Karen has over thirty years of diverse healthcare administration and consulting experience and has held top-level nursing and hospital administration positions in the US and abroad.
Karen assumed the Chief Executive role at Kirby Bates in 2003. She wanted to combine her experience and expertise in nursing and hospital administration with her experience in healthcare consulting to shape exceptional healthcare leadership teams and ultimately improve patient care.
Karen was previously the Senior Vice President for Patient Services at Boston University Medical Center, and Associate Director of Nursing at the University of California, San Francisco. In 1990, she entered the international healthcare arena as the Executive Director and Chief Operating Officer at Healthcare International, LTD, an international tertiary care hospital and hotel complex near Glasgow, Scotland that she helped to design, equip, staff, commission and then manage. She began her consulting career in 1995 as a Senior Consultant, and then a Director, at Harvard Medical International, an affiliate of Harvard Medical School, where she provided consulting services in India, Abu Dhabi, Spain and various other international locations.
Karen has published papers on topics important to nursing administrators, including variable budgeting, operating room productivity and alternative patient care systems. She is particularly skilled in organizational evaluation and re-design, program planning, variable budgeting and staffing, and facility design. She quickly evaluates an organization and/or department and develops cost-effective recommendations for improving structure, roles and outcomes.
Karen has a strong professional network. She has been a member of the American Organization of Nurse Executives (AONE) for over 30 years, is a Past President and current member of the Organization of Nurse Leaders of Massachusetts, Rhode Island and New Hampshire (ONL), a current board member of the Pennsylvania Organization of Nurse Leaders (PONL) and a Fellow in the American College of Healthcare Executives (FACHE). Karen is also on the board and active in On Nursing Excellence, Inc., a non-profit 501(c)3 organization devoted to expand the effectiveness, efficiency, wellbeing and recognition of the healthcare workforce and she is a member of the API Advisory Board.
Karen received her Bachelor's Degree in Nursing from the University of Michigan, her Master's Degree in Administration from the University of California, San Francisco, and she completed a Johnson and Johnson Nursing Executive Fellowship at the Wharton School in Philadelphia, PA. Karen is also board certified by the American Nurses Credentialing Center as Nurse Executive Advanced (NEA-BC).
Melissa A. Fitzpatrick, MSN, RN, FAAN
Melissa has over thirty years of healthcare leadership experience and has held a variety of roles including Vice President of Critical Care and Cardiac Services at the Dartmouth-Hitchcock Medical Center and Senior Associate Chief Operating Officer and Chief Nurse Executive at Duke University Medical Center. Melissa also served as the Editor-in-Chief of the Nursing Management Journal and then as the Chief Healthcare Strategist at the SAS Institute. From 2007 until 2015, Melissa served as the first ever Vice President and Chief Clinical Officer at Hill-Rom. She joined the KBA team in 2019 as Chief Operating Officer and is responsible for leading the business operations, technology and marketing teams.
To each of her roles Melissa has brought decades of clinical and executive experience and domain expertise, thought leadership and strategic guidance to her teams as they work together to improve patient care delivery and caregiver safety and satisfaction. Melissa has served as a mentor and role model to thousands of nurses around the globe and as a consultant to hundreds of healthcare leaders and teams as they strive to improve clinical and operational outcomes and to reduce preventable adverse events.
Melissa is a nationally and internationally recognized consultant, speaker and author on clinical and leadership issues in healthcare, with many peer reviewed publications and book chapters to her credit. She is a highly sought-after motivational speaker who has delivered hundreds of national keynote addresses to a variety of nursing and healthcare audiences. Melissa is a past National President of the American Association of Critical-Care Nurses and the Foundation for Critical Care. She was inducted as a Fellow in the American Academy of Nursing in 1997 and was the Distinguished Alumna at the University of Pennsylvania in 2010. Melissa was featured on the cover of the February 2012 issue of Nurse Leader with an extensive interview as an AONE Leader to Watch. She received the 2017 Distinguished Alumna Award from Gwynedd Mercy University. Melissa is actively engaged as an officer, task force leader and member of many national nursing and healthcare organizations and Boards and serves our industry at the highest level with integrity and passion.
