Building a High Performance Culture in Your ASC Part 1: Patient Safety & Improved Outcomes

Culture defines how people act day in and day out, and in an organization, it is the set of behaviors that determine both how things get done and why things get done. When you have a high-performing culture, it can impact all corners of your surgery center from increased staff engagement, to productivity, and even to better financial outcomes.

High-performing surgery centers achieve better financial and non-financial results (such as patient satisfaction, employee engagement and retention, etc.) than their peers over a long period of time.

For hospitals, an examination of data from 253 healthcare organizations revealed that more organizations with high percentages of highly-engaged units earned the top Leapfrog Hospital Safety grade compared to units with low engagement.

3 Key Steps

Building a high performance team in an ASC is no different than in any other industry since the same principles apply. No one-size-fits-all formula exists but there are key steps along the way of cultural transformation. Partners at Bain & Company suggest three key steps to build a high performance culture: ‘define, align and build.’

Define the new culture: The first job is to define what you want and to describe the goal in terms of specific behaviors on how you want to reshape your company culture.

Align the leadership team: Cultural change begins at the top and won’t get far if senior leaders aren’t on the same page.

Build: Build an organization that reinforces the culture. Align every element of your organization around the cultural objective and develop procedures, decision roles, and incentive systems to reinforce the culture.

Note that behavior change doesn’t happen automatically. Individuals may know what’s expected of them but they still need to embark on a personal journey of change before they truly live the new culture. When your staff “know” and “see” what’s important, they will be more likely to adopt your company culture and learn new behaviors.

Bain & Company research suggests that companies with a high-performance culture grow about 20 percent faster than average companies.

Bain research also identified 6 key attributes in every high performance culture:

• They aim high and are fundamentally dissatisfied with the status quo.
• They focus externally (customers or patients) rather than internal politics.
• They think and act like owners and take responsibility for overall performance.
• They have a tendency toward action.
• They support teams and reward team players who bring their personal best to the table
• They embrace change and innovation.  

Patient Safety & Improved Outcomes

According to an investigation by Kaiser Health News and the USA TODAY Network, more than 260 patients have died since 2013 after in-and-out procedures at surgery centers across the country (5,600+ centers). Thousands of times each year, surgery centers call 911 as patients experience minor to fatal complications. Healthcare-associated infections (HAI) are common and complicated — yet largely preventable.

For ASC’s, patient safety is not well documented since no national authority tracks the tragic outcomes. But for hospitals alone, the statistics clearly show that more should be done regarding patient safety on both ASC and hospital settings.

A 2018 LeapFrog Group report on healthcare-associated infections (HAI) revealed that each day, around one out of 25 patients in U.S. hospitals contracts an HAI. Of the approximately two million American patients who acquire an HAI annually, an estimated 90,000 will die.

Studies have shown that selected HAIs can be reduced by as much as 70% with the help of the proper patient safety interventions. This is why creating a patient safety culture is paramount in your facility. Here are key steps to take along with some recommendations by The American College of Surgeons:

Define

> Aim for "Zero Harm": Safety should permeate throughout facility operations to prevent avoidable harm to both patients and employees. Assess internal safety culture and identify ways to get more people involved.

>Apply physician-led, patient-centered care models: A team-based approach where resources are coordinated in all steps of care improves the quality and safety of an episode of care.

Align

> Surgical quality officer: A surgical quality officer can lead efforts to maintain and build clinical protocols, practice standards and internal systems that ensure quality patient care.

> Create an internal surgical safety and quality committee: The creation of a new committee dedicated to surgical safety and quality improvement with an infrastructure that allows it to be sustained over time is a long term way to improve surgical quality and safety.

Build

> Conduct quality improvement forums: ASC’s can review surgeon performance and case data to create opportunities to improve surgical care.

> Surgical reliability, safety and quality: Proactively improve ASC operations and procedures around surgical quality and safety.

> Use data to assess improvements: Benchmark performance and evaluate outcomes by collecting and using data to achieve surgical safety and quality improvements.

> Develop human resources procedures & incentive systems: Put top performers in the jobs where they have the greatest impact on critical decisions. Create incentive systems that encourage and reward improvement in patient safety.

Transforming into a high-performing culture is very effective and proactive way to improve ASC operations and procedures. By doing so, your ASC will stand out as a leader in patient safety and improving quality outcomes in the outpatient surgery setting.

In Part 2, we will focus on transforming your ASC culture to drive better patient experience and satisfaction.

David Hamilton is the CEO of Mnet Health Services, a Business Process as a Service (BPAAS) and Financial Technology (FinTech) firm with a specialized focus on End-to-End Revenue Cycle Management, Care Coordination, and Quality Assurance in the healthcare industry.