August 21, 2018

OR Manager’s ASC Blog: Welcome

By: Beverly Kirchner BSN, RN, CNOR, CASC

OR Manager’s ASC Blog: Welcome

by Beverly Kirchner BSN, RN, CNOR, CASC, COO, SurgeryDirect, LLC


It all starts with the first blog post.

This blog is meant for all ambulatory surgery center leaders (whether a charge nurse or an administrator) as a means to stay in the know (read: stay current) in an ambulatory industry that is evolving and changing at a faster rate than ever before.

OR Manager is teaming up with ambulatory leaders throughout the industry to create the ASC blog.

These leaders are going to share their stories and their expertise and hopefully provide you, the reader, with enough new knowledge to keep your head above water and your bottom line in the black.

I am humbled to be asked by OR Manager to write the first blog post. Having broad access to best practices and experiential learnings is essential to winning in today’s dynamic industry. The ambulatory pioneers would have loved to have a blog (sadly, blogs didn’t exist back then) like this to turn to. This blog is for you, and I cannot wait to see the path we take it on, together.

It is nice to know a little ambulatory history.

The ambulatory industry began as a concept in the mid-1960s. Healthcare professionals and government officials were looking for a way to make outpatient surgery more affordable. However, it wasn’t until February 12, 1970, that the first freestanding ambulatory surgery center (ASC) opened its doors to patients in Phoenix, Arizona. By the mid-1970s, there were 67 ASCs in operation. The industry continued to grow with the number of ASCs reaching triple digits by the end of 1979.

Other organizations, such as the American Society of Anesthesiologists (ASA) and the American Medical Association (AMA) began endorsing rules, regulations, and best practices for physicians working in an ASC. In 1982, the Centers for Medicare and Medicaid Services (CMS) began supporting the ambulatory industry as a payor. Back then, CMS allowed roughly 200 procedures.

It was 1985.

And I was just beginning my career as an ASC leader. This was a period of steep growth for the ASC industry. Nurses who took the leap from acute care to outpatient facilities had no one to guide them. There were few ambulatory educational programs and even fewer best practices. The federal and state agencies had not yet begun to publish guidance on the rules and regulations of how to manage an ASC.

I succeeded during this time thanks to our industry organizations, such as the Federation of Ambulatory Surgery Centers and the Association of periOperative Registered Nurses (AORN), as well as other experienced ASC nurses willing to share their stories and best practices with me. We had a lot of the same concerns back then: State health departments’ interpretation of the CMS Conditions for Coverage (CfC); licensure surveys (licensure was required in most states at that time); keeping up with changing regulations; and keeping costs down.


We have more agencies overseeing the ASC industry than anyone would have dreamed of in the beginning. There are presently 5,480 Medicare-certified ASCs in the United States. And this number does not account for ASCs that are office-based and/or choose to not be accredited. That means we have a community of roughly 6,000 ambulatory nurse leaders (math: one nurse leader for each ASC plus the management companies’ local, regional, and executive nurses).

Keeping up with change.

With the overwhelming amount of change happening in the ambulatory industry, the nurse leader needs help in keeping up with change. With as complicated as the 1,300+ rules and regulations the ambulatory industry is now measured against, the nurse leader needs more sources of information and learning than ever before.

As one of the premier sources for information on management of the inpatient and outpatient surgical suite for 31 years, OR Manager understands your needs, the needs of the ambulatory leader, and why high-quality information needs to be accurate, complete, consistent, unique and timely.

Through this blog.

The leaders of OR Manager are working tirelessly to provide you real-time updates and trends in the ambulatory industry, to help you be successful. Some of the upcoming blog topics are slated to include: Starting your Spine Program (Best Practices and Disasters to Avoid), Beginning Your Total Joint Program, Turning Data into Dollar$ (A QAPI Journey), New Ambulatory Regulations (and Impact to Your Bottom Line). However, as stated above, OR Manager is looking for your input to guide us down the path that you see as a need (or maybe you would like to contribute as a guest writer).

Look, none of us want to reinvent the wheel. We honestly don’t have the time for it. However, we can all strive to be life-long learners; always searching for ways to improve. As a seasoned (yes, that means I’m “older” not “old”) leader, OR Manager has helped me to make many successful changes within my ASCs. Whether it was ensuring compliance to rules, regulations and CfCs or helping me to improve my leadership and communication skills within today’s cross-generational workplace, OR Manager has been there.

Thank you.

This all works by having ambulatory nurse experts willing to share their knowledge and experiences, freely and by feedback and input from nurse leaders like you.

Now, as for how to end with a bang? Well, that’s another blog post for another time.


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