Melissa earned her Bachelor's degree in Nursing from Gwynedd-Mercy College and her Master's Degree in Nursing from the University of Pennsylvania.
M. Jane Fitzsimmons, MSN, RN
With more than thirty years of diverse healthcare leadership experience, Jane has expertise in executive search, leadership, and consulting. Prior to joining Kirby Bates in 2007, Jane held senior executive search positions with regional and international search firms. She has successfully managed executive and senior leadership searches for a broad range of healthcare organizations and systems across the country.
Jane has served in executive level positions as the Chief Operating Officer and Chief Nursing Officer in Massachusetts and Michigan. In these roles, Jane led the revitalization and turnaround of operations and patient care services. As the Vice President for Patient Care Policy for the Massachusetts Hospital Association, she worked directly with cabinet-level policy makers and provided leadership on state and federal policy. She has also established coalitions among health industry leaders and initiated action on critical healthcare legislative, regulatory and programmatic issues. Jane has consulted with healthcare organizations on leadership infrastructure, resource management, patient care services redesign, and achieving financial and quality imperatives.
Professionally active, Jane has served on a number of committees and boards for community, healthcare and professional organizations. She has presented at state and regional forums on a number of topics and has published in leading journals and publications. Jane is actively involved in the American Organization of Nurse Executives (AONE); the Organizations of Nurse Leaders MA, RI & NH, and the American Society for Healthcare Human Resources Administration.
Jane received her Bachelor of Science in Nursing from the University of Rhode Island and her Master of Science in Nursing from Boston University. She completed a post-graduate program in Health Policy at Harvard University and received certification in Health Care Mediation through Boston University School of Public Health. Jane is currently an Adjunct Faculty member at Emmanuel College School of Nursing and teaches Organizational Development in Healthcare in the graduate program.
Peggy Loughery, MSN, RN
Peggy has over fifteen years of diverse management and education experience in teaching, not-for-profit, and for-profit hospitals. Prior to joining Kirby Bates Associates, she held positions as nurse manager, nurse educator, and nursing supervisor. During her tenure as Nurse Manager, her unit was awarded Unit of the Year from Nursing Spectrum. Peggy also served as the Director of Staffing at the Medical College of Pennsylvania where she actively participated on the contract negotiation team and led the organization through a Nursing strike. In addition, Peggy has served as an interim manager and consultant in the areas of quality, staffing and scheduling. She has presented on clinical topics such as restraint reduction as well as patient focused care.
Since joining KBA in 2005, Peggy has conducted more than 200 leadership searches at organizations across the country. She has exceptional expertise in research and candidate development and has outstanding interpersonal skills. Peggy forms strong working relationships with clients and candidates and effectively meets client timelines by ensuring an efficient search process. Peggy also has a very broad and diverse professional network.
Peggy is a graduate of Hahnemann University/Drexel School of Nursing and completed her Bachelor's degree with honors at LaSalle University, Philadelphia, PA. She received her Master of Science in Nursing from Drexel University in 2018. Peggy is actively engaged in professional and community activities. She is a member of the Pennsylvania Organization of Nurse Leaders (PONL) as well as the Southeastern Pennsylvania Organization of Nurse Leaders (SEPONL).
Judy Hayes, MSN, RN, NEA-BC
Judy Hayes, MSN, RN, NEA-BC joined Kirby Bates in 2017 as Vice President of Executive Search and Interim Leadership. With 35 years of nursing leadership experience, Judy Hayes matches KBA clients with culturally complementary candidates.
Prior to joining Kirby Bates, Judy served as Vice President of Patient Care Services and Chief Nursing Officer at Brigham and Women's Faulkner Hospital, a Partners Healthcare member. Before that, she was Director of Professional Practice Quality and Staff Development; Director of Utilization and Care Management; and held other leadership roles at hospitals throughout the region.
During her tenure, Judy developed special expertise in creating new systems and roles for facilitating the nursing department's adoption of new technology, as well as new clinical roles. She also earned national recognition for patient satisfaction and quality results.
Judy earned a Bachelor of Science in Nursing at Saint Anselm College and was awarded a Master of Science in Nursing from Salem State University. She is board certified in Nursing Executive Administration by the ANCC and is a member of ONL for Massachusetts, Rhode Island, Connecticut, New Hampshire and Vermont, and AONE. Judy also serves as a member of the editorial board for Dimensions of Critical Care Nursing.
