PYA Covid-19 Information Hub
Published May 28, 2020

3 Keys to Successfully Reopening Ambulatory Surgery Centers

As the national economy (and healthcare specifically) progresses toward a semblance of pre-COVID-19 operations, ambulatory surgery centers (ASCs) are attempting to resume elective surgeries, but not without challenges. To gain a “boots on the ground” perspective, PYA interviewed a leading ASC administrator whose facility recently resumed operations. While there are numerous factors an ASC operator must consider in reopening, PYA has identified three key areas to help in that undertaking.

  1. Effective Communication – With so much uncertainty surrounding socialization and human contact, it is vital to communicate with patients. Interestingly, our interviewee disclosed that most of the patients his ASC contacted to reschedule surgeries and procedures were willing to do so; however, most had questions. Creating and executing a proactive, comprehensive communication plan can help patients feel comfortable about proceeding with their planned procedures and surgeries. Consider informing patients about revised operating days/hours, the COVID-19 patient screening process, increased patient safety precautions, and the center’s visitor policy.
  2. Operations Capacity and Hours – Patient and staff safety as the priority requires modifications to patient flow, scheduling, and capacity. Most ASCs were not designed to accommodate “social distancing space” during in-take, pre-op, procedures, post-op recovery, and discharge processes. In evaluating restart capacity, the administrator we spoke with decided to expand the length of time between each patient’s scheduled procedure, thereby reducing the capacity in both pre-op and post-op recovery spaces. Implementing such a safety measure minimizes and nearly eliminates encounters between patients, but it does come with a downside—reducing the available ASC capacity during a normal eight-hour day to less than one-half of pre-COVID-19 levels. An ASC may need to determine whether to extend normal operating hours or add Saturday schedules to meet the growing demand. Any of these options to expand will increase the overall costs, so each ASC needs to determine how to scale its capacity to best meet the needs of the center.
  3. Financial analysis – Of utmost importance is analyzing the ASC’s breakeven point. While lower case volumes and patient throughput are realities, projecting revenues and expenses under the temporary “new normal” can help operators make informed decisions for maintaining financial stability. Consider the impact of new operating hours, reduced case volumes and patient throughput, and incremental expenses as you develop this analysis.

For example, our interviewee stated that the costs of personal protective equipment have increased for his ASC by a factor of three to four times. Other expenses for items or services that may have once been considered preferable, but not a necessity (reusable cloth gowns versus paper patient gowns as one example), had to be cut or eliminated. Further, in the event of implementing revised schedules, consider staffing needs. As most ASCs are anticipated to initially operate at a limited capacity, consider alternating staff schedules to avoid staff downtime and to maintain equitable staff hours for those with similar roles/positions.

The reality is that the return to normal ASC operations will be challenging and extensive. As ASCs reopen for business, they will need to implement a plan to operate safely and efficiently. Consideration of these key areas may help ASCs rebound during this time of uncertainty.

While your ASC is evaluating its reopening plans, PYA’s experienced executives can provide ideas and perspectives along the way. For additional current and post-COVID information, visit PYA’s COVID-19 hub, or contact a PYA executive below at (800) 270-9629.

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