med HQ with our listeners, please? Sure. So actually my first career out of college, I ran minor league baseball teams.
00:01:54
Speaker
and then transitioned 15 years later over, actually just accidentally fell into healthcare staffing, and I've been doing it 22 years since. MedHQ is all about the surgery centers, and part of my role in this is to help provide a staffing solution, and we do that through something we call a talent portal.
00:02:17
Speaker
Very cool. I can imagine that that is much needed with the last couple of years with the way things are trending. We'll certainly get into that.
Recruitment Strategies for Surgery Centers
00:02:28
Speaker
So we're in the middle of our de novo series where we're sharing advice with our listeners about how to open up a surgery center. And last week we covered clinical preparation, which touched a little bit on which staff members to hire and in which order, but we didn't go too deep into it. So today we're going to expand on that and then talk about how to actually find your dream team. So for those who are working on opening up a surgery center or considering it,
00:02:53
Speaker
How early on do you start recruiting members of your team and which roles do you look for to fill first? So if a center's utilizing an advisory firm such as Avonza Strategies, they'll typically focus on finding the administrator first and that'll be typically six months out. Okay, gotcha. And how is recruiting for a surgery center different than recruiting for a hospital setting?
00:03:22
Speaker
So this may be a little more long-winded answer than you're looking for. So obviously the number of employees in a hospital is significantly larger than in a surgery center. So recruitment in a hospital, specifically in the OR, and we'll use a level one trauma center as an example. So they're open 24 seven, 365, and it's not as structured as a surgery center. They don't know what's coming in next.
00:03:51
Speaker
And so the nurses that work in the OR in the hospital are typically going to be more specialized, again, because they don't know what's coming. On the surgery center, because there's fewer employees, those nurses and employees are typically more of a generalist. And one of the things that nurses and employees enjoy about a surgery center is there's no nights, no weekends, no holidays, and no on call, which is a tremendous benefit.
Staffing Solutions: Flexibility & Transparency
00:04:20
Speaker
The other difference is, so in a hospital, they have many different units. And so the C may come to the HR talent acquisition team and say, Hey, you remember that ICU that I closed down six months ago? Well, we need to reopen it because the census is going through the roof. So we need you to go out and find 40 full-time equivalents.
00:04:43
Speaker
That team is going out, they're finding 500 resumes that are going through those resumes, narrowing it down to 100 that look like they have the experience. They're doing a phone interview with those 100. Of the 100, they may be like 25. And so they'll bring the 25 in for an in-person interview. And these in-person interviews are no longer coming in an interview with HR, and we'll let you know if you have a job or not. It's now the
00:05:12
Speaker
directors of nursing, it's the unit managers, it's peer panel reviews. And so the process is way more involved. And so when the group gets through those 25 in-person interviews, they may have five out of the 40 that they need to hire. So they have to redo that process. And part of how we approach this helps them address that. Gotcha. Yeah, that's great. It is a numbers game, right? You need app. It is cool.
00:05:43
Speaker
And all right, so let's talk about flexibility. So when you are looking to hire people, what kind of options do they have when it comes to staff and flexibility? So it's a great question. And different centers are at different places in their life cycle. If they're at the beginning, it's different than if they're a year or two in and they've got their feet wet and now they're ready to grow. We have a center that we're working with that has a plan in place with multiple different phases.
00:06:13
Speaker
And our part of helping them out is being strategic about how they grow their staff. So we operate your typical 13-week contract, which is they show up, they work for 91 days, and then they're gone. We do attempt to firm with no conversion fee. Again, no conversion fee because we're trying to be very mindful of the centers and the amount of money that they have to be able to put out for new staff.
00:06:42
Speaker
And then we have a direct hire solution, which in my experience is typically for leadership type positions. But what we're finding is the centers are looking primarily a direct hire for all of their staffing needs. So in the example where that facility is working in stages, they have the ability to, as they know their cases are going to grow, they can bring a nurse in for 13 weeks.
00:07:10
Speaker
then when they know that the growth is going to continue, then they can do attempt to perm. Or if they're an established center and somebody leaves, they can simply do a direct hire search. Gotcha. And do you find when obviously transparency
Leadership Qualities for Surgery Centers
00:07:28
Speaker
is key, right? The person being hired knows exactly what their trajectory is, the length of their contract, all of that. Do you find that obviously being flexible with all these options increases the applicant pool or
00:07:40
Speaker
How does that typically, what do you see there? So typically when you compare a nurse working in a hospital and a nurse working in an ASC, the pay scale on the ASC side is typically a little bit lower again, because they're more of a generalist than the specialist in the hospital. Again, it all goes back to that work life balance for the nurse nurses, specifically hospital nurses.