Livonne Engebrecht, BA
Livonne Engebrecht has served as a Search Associate at Kirby Bates Associates (KBA) since 2015. She brings 20 years of healthcare executive recruiting experience, having worked in two other specialty search firms before joining KBA. As a talent acquisition specialist, Livonne partners with nursing leaders to learn about their career trajectory and future goals, as they explore the next step in their career. She has excellent communication skills and attention to detail, ensuring an efficient and enjoyable process for every candidate.
Livonne strives to fully comprehend the unique needs of clients and candidates in order to meet the goals of the individuals and the organizations that KBA serves. She is passionate about her role as a member of the KBA team where she works with nursing leaders to identify candidates who meet the leadership needs of hospitals and healthcare organizations. She admires and respects executive nursing leaders for their expertise, education and dedication to delivering excellent patient care.
Livonne received her Bachelor of Science degree in Psychology. She grew up on Long Island NY, has lived in Westchester County NY, Sonoma County CA, Portland, OR and currently resides in Helena, MT. In her free time, she enjoys spending time with her beautiful granddaughter.
Erinn Riley is an experienced healthcare talent acquisition specialist, having worked in the areas of nursing, therapy, pharmacy, behavioral health and medical device recruitment.
Erinn initially joined Kirby Bates Associates as a Search Associate in 2011, returning in 2015 after a brief hiatus to explore the hiring and onboarding process through in-house corporate recruiting. Erinn's broad experience in healthcare search helps to bring fresh strategies to her candidate development methodology.
Prior to her current tenure with Kirby Bates Associates, Erinn was the Talent Acquisition Manager for a medical device company, where she managed a sales recruitment team, as well as online recruitment, candidate development and onboarding. Previously, Erinn was a Recruitment Consultant for a recruitment process outsourcing firm.
Earlier in her career, Erinn was a Department Leader, recruiting temporary and permanent healthcare professionals in Nursing, Therapy, Pharmacy and Behavioral Health, building out a geographic area in the state of Pennsylvania. Erinn began her career working as a recruiter specializing in the placement of Nursing professionals for Army Medical Centers in Hawaii and San Diego.
Erinn received her associate's degree in business from Delaware County Community College in Media, PA. In her personal time, Erinn enjoys spending time with her husband and four children.
Shari Berenson joined Kirby Bates Associates as Operations Manager of Search Services in January of 2017. Her work for KBA is focused on ensuring operational efficiencies among the Retained Search team and coordinating logistics between clients and candidates during the interview phase.
Prior to joining KBA, Shari served as the Senior Executive Assistant to the Chief Product Officer for Progress Software, NC, supporting a global team. Shari's career combines healthcare administrative and executive search experience that spans over 15 years. She served as Executive Assistant to the Chief Operating Officer and the Vice President of Operations at Lahey Beverly Hospital, and as Executive Assistant for two Boston‐based executive search firms: CT Partners and RM Nephew and Associates. In the latter positions, she supported senior partners in C‐Suite and Board recruitment.
Doris A. Sinkevich, MS, RN, CENP
Doris has over thirty years of nursing and healthcare leadership experience in acute care, behavioral health, and long term acute care settings including public and private hospitals, for-profit organizations and private industry. She has held senior nursing leader leadership positions at multiple hospitals along with serving as Chief Operating Officer and Chief Nurse at Beth Israel Deaconess Hospital-Milton, Westwood-Pembroke Health System and Walden Behavioral Care, all in Massachusetts. In addition, she has served as an interim Chief Nursing Officer and Healthcare Consultant in numerous hospitals throughout New England.
In 2015, Doris assumed the role of Executive Vice President, Interim Services at Kirby Bates Associates. She leads the service line that provides expert executive and service line interim leaders at times when organizations are in need of transitional leadership. With considerable experience in C-Suite positons and as having served as an interim executive, Doris brings a unique perspective in leading the highly effective KBA interim leadership program.
