Staffing: The 7 Habits of Highly Effective Administrators

Whether you're a new OR leader still settling into your role or you've been herding surgeons for years and have the battle scars to prove it, one thing is certain: You've got an incredibly challenging job that's been known to chew up and spit out nurse managers who didn't have what it takes to run the show. No worries. We've got you Coveyed. With a nod to self-help guru Stephen Covey's The 7 Habits of Highly Effective People, here are the 7 habits of highly effective surgical administrators.

1. Keep your facility in continuous compliance
Making sure your facility complies with reams of regulatory requirements is a mission-critical part of your job. Ambulatory surgical centers (ASCs) must comply with the federal requirements set forth in the Medicare Conditions for Coverage (CfC) in order to receive Medicare/Medicaid payment. The regulations inside Appendix L (osmag.net/Za6KHy) of CMS's 151-page State Operations Manual, "Guide for Surveyors: Ambulatory Surgical Centers," is probably the most comprehensive document available to help ASC administrators understand the nature and scope of their jobs. In addition to Appendix L, download Appendix Z (osmag.net/rN4KZg), which offers emergency preparedness guidelines for all providers.

For you hospital leaders, "The Joint Commission's Electronic Accreditation & Certification Manuals," which includes all of the standards and requirements for TJC accreditation and certification, is likely your best bet. For a fee, you can download it here: osmag.net/6JYkbT.

2. Manage meetings like a boss
Whether it's a short staff meeting or a comprehensive board retreat, develop your agenda, stay on topic and respect everyone's schedules by beginning and ending the meeting on time. One tactic: Pause the meeting with 10 minutes left on the schedule and ask attendees if they are confident the meeting will end on time with all issues addressed. If not, poll attendees again to determine if all are willing to exceed the allotted time, or if you should schedule another meeting to finalize the matters at hand.

3. Monitor supply costs like a hawk
The average surgical center racks up $1.5 million annually in operating expenses. Of that, $464,000 is spent on drugs and supplies. Use every tool at your disposal to keep supply-chain expenses in check. There's no shortage of software solutions promising to do just that, but beware: Choosing the wrong procurement and inventory management system will actually add work for you.

I once worked at a facility where the system was so inefficient we'd have to take lots of extra steps to order and track our supplies. Our purchasing agent would often end up taking home a huge stack of paper invoices to work on after hours. I'd then have to manually enter them into QuickBooks. It was an exercise in redundancy. Insist that your inventory management system lets you update supplies seamlessly and run invoicing directly through it, connects directly to suppliers and integrates with QuickBooks or whichever accounting software you're using. You want your system to work for you, instead of you for it.

4Know what you don't know
There's so much to learn and so much to monitor as an administrator. You can't figure it out all at once. Admit what you don't know, and get the clarity you need to determine:

• What you need to learn right away. For example, if you're undergoing CMS and accreditation surveys in the same year, identify all the major issues you need to address well in advance. Determine exactly what the agencies are looking for and whether you're currently in compliance.
• What you can delegate to others to learn. You can always look to enthusiastic workers as potential candidates for delegating those time-consuming tasks that take you away from your core work (like preparing for 2 surveys in a single year!), but here's another option: Look to staffers who are most vocal in their discouragement. They may be the perfect candidates for creating more efficient processes.
• What you can set aside for later exploration. If it doesn't impact revenue, patient care or violate a regulation, you can probably back-burner the task.

5Have a sense of direction
"I don't know where I'm going, but I'm on my way." This quote from poet Carl Sandburg perfectly encapsulates the challenge of running a facility in the midst of so many competing priorities. Though it's tempting to simply respond to the latest crisis or opportunity, successful leaders always have a destination in mind, and lead toward it. Sounds obvious, right? The reality is often difficult — especially when the breakneck pace of surgery makes it easy to be distracted by competing priorities. Don't execute against anyone else's plan; clearly plot how you want to achieve your results, and learn how to motivate and engage your team to get there.

6Master the surgical schedule
Speed is everything in outpatient surgery. Getting as many patients through the door as safely and effectively as possible requires a certain level of wizardry when it comes to effective scheduling. It touches all aspects of facility operations, and requires constant review to optimize resources and minimize downtime. My advice: Abandon the Excel spreadsheet and instead embrace technology to automate and smooth all aspects of the scheduling function — block scheduling, customized reporting, scheduler communication and more.

7ABR — Always Be Recruiting
No matter how positive of a work environment you establish, staff turnover is a harsh reality of the OR. Recruitment is a crucial element of your job. If you're using an online job search site like Indeed, be sure to use any relevant filters — the specific education (BSN), certifications, years of service and specialization — or you'll wind up with a virtual mountain of resumes that aren't relevant for the position you posted. Also, if you're not open to inexperienced staff or new grads, clearly state that in the job description.

If you're using a recruiter for a highly skilled clinical position, you'll want to vet the recruiter accordingly. Think of it as a job interview for the job-candidate finder. Ask about the recruiters' up-front costs, finders' fees and whether they have a noncompete clause that would prohibit you from using other recruiters if you retain their services. Finally, review the entire recruiter contract with a fine-toothed comb.

Trust yourself

Remember, this isn't going to be an overnight process. Becoming a successful administrator takes a willingness to learn, an ever-constant push to refine and improve processes, and a readiness to celebrate victory as well as admit failure. Remain patient with your own limitations — you'll be an expert in no time. OSM