Ambulatory Surgery Centers (ASC) are busy – really, really busy. And yet one of the most time consuming processes is essential to their business – gaining ASC Medicare Certification through either AAAHC or AAAASF, whichever is most appropriate to their ASC. Working with experienced medical practice consultants who have deep experience with ASC Development is key, as the case study below indicates. Plus, this ASC took the opportunity to eliminate waste in workflow and improve overall operations.

Accreditation & Improved Workflow Processes make Clinic Vision a Reality
A local multi-clinic Eye Surgery Group with Ambulatory Surgery Centers (ASC) engaged us to help weigh the choices for accreditation, as well as for project management and oversight for the certification process. We worked with the ASC practice on the development and implementation of the chosen AAAASF Accreditation, including creation of policies, procedures and conducting a mock survey. Additionally, our ASC staffing redesign resulted in a projected $270,000 annual savings.
Phase I

• Review of accreditation standards for comparison to the client’s exiting Medicare (DOH) Certified ASC facility, as well as current operational policies and procedures, governing body documents, personnel policies, OSHA standards and Fire and Safety procedures.
• Assisted in the Functional Program and Facility physical layout design.

Phase II

DNA’s engagement continued in order to help coordinate completion of the required initial application documentation and ready the ASCs prior to the Accreditation site visit.
• Facilitated weekly leadership meetings to review progress and assign tasks. DNA also participated in the ASC facility design and safety requirements, including meeting with the DOH representative.
• DNA’s Certified Coder worked closely with the coding department, verifying and updating the ASC’s retinal fee schedules, facility and professional codes.
• Conducted mock survey site review for readiness prior to the survey visit. Clinic passed Accreditation after the initial site survey visit.

Phase III

The Medical Director requested that DNA conduct an operational assessment at designated ASC sites that would provide insight into patient flow, support staffing model and RN resource allocation. Recommendations were:
• Align Medical Assistants with appropriate tasks, freeing RNs to clinical focus.
• Assign RNs work that used their clinical, rather than administrative, skill set.
• Use a Just-in-Time (JIT) supply ordering methodology to improve space utilization as well as cash flow.

Results
Cost savings due to staffing model adjustments provided a cost-decrease of $8-10 per hour per FTE. Benefits included, savings totaled approximately $43-54,000 annually for a single ASC. Standardization of the proposed care delivery system throughout the four ASCs could approximate annual savings as high as $270,000.

The Eye Surgery Clinic stands as a proactive example of an organization ensuring their investments were solid and well-founded. Stakeholder decision-making had accurate, well-researched assumptions of volume and net revenue to rely on. The medical practice as a whole retains a sustainable position for cost-cutting due to initiatives undertaken during the Accreditation process. Natural attrition will allow continuation of staffing redesign, leaving the right staff doing the right work in the right amount of time.

Our clients are the best! See what another ASC client had to say about Derry, Nolan & Associates:

“I love my new ASC. The practice, office, and operating room space were flawlessly developed and managed by the team at Derry Nolan. Without them, I would not have arrived at this splendid practice setting.”— Dr. Dan Downey,
Downey Plastic Surgery

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