Doris has demonstrated proficiency in many settings that have required significant change. Her greatest skills are often demonstrated in situations requiring turnaround and restructuring to achieve exemplary outcomes. She quickly establishes positive working relationships within environments and through this is able to develop highly functioning results-oriented teams. She has fostered transformation in several organizations resulting in highly reliable performance, consistently achieving high value, quality improvement and cost efficiency.
Doris has been a long standing member of the American Organization of Nurse Executives (AONE) along with being a Past President, Board member, current member, and committee member of the Organization of Nurse Leaders of MA, RI, NH, CT, and VT (ONL). She has frequently served as a preceptor for nursing administration master's degree students along with being a faculty member for review courses for the ANCC certification process. In addition, she is a member of the American College of Healthcare Executives. She has received recognition awards from a number of community groups including hospice and community life centers in reflection of her commitment to broaden the agenda of hospitals beyond the hospital walls.
Doris received her Bachelor of Science Degree in Nursing and her Master's Degree in Nursing Administration from Boston University School of Nursing. She holds distinction in being in the inaugural group of nurse executives who received national certification as Certified in Executive Nursing Practice (CENP) through the American Organization of Nurse Executives (AONE).
Colleen A. Chapp, MHA, MSN, RN, CENP, FACHE
Colleen is an accomplished healthcare executive with over thirty years of diverse and progressive clinical and operational leadership experience. Colleen has served as Chief Nursing Officer, Vice President of Patient Care Services, Regional Services Consultant, Senior Vice President for a national Interim Leadership Services Firm, and an Executive Healthcare Advisor. She provided Interim CEO and CNO executive services in Oregon, Nebraska, and Ohio. As Vice President, Interim Leadership Services with Kirby Bates Associates, Colleen will build on her foundation as an Interim Leader in healthcare organizations and ten years as a Leadership Advisor and Senior Vice President for an Interim Leadership Services Firm.
Colleen has operational leadership experience in acute care, continuum of care service lines, and professional services settings. Previous roles encompassed multi-campus medical centers, community hospitals, critical access hospitals in public, not-for-profit and for-profit health systems. Colleen has demonstrated success in performance and organizational improvement, professional relationship building, business development and growth, clinical-financial communication with positive results, and leadership development. She is recognized for creating collaborative environments, leading teams through change and transition, engaging interdisciplinary teams to effectively achieve organizational goals, working with Boards and Executive Teams on integration of community and regional resources, along with aligning strategic initiatives and community assessments resulting in plans for action.
Colleen has an expansive professional network. She is Certified in Executive Nursing Practice through the American Organization of Nurse Executives. She is a Fellow in the American College of Healthcare Executives, and has been a long-standing member in AONE and ACHE. Colleen is Certified as an Organization Transition Management Consultant. She is also a member of the Healthcare Finance Management association and Sigma Theta Tau International Nursing Society. Colleen was the first recipient of the Nebraska Rural Health Association President's Award.
Colleen received her Diploma in Nursing from Bryan Memorial Hospital School of Nursing, her Bachelor's Degree in Nursing and Master's Degree in Nursing Leadership from Seattle Pacific University, and a Master's Degree in Healthcare Administration from Chapman College. Colleen is a student in the Doctor of Strategic Leadership program at Regent University.
Dee Dana, MBA, BSN, RN
Dee joined Kirby Bates Associates in October of 2018 as Director of Talent Acquisition, Interim Services. Her focus is candidate recruitment and development with the goal of matching exceptional interim candidates with client organizations in need of executive nursing leadership. She is returning to Kirby Bates, having previously worked for Bates and Associates earlier in her career. At Bates and Associates, Dee had primary responsibility for candidate recruitment along with other aspects of leadership placements.
Dee has extensive nursing experience in a wide variety of clinical settings as well as private industry interim engagements, including a national pilot program with Hewlett-Packard. After receiving her MBA in Health and Medical Services Administration, she joined the Medical Information Services Department at Temple University Hospital in Philadelphia as Project Coordinator. While there, she was a key contributor to several major initiatives, including the implementation of the electronic medical record, registration and financial systems interfaces, and the opening of Temple University Children's Medical Center.
Dee received her bachelor's degree in Nursing from the University of Pennsylvania, and her MBA from Widener University. She lives outside of Philadelphia, PA.
