The fast-paced ambulatory surgery center (ASC) environment requires Directors of Nursing to wear many hats. Typically, in addition to an important clinical role such as infection control nurse or safety officer for their center, an ASC Director of Nursing also is responsible for ensuring the center is fully staffed, well-managed with a focus on patient safety and continues  operating smoothly when it comes to administrative functions and accreditation.

Two of Regent’s clinical operations leaders, Kathleen Bernicky, BSN, and Carla Daley, RN, BSN, believe staying on top of staffing and adhering  to all State, Federal and Accreditation standards along with Medicare’s changing reporting requirements are among the most challenging issues facing Directors of Nursing (DONs) today.

Juggling Staffing Issues

“One challenge is staffing your surgery center with qualified people who will stay in the positions even through season fluctuations,” says Kathy Bernicky, Regent’s vice president of risk management and clinical operations. “Many times, when we have fluctuations, people don’t get through that, and we end up re-staffing, and that’s a really tough thing for DONs. Another challenge is the nursing shortage many areas of the county are experiencing particularly with OR nurses. We have to be clever about where to look for them, and even to consider training a new nurse to be an OR nurse.”

Regent helps ASCs address staffing challenges with both training and experienced counsel. Carla Daley, Regent’s senior director of clinical operations, says: “We’re working with our DONs all the time on staffing – we rotate people to ensure fairness regarding who’s going home or getting low censused. There’s a lot of creative thinking and staffing that needs to occur. For example, we may bring in a traveler if it’s a short burst. They’re highly trained nurses and we’ve had great success with that in our centers. It’s really helpful because then when the census goes low, we don’t re-contract.”

Coping with Reporting Changes

Another evolving issue for DONs has to do with the reporting that’s required by Medicare. “The measures change every year, so it takes a lot of time for DONs to actually sit down and educate themselves on these measures, to monitor and collect the data, and report it,” says Daley.

Regent works to help educate DONS on these changing requirements. Says Bernicky: “We help keep them abreast of anything new, and we help them update their policies so they’re compliant with new standards and regulations.”

The Regent team communicates in part via a monthly clinical e-blast that covers many different topics to give DONS the most updated policies and forms. Bernicky and Daley also participate with ASC Quality Collaboration, sharing information to help keep centers up-to-date on reporting requirements.

What’s on the Horizon?

As the role of ASC DON continues to evolve, Bernicky predicts a continuing increase in requirements for quality measurement and benchmarking. “Our world is becoming more and more data-driven,” she says. “It used to be just managing patient care, but now the DONs are required to collect, measure and report many clinical metrics. “That’s not going away.”

If you’re interested in learning more about clinical operations in today’s ASCs, contact Thomas Crossen of Regent Surgical Health.