2023 Road Warriors Share Their Secrets to Successful Interim Leadership
Our Interim Leadership shared how to set expectations and acknowledge fears. Give your successor something they can build on. These are just some guidance our 2023 Road Warriors shared in their interviews. Other highlights include tips for smoothing out surgical care coordination and how to capture that sometimes-elusive revenue boost. To watch full interviews, click here.
How do you quickly calm everyone’s fears about new leadership and gain staff confidence?
Cecily Proveaux – Make it very apparent that you are listening. Acknowledge their stress. Identify low-hanging fruit to establish trust with them. They need to know you’re not just there to show up every day but there to do something every day.
Sue Bowers – I take it slow for the first couple of weeks. Nobody likes a stiff broom coming and ripping off a band-aid. I let them get to know me, and I share some personal vignettes—good and bad stories—so they know that everything I do isn’t right. We’ll try things one way, then their way. We’ll tweak it. I’m not going to come in and make major changes. I also don’t want them to perceive me as someone who will come in and be gone. I want to put processes in place that will last.
Wayne McFatter – You need to meet with immediate supervisors to set expectations. I’m not here to upset the apple cart or turn the world around. I’m here to make their lives better. You go to the OR and spend time with staff and surgeons. Take baby steps in the beginning so they don’t get fearful. Learn their flow. There are a million ways to do things, and I want to learn about their culture and how they do things. I won’t change anything without understanding the why behind what you’re doing.
What initiatives or strategies have you implemented to increase revenues as an interim?
Rick Coffman – I look at the contracts with our vendors—internet providers, linen providers, surgical vendors—and see if I can renegotiate those contracts. I right-size staff, see if we’re paying our bills on time, and that our invoices are paid on time. I did that at Greenspring Surgery Center, where there was a very budgeted profit margin, and we realized a very high-profit margin.
Thomas Fields – One thing I’ve been working on is high efficiency. Working with anesthesia and our primary orthopedic surgeon, we went from 6 hips and knees per day to 10 per day and getting done by 3:15. We do this twice a week, Mondays and Thursdays. That enhanced revenue by millions of dollars annualized. Total resource expense did not increase because it’s the same FTEs. We worked diligently to reduce waste. This is now in its fifth month and running pretty well.
Wayne McFatter – Accessibility is probably the number one problem in most ORs because the volumes are out there—especially inpatient volumes—which translates over to surgery for the most part. We need to break down those barriers to access. We need a visualization of the schedule. Most surgeons have block time, but sometimes they need to work outside their block. They need to see what the availability is. That OR time goes unused.
Another big challenge is that nurse and surgical technician travelers are still eating up a lot of revenue. This is probably the second thing bringing revenue down. It’s a double-edged sword because you need people to handle the volume. If you can, create positions at your organizations and bring in new grads or people that can learn Periop 101 to increase staffing. The ability to grow and create your own OR nurses is key.
What are some of the challenges of surgical care coordination? How can directors make it smoother for patients, surgeons, and staff?
Cecily Proveaux – Keep the doors of communication open between all those different [stakeholders]. In some places, they’re all in the same department; in others, they’re not. Establishing a relationship with a contact person in each department is very effective. You let them know that you are the person they can talk to if they have issues. There’s more accountability if people have a more personal connection.
Nathan Mason – I look at inventory utilization. Looking at what sets we have: what’s in those trays, removing items, adding items, building new sets. When case delays and canceled procedures occur, surgeons can trace back to whether we had the right instruments at the right time. We need to ensure we have what is in line with the provider’s expectations.
Rick Coffman – Surgical care coordination is very dependent upon the specialty. Orthopedics, urology, colonoscopies, and endoscopies all look different. The surgery scheduler needs to capture on the front end to keep us from having canceled cases. I sit with the managers and charge nurses to let them know what they need to be on the lookout for on the front end. Our materials manager needs an opportunity to view the schedule to ensure they have the right equipment on the shelves before surgery happens. We need to know our patients understand their surgery. That goes back to the charge nurse interviewing the patient to make sure they understand everything.
Tips for mentoring your successor?
Cecily Proveaux – I do a lot of legwork in finding those contacts inside and outside the OR—people in facilities and clinical engineering. I work with the team to streamline processes. I write everything down and create a package to hand off. If I get the opportunity—which honestly doesn’t happen very often—I spend time with the person permanently placed in the position.
Rick Coffman – I provide a folder with all of the critical information. I have a meeting with them to talk about the culture, what to look for, and the pitfalls with each department so they have a good idea of what success looks like. I’m not telling them how to do their job. I’m just giving them a good understanding of the personalities at play. If they get that in the beginning, it gives them a better footing.
Wayne McFatter – As a manager or director, you go through many emotions during the day. You have to be able to keep an even keel. Take a deep breath and think about things before you react. Many people come at you from different directions, so maintaining composure and calmness will go a long way vs. automatically reacting to every situation. Everyone has made that mistake. Every story has two sides, so don’t overreact to one side before hearing both. Staff typically takes on your personality, so if you’re calm, cool, and collected, most of the time, staff will be that way too.