Jacquie Acheson, AAS
Jacquie joined Kirby Bates Associates in March 2016 as Operations Manager, Interim Services. Her role ensures that operational details of every interim engagement are efficiently managed to streamline activities for interim leaders, while meeting all onboarding requirements to the client's satisfaction. Her expertise in organization, execution and attention to detail is exceptional and supports the expanding KBA interim service line.
With over thirty years of work experience, Jacquie has gained a strong background and many successes in administrative support roles in hospitals in MA as well as customer service and operational support in the financial and sales industries.
Prior to joining Kirby Bates, Jacquie served in Executive and Senior Administrative support roles at Beth Israel Deaconess Hospital-Milton and Walden Behavioral Care in Massachusetts. She has served in other administrative support and sales positions at several Fortune 500 companies, along with being a founding partner in 1985 of a successful insurance inspection company.
Jacquie received her Associate of Applied Science in Office Administration from Katharine Gibbs College, Boston, MA 2006.
Ellen Berenson, BA, AS
Ellen joined Kirby Bates Associates as Administrative Manager, Interim Services, in January 2019. Ellen facilitates the operational stages for interim engagements from business development through completion of the engagement. In this key role, Ellen ensures execution of all details resulting in high client satisfaction.
Ellen brings to KBA a wealth of Executive Search experience from past tenures as a Project Manager at RM Nephew and Associates, a Research Associate at Korn/Ferry International, and an Executive Assistant and Project Manager at Spencer Stuart. Ellen's retained search experience includes searches in Healthcare, Board, C-Suite, Technology, Finance, and Education. Prior to entering the Executive Search field in 2003, Ellen was an Office Manager for an investor relations firm.
Ellen began her career as an Operations Facilitator at American Express Business Travel Customer Service, where she managed corporate training, technology, statistical analysis and reporting for a large call center. Promoted to Area Team Leader, Ellen managed a portfolio of client travel offices in some of New England's largest corporations, including Bain & Company, McKinsey & Company, Textron and Motorola.
Ellen earned a Bachelor of Arts degree in Writing, Literature and Publishing, summa cum laude, from Emerson College and an Associate of Science degree in Travel/Tourism Management from Johnson & Wales University. Ellen is an avid photographer and editor of the Stony Brook Camera Club's award-winning newsletter, Reflections. She lives outside of Boston and enjoys spending time with her rescue pup, Boone.
Pamela DeCampli, MSN, RN, NEA-BC
Pam has thirty years of broad management experience in university teaching hospitals, private not-for-profit hospitals, and for-profit community hospitals. She has held senior nursing leadership positions at Thomas Jefferson University Hospital and Pennsylvania Hospital in Philadelphia. She was the Vice President for Patient Care Services at Graduate Hospital and the Chief Operating Officer at Medical College of Pennsylvania. Both of these organizations were part of Tenet Healthcare in Philadelphia. She is currently the Chief Transition Officer at Kirby Bates Associates, LLC where she leads healthcare management executive coaching services as well as leadership succession planning initiatives.
Pam has served on the Nurse Advisory Council of the Hospital Association of Pennsylvania and was an Adjunct Assistant Professor at MCP Hahnemann University for over six years. She has also been a Clinical Instructor at Thomas Jefferson University and the University of Pennsylvania, and a Clinical Associate at the Villanova University College of Nursing. Pam currently serves on the Board of Directors for the School of Nursing at Villanova University and is an active Board of Director for the Good Shepherd Rehabilitative Network.
Pam is a Past President of the Pennsylvania Nurses Association (PNA), Philadelphia County District, and has served on multiple PNA committees and boards. She served as Secretary and President to the Board of the Southeastern Pennsylvania Organization of Nurse Leaders and was a Board Director for the Pennsylvania Organization of Nurse Leaders as well as the local American College of Healthcare Executives Chapter serving as the Co-chair for the Career Development Committee for four years. She is a member of the American Organization of Nurse Executives, Pennsylvania Organization of Nurse Leaders and the Association of Perioperative Nurses.
Pam received her Bachelor of Science Degree in Nursing from Indiana University, Indianapolis, IN and her Master of Science in Nursing Administration from Villanova University in Villanova, PA. She is certified through the American Nurses Credential Committee as a Nurse Executive – Advanced.