00:08:04
Speaker
have gone through something absolutely horrific over the last three and a half years. And quite honestly, some of them are looking for that to ease a little bit. Yeah, absolutely. And how important is flexibility for the providers? Does that work the same with them? Well, again, it goes back to the work-life balance where they can actually
00:08:30
Speaker
celebrate Christmas with their family rather than having to work the night shift. And typically there's a rotation in the hospital where you're going to work one or two holidays in the surgery center. That doesn't exist. And so it's a wonderful thing. Yeah, that's certainly a nice perk. And when you are in your search, what qualities should you be looking for in a leader? So I think it varies from center to center. Again, if you're a new center,
00:08:59
Speaker
You're going to hire somebody that has experience in setting up a new center and developing a culture. Are they a center that's been underperforming? Do they need someone to come in and really get the group going? Some of the information that we want to know from the center when we do a search is, again, about the culture, top selling points of the center, what the interview process is like, how many cases per month does the center handle?
00:09:27
Speaker
All of those bits of information give us a better understanding of what we're looking for. Sure. Yeah, that makes sense. And what kind of professional growth do you find to be available at a surgery center?
Professional Growth Opportunities
00:09:43
Speaker
So again, less specialized, more generalized. So in the hospital, you'll have a nurse that does the pre-op. You'll have a nurse that does the OR and you'll have a nurse that does the PACU or the post-op.
00:09:58
Speaker
in the surgery centers, a lot of times the pre-op nurse is also the post-op nurse. And sometimes, you know, in as much to speaking to professional growth, a lot of times these nurses can come in as one thing and be cross-trained to become a much more different thing, expanding their growth and their ability.
00:10:18
Speaker
Yeah. And are there between all the state associations and all the accrediting bodies and all of that, are there resources out there for them if they do want to get into another area of the ASC or, or continue to learn? I think there's always an opportunity for continued education and you can find those really almost anywhere, whether you go to the American Heart Association or the state ASC association.
00:10:47
Speaker
they have all that information available. Sure.
Cultural Fit in Recruitment
00:10:51
Speaker
Okay. And so when you are going through the interview process, how can you make your team that you already have feel included? And why would that be important? Well, obviously valuing everyone's input on the team, that's the definition of inclusion. But when you include them on that peer panel in the interview process, it really allows everybody to have a say.
00:11:17
Speaker
And at the end of the day, one of the things or two of the things that you really want to make sure you focus on is, are they clinically what they say they are? Because obviously that's most important. And also, will they be a cultural fit with the team? And who better to help drive that than the actual team?
00:11:36
Speaker
Yeah. And do you have them actually interview the candidate or do you just go back and share the experiences you've had with the team or you want them actually interviewing the candidate too, or at least meeting them? I think actually having them meet them. The other thing it does is it allows the candidate that's interviewing to really get an idea from a peer level, what does it really like to work here? I get what the administrator says. I get what the director of nursing says. I get what the charge nurse says.
00:12:05
Speaker
But really, what is it like? What is it like to show up at eight and leave at five? And the kind of cases that we have, how complex are they? Those kind of questions, I think the interviewee will have an easier time asking that of their peers or would-be peers. Yeah, that makes sense.
00:12:26
Speaker
and actually getting like, here's what I hear. Here's the spin I'm hearing, but is it actually true? And I know we've talked about the hospital a couple of times, but I would imagine maybe there's a smidge of disbelief coming from the hospital. Is it true over here that this is what the experience is actually like? Exactly. Awesome. Well, this was all super helpful. And we do this every week with our guests. What is one thing our listeners can do this week to improve their surgery centers?
Patient-Centric Approach & Effective Teams
00:12:57
Speaker
The two suggestions that I would offer, and I, this comes from a perspective of somebody who works in healthcare staffing that we've decided that we're going to be a patient centric organization. And by patient centric, obviously we work with nurses. We work with facilities and both of their goals are to make sick people feel better. So everything that we do at MedHQ needs to be in support of that.
00:13:25
Speaker
So that's why we're patient-centric. So one of the things I would say is continue to be overly communicative with the patients and families because they don't know what a gallbladder is and they don't know what it does, but the nurse does and the nurse can explain it. So it's a tremendous resource for the patients and their families. The other thing I would say is these ASCs are much smaller.
00:13:53
Speaker
Most don't have a recruiter on staff, and obviously I'm biased. I would suggest using a patient goes to a surgery center to have surgery by an expert, and that's understandable. You wouldn't go anywhere else other than where there was an expert. In regard to building your dream team, as it were, I would suggest using professionals also, because they're going to know what you're looking for.
00:14:21
Speaker
and they can deliver the right kind of people so you're not wasting your time. You'll save hours and you'll save money by using an experienced healthcare recruiter. Perfect. That is great advice. All right, Andy, we appreciate your time and all your expertise. Thank you. Thanks, Erica. Take care.
Navigating the Healthcare Gig Economy
00:14:42
Speaker
As always, it has been a busy week in healthcare, so let's jump right in. Our first story comes from Med City News. As a result of the staffing shortages that the industry has been facing, healthcare organizations are now leaning into the gig economy, and they're calling it the gigification of healthcare.
00:15:02
Speaker
So first, what does that even mean? So the gig economy is defined as a labor market characterized by the prevalence of short-term contracts or freelance work as opposed to permanent jobs. Individuals work on specific tasks or gigs rather than being employed in traditional ongoing jobs with a single employer, salary, all of that. So what is fueling this?
