By Sandy Berreth, RN, CASC, Administrator, Foothill Surgery Center at Sansum Clinic, Santa Barbara, California
Having worked in healthcare for 40 years, with the past 20 years as an ASC administrator, I was asked to share a few tips for a successful career in ASC management. Here is a what I have learned.
1. Being the administrator doesn’t mean you know it all. In fact, as you start this journey, you will realize you know very little. If you’re new at a position, why would you know it all?
Let’s talk a little about you. You were probably the best at your previous position. That’s why the doctor said, “I want HER/HIM!” when they were starting a surgery center. I want you to think back to how you became the best; you need to use the same process to become the best administrator/manager that you can be.
You will make mistakes, but you are not alone. Some of us have made life-changing mistakes, but you will find a way to move forward. It may take a while, and it may only happen by taking baby steps, but you will persevere.
2. Find a mentor. Go to a conference and find someone who is speaking your language. If the speaker is talking about a specific topic you might not be aware of, ask questions. Find a speaker that you enjoyed, stay in touch, be a pest. Most of the speakers at the major ASC conferences have been exactly where you are now. Seek knowledge, ask questions, listen, read—never stop learning.
3. Take notes, cut out articles, don’t assume you will remember what you learn. Then, when you need to make a point or defend your stance, you will have solid support in the articles and speaker notes that you have gathered. Never enter into a topic discussion without solid resources for your beliefs.
4. One of the reasons we got ourselves into this business of ambulatory surgery is to provide a service. That service, defined by your governing board, is essentially your ASC’s “goals.” Along with your governing board, build a ladder to success through developing attainable goals. My advice: Make them practical.
Here’s an example. The physician partners want the surgery center to be profitable. Now, how do we do that? We start with the basic goal of profitability. What do you need to achieve that basic goal? Well, you need commitment to volume, you need good payor contracts and you need a method of comparison with the best (i.e., benchmarks). We all know it’s not that simple, but this is a good start.
5. We have learned one of the best contract negotiation tools is earning and maintaining accreditation. Every administrator needs to know where to find the resources to help achieve accreditation, and that’s through the standards. So, where do you find the standards and how do you make them a daily consideration in your center? Commitment to the standards start with your most valuable resource: Appendix L, also known as the State Operations Manual Appendix L – Guidance for Surveyors: Ambulatory Surgery Centers. Have this on your desktop and be familiar with what it says, but don’t try to memorize it; that’s just not possible.
Remember that the most important part of the standards is the interpretive guidelines. These are your stepstool to successfully understanding the standards. Use your knowledge of the standards as a pivotal point of reference when developing the governing board agenda. You will have immediate credibility. That’s important when you are often the center of attention when surrounded by physicians. Let’s face it; most of them are very smart, and that can be intimidating. But if you have knowledge they don’t possess, you are the star. You know the standards, you listen to colleagues as they talk about the standards, you ask questions when you don’t understand and you keep learning.
6. All good leaders will tell you this: mentor, encourage and support. Your staff is your most available asset. Remember that you are their leader. We have heard that leadership isn’t mystical or mysterious. It is not just for a chosen few. In my opinion, leadership qualities can be learned. The key that you, as the student, need to understand is that leadership is about intelligence, change and vision. Vision not to see the future, but to establish significant goals, focus on the message and inspire your staff to believe. Face your challenges with clear thinking. If you don’t know the answer, do not “fake it ’til you make it.” See #2: Use your mentor! Build trust, let other know you are on their side, correct mistakes, but remember to do it with calmly and without anger.
I have learned to be yourself, warts and all. Use your strengths to identify your staff’s strengths. Hold yourself to a higher standard, understanding that sometimes you will fail, but pick yourself up and try again. It builds respect and trust.
7. Finally, always remember your staff is your greatest asset. Treat them with the respect, honor their journey.
So those are my words of wisdom. I hope they help you on your own journey.
— Sandy Berreth, RN, and proudly CASC