Pam is particularly skilled in assessing organizations and developing practical approaches for enhancing both the quality and operational performance of services provided. She is a skilled professional certified coach and is frequently engaged to mentor and coach healthcare leaders. She has also given multiple presentations on managed care, pricing strategies, quality measurement, leadership, and other related topics.
Lorrie Favret Anderson
A knowledgeable sales and marketing healthcare industry professional, Lorrie has broad experience in business development, sales management, new product launches, and start-up business leadership. She began her career in the pharmaceutical sales industry with Lederle Laboratories and Wyeth in 1993. Lorrie distinguished herself as a reputable leader and effective sales professional with her ability to build trust and promote strong, long-lasting customer relationships by partnering with them and understanding their needs. Lorrie has worked with personnel from a wide variety of healthcare organizations including community hospitals, academic medical centers, and independent physician offices and managed care organizations.
Lorrie's start-up experience began in 2007 as Director of Business Development with Vestagen Protective Technologies, delivering advanced performance textile technologies to the medical market, focused on reducing hospital acquired infections. She then served as Director of Marketing for Agile Health, a start-up digital patient engagement organization offering a suite of trusted behavioral change programs using interactive text messaging.
Lorrie earned a BA in Political Science with French and History minors from the University of Alabama where she lettered in Waterskiing and served in the legislative and executive branches of Student Government. Lorrie is an avid runner, likes to travel and is a devoted school and church volunteer. She and her family live in Central Florida.
Jennifer Insua, BS
Over the past fifteen years, Jennifer has held various positions in hospital administration and healthcare human resources. Jennifer joined Kirby Bates Associates in September 2007. She is responsible for the operation of all office and human resource functions and financial management.
Prior to joining Kirby Bates, Jennifer served as a Human Resources Recruiting Assistant at Tenet Healthcare's Philadelphia Regional Corporate office. She also served as the Administrative Assistant to the Chief Nursing Officer and the Vice President of Clinical Services at Graduate Hospital in Philadelphia, and the Executive Assistant to the Chief Executive Officer at Elkins Park Hospital in Elkins Park, PA.
Jennifer received her Associate Degree in Science from Camden County College, Blackwood, NJ and her Bachelor of Science from Drexel University, Philadelphia, PA.
Nikhol Perez, MBA
Nikhol Perez has a decade of experience in coordinating accounting operations, preparing and analyzing financial statements and improving business processes. She joined Kirby Bates as Finance Manager in 2018.
Prior to joining Kirby Bates, Nikhol served as a Senior Accountant in various industries broadening her experiences. The foundation of Nikhol's success is her ability to align business strategy with established financial accounting principles. She strives to help companies increase profitability, achieve corporate goals and make informed business decisions.
Having recently earned a master's degree in business administration from University of Central Florida, Nikhol is well-equipped with the latest analytical tools, business techniques, problem-solving abilities and decision-making skills. Though she has highly desired accountant traits, she does not consider herself a typical accountant. She believes her strengths lie in her flexibility and ability to build relationships.
Betsy joined Kirby Bates in 2014 after serving for five years as a Research Specialist for an executive search firm serving children's hospitals nationally. Her responsibilities include: electronic marketing; formatting and revision of candidate resumes; researching organizations and resources; database and mailing list maintenance; and assistance with coordination and travel of candidates and staff.
Prior to beginning her career in search, Betsy spent 14 years at the University of Pennsylvania's School of Medicine as an Analyst and Manager in Administration and Finance. She attended the University of Pennsylvania's Wharton School of Business from 1989 – 1994.
This book provides experienced and novice healthcare leaders with the information, leadership structures, and practical strategies needed to successfully oversee both patient outcomes and balance sheets.
Unique Challenges from Surgical Services
Serving as the leader of surgical services within an organization can be a daunting endeavor for a new executive. Unless they have actually worked at an operating room (OR) table as a surgeon or surgical nurse or managed a surgical product line, most new executive leaders lack an operational frame of reference for the unique concerns and challenges present in the contemporary OR’s dynamic environment. The dress is different, the language unique and the management nuanced. Operating rooms have their own supply chain, scheduling and billing systems, and procedure codes. What can be touched or where one can safely tread is closely monitored.