00:15:28
Speaker
The US Bureau of Labor Statistics predicts over 2.6 million new healthcare jobs by 2031, meaning employers need to accommodate how the next generation of healthcare professionals want to work. Now, this, of course, does not apply to everyone, and not everyone will be interested in these types of relationships and contracts.
00:15:50
Speaker
It definitely takes a certain type of person who has the interest and ability to manage, you know, I have a couple shifts here, a couple shifts here. I do this at night, this during the day. You know, that life is certainly not for everybody, but it at least has to be an option.
00:16:08
Speaker
So the first tip that they gave is to lean into apps that allow you to view schedules, swap shifts, and receive payments. These tools can offer autonomy to workers who seek careers that allow them to work more on their own terms.
00:16:23
Speaker
The second tip is flexible work and flexible pay. So if people want to work remotely, maybe you can weave different telehealth options into your practice, or as most millennials and Gen Zers live paycheck to paycheck, maybe you have an instant payment option versus biweekly deposits.
00:16:42
Speaker
And lastly, growth-based perks could be enticing as well. So unique rewards and benefits instead of the usual, such as financial literacy and coaching, tuition coverage, cash back on gas, and other offerings will give you a big advantage over those around you that don't offer things like that. So the moral of the story is that tapping into the talent pool of gig workers
00:17:06
Speaker
might help ease staffing shortages and retain and motivate your team. And then also get you set up for success for kind of the next generation of healthcare workers that are coming. Switching gears, ASCA officially submitted their comments in response to Medicare's 2024 proposed payment rule for ASCs and HOPDs.
Medicare's 2024 Payment Rule Response
00:17:30
Speaker
So their final comments ended up being 22 pages long. So I'm just going to give you some of the highlights here.
00:17:36
Speaker
But I will link their full comments in the episode notes as well. So you can easily check those out. They really went to bat for the industry as expected. And I was really impressed because they just presented their arguments extremely well. Lots of detailed reports and data points. So a lot of the stuff they were sharing didn't come off as opinion. It came off as fact. So here's a quick recap. Aska commented on ongoing payment issues.
00:18:02
Speaker
such as the need for alignment of inflation update factors between ASCs and hospitals, the removal of secondary adjustments that depress ASC reimbursement rates, and issues with Medicare's process for moving procedures to the ASC covered procedures list.
00:18:18
Speaker
As you probably remember, they're only accepted one. I think ASCA was 60-something that they had submitted and they only took one. So hopefully when the proposed rule comes out, we'll see a lot more on there.
00:18:34
Speaker
ASCA also commented on proposed updates to the ASC quality reporting program, including opposing the newly proposed ASC7 volume measure and continuing to request removal of the ASC11 cataract measure. And lastly, continuing to request the removal of the ASC20 COVID-19 vaccination measure.
00:18:58
Speaker
And last but not least, ASCA also submitted comments in response to the 2024 updates to the Medicare physician fee schedule. Now these policies don't always or rarely directly impact ASCs, but they do impact the clinicians who work in surgery centers. So thank you to ASCA for advocating on behalf of the industry. And we can expect the final rule to be released around November 1st.
00:19:26
Speaker
Our third story is from Healthcare Dive.
New Jersey Nurses' Strike
00:19:30
Speaker
More than 1,700 nurses have been on strike in New Jersey since the beginning of August at Robert Wood Johnson University Hospital. The strike just hit its 40th day last week, but the parties were expected to meet on September 14th. So hopefully by the time you are listening to this, there has been some resolution or progress made in the right direction.
00:19:54
Speaker
If you haven't been following the story, the nurses first authorized a strike in July after failing to negotiate a new contract. So nurses walked off the job on August 4th, citing unsafe staffing levels and insufficient pay as primary concerns, in addition to reining in health insurance costs. So the parties have remained at an impasse since August 16th, despite even bringing in federal mediators.
00:20:23
Speaker
As with all strikes, both parties are suffering ultimately. The 965-bed hospital said it spent $45 million on a team of 1,000 contracted replacement nurses. Of course, the 1,700 nurses who are on strike just lost their health insurance amongst experiencing other financial losses.
00:20:47
Speaker
Again, hopefully the hospital will commit to enforceable nurse to patient ratios, which seems to be the biggest holdup here. And of course, staff safety and pay and just other staffing agreements. And I hope they can come to a resolution so life can resume back to normal as much as possible.
Innovative Prostate Cancer Treatment
00:21:07
Speaker
And to end our new segment on a positive note, a revolutionary search and destroy drug for treating advanced prostate cancer could improve the quality of life for thousands of men each year. PSMA acts like a guided missile by hunting down cancerous cells and delivering a targeted dose of radiation, leaving healthy tissue untouched.
00:21:31
Speaker
A total of 617 patients took part in a trial led by the Institute of Cancer Research in London, and it found that men treated with the drug lived for longer before their pain levels increased. For patients taking PSMA, it took 9.7 months for quality of life to worsen compared to 2.4 months amongst men who were receiving standard care.
00:21:56
Speaker
So, hopefully, this could pave the way for a new era of these nuclear treatments for other cancers as well. And that news story officially wraps up this week's podcast.
Closing Remarks & Listener Engagement
00:22:08
Speaker
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.