Once referred to as “the workshop” of the hospital, with all of its tools and gadgets, the OR has rapidly evolved into a high-tech robotic center. Staying current with the ever-evolving clinical evidence on everything from safe patient positioning to the use of sophisticated technologies requires constant practitioner vigilance. Thousands of pages of federal and state regulations, along with various professional association practice guidelines, govern everything from cleaning protocols to physician preceptorships. Well-educated physician and nurse practitioners, emerging from the finest sites of higher learning, require thousands of additional hours of training to be judged proficient in the surgical arts. The fact that operating theatres are by necessity isolated from the rest of hospital operations makes it increasingly difficult for an executive to understand and experience this very different world.
In the past, it was not uncommon for surgical service operations to be the bastion of an elite group of physicians who operated behind closed doors, controlled the granting of practice privileges to colleagues and determined everything from professional standards of behavior to who would receive preferential time on the OR schedule.
However, the importance of the operating room to the overall success of a healthcare organization has cast a new light – a very bright spotlight — on operating rooms. It is of critical importance for the new executive to gain an immediate understanding of complex OR operations. While simultaneously providing the greatest contribution of total revenue for the average hospital, the OR represents the location of greatest legal and patient-safety risk and the largest investment in physical assets and materials.
Additionally, the rapidly evolving payment landscape now includes innovative provider models affecting ORs and once unthought-of partnerships. Surgeons can now be competitors and collaborators simultaneously as they develop their own surgical centers. Revolutionary technology is blurring the traditional boundaries of radiology, cardiology and surgery. The new executive may be rapidly immersed in conversations about building or buying ambulatory centers, recruiting a new surgeon in a technology-intense specialty or mediating block scheduling conflicts. Such topics rarely, if ever, emerge in other areas of hospital operations
A Systems Approach
The “operating room” was once the label for actual operating suites and all departmental activities related to the management of ORs, including finance, supply chain, materials management, scheduling and more. Organizations now recognize that effective management of this complex operation requires a systems approach, both to improve the way a patient experiences a surgical procedure and to align practitioners in the creation of effective and efficient processes. Increased payer interest in this most-costly aspect of healthcare also has fueled the new approach.
Industry process improvement efforts have confirmed the benefit of subsystem alignment as a precursor to system optimization. Once separate silos of care must now function in complete synchronicity for care to be safe, cost-effective and efficient. Navigating a patient through a surgical event requires the systemic efficiency of the following processes: scheduling in the physician’s office, preoperative testing and anesthesia assessment, the arrival and check-in processes, pre-procedure holding, the surgical procedure itself, post-anesthesia recovery and discharge and post-procedure follow-up. Optimizing any one of these processes does not necessarily improve the entire experience for either the patient or the provider.
As a result, formerly disparate departments or functions typically are now referred to as perioperative services or surgical services. This name change suggests more than a simple refresh of signage. Driven by contemporary payment structures, optimization of processes and labor across the entire surgical event is required. Additionally, competition is playing a major role. Hospitals are now competing with a growing number of alternate sites for delivery of surgical services, including surgeon offices, ambulatory surgery centers and even clinics in the local mall. Each of these sites advertises the fact that procedures can be performed cheaper, quicker and with great convenience. Customers are responding.
The term “surgical services” is used in this text to refer to the surgical product line and the fully integrated system of surgical care, including sites of care (inpatient and outpatient) and their strategic, operational, management and business processes. When referring to the actual suite where the procedure is performed, the term “operating room” is used.
About Kirby Bates Associates Kirby Bates Associates, LLC, drives healthcare organizations to achieve high quality, cost-effective patient care through a comprehensive portfolio of proven leadership services, including Executive Search, Interim Leadership, Leadership Coaching and Operations Consulting. As former CEOs, COOs and CNOs, our effective approaches achieve sustainable outcomes for our clients’ greatest leadership challenges.
About Sullivan Healthcare Consulting Sullivan Healthcare Consulting (SHC) helps maximize the return on investment in the perioperative suites of hospitals and ambulatory surgery centers. The firm’s consulting practice serves clients across the United States and Canada. Toll free number: 866-303-8968.
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