What Makes Some Outpatient Surgery Centers More Efficient Than Others

Walk into two different ambulatory surgery centers on the same day—and you’d swear you’re in completely different fields. One runs like a well-oiled machine and everyone glides from pre-op to the actual operation at the correct times with everyone knowing what they’re doing. The other? Delays manifest, empty operating rooms abound as people wait for their own turn, and staff who had expected to have an easy day now look stressed.

It’s not that one surgeon is better than the other or that one center has shiner equipment than the other. Instead, it’s how everything operates. But what’s worse is that when a center operates ineffectively, it compromises patient safety, employee satisfaction, and the business’s entire viability.

But What’s the Real Issue with Scheduling?

Most surgery centers think they know how to schedule their operations. They block off times, book the procedures, and it’s a done deal. But what’s most efficient? They’ve calculated their actual case times—not what everyone hoped would be the case.

A knee arthroscopy may be slated for 45 minutes. By the time you factor in appropriate positioning, actual procedure and turnover, it’s more likely upwards of 75 minutes. If each center is expecting about a dozen cases a day, it sheds light on why some centers are two hours behind by twelve o’clock.

The more efficient facilities keep obsessive track of their real numbers. They understand that Dr. Johnson runs an average of 15 minutes longer than Dr. Smith on the same procedure—since it’s her first case of the day—so they allot that time into the schedule instead of wishing it weren’t true. It may seem simple, but few places do it because it requires someone responsible for pulling the data to make unpopular scheduling decisions that frustrate a physician who simply wants to back-to-back cases without any extra time.

Turnover Will Make or Break Your Day

This is where it gets expensive. If you have an operating room that’s empty, money is quite literally leaving the building. The center pays for the room, instrumentation and staff regardless of whether it’s occupied; therefore, single-digits-minutes add up exponentially if multiple rooms are running behind.

In efficient facilities, turnover of rooms happens with precision. It’s not about rushing a cleaning team—it’s about anticipation. The next patient is in pre-op, already aware they’re up next. The surgical trays are prepped beforehand with no clutter. The anesthesiologist knows exactly when they need to arrive to provide care. Everything happens in parallel instead of sequentially.

In struggling centers? They clean a room and find themselves waiting for the next patient to finish preparations. Or the next patient’s ready but the instruments aren’t yet processed. Or they’ve prepped everything but the anesthesiologist is still finalizing notes from another case down the hall. It may only be ten or fifteen minutes at a time—but after several rooms and several case turnovers, you’ve lost an additional day’s worth of cases.

Facilities looking to rectify this operational element often rely on ambulatory surgery center consulting professionals to help assess what they can do better and identify problematic areas that impede efficiency.

Staffing Models that Make Sense

Where a lot of centers go wrong is with staffing from the very beginning. They either overstaff—killing their profitability percentages—and understaff—creating chaos and overwhelming their employees during tough seasons when they should have help.

The most efficient centers figure out flexible staffing models based on their actual case volume. Some cut per-diem staff on heavy days to avoid full-time staff sitting idly on slower days—and vice versa—so they bring in transient personnel when needed. Others cross train their team well-enough so nurses can float between PACU, pre-op and sometimes even to the front desk if there’s an overflow of patients needing help.

It requires more upfront training but means you’re not paying five people to do nothing when you only need three.

The staffing conversation is sensitive because it involves labor expenses—which are usually second only to rent and equipment expenses in terms of overhead—and cut too closely results in loss of quality but too high means centers can’t compete on price.

The most efficient centers adjust their staffing ratios against case volume monthly—but the rest do an annual review at best.

Supply Chain Optimizations (Or Lack Thereof)

You would think ordering supplies wouldn’t be complicated—but you’d be amazed at how many dollars get flushed down the toilet here. Some centers order based on gut feeling with no real tracking determining what’s used versus what’s expired on the shelf.

The most efficient centers have preference cards—and actual cards—for each surgeon that are up-to-date and realistic. They track supply costs per case and realize when things start going up and has negotiated group purchasing agreements—and actually uses them instead of blindly ordering whatever rep walks through that day with lunch.

There’s also inventory management at stake, as well. Too much inventory ties up cash and generates waste; too little means constant emergency orders at exorbitant prices; finding a sweet spot is ideal when someone pays attention—but you’d be surprised how often this doesn’t occur.

Communication Systems That Don’t Rely on Mind Reading

Less-efficient centers rely on people shouting down hallways, frantic texting during procedures or hoping someone checks a whiteboard when it comes to communication among staff about what’s going on in any other department.

More well-oiled machines possess real communication systems, updated dashboards displaying case status or opportunities for handoffs by structured means where everyone is on the same page.

The surgeon knows when they should arrive because someone tells them at that time—they don’t wonder why they’re arriving 30 minutes early “just in case.” PACU nurses know how many patients are coming and at what time so they can prepare themselves accordingly. The front desk gets accurate information so they can relay messages to families.

The Financial Transparency Element

The most efficient ambulatory surgery centers share financial information with other leaders—even other staff. Everyone has access to how much each case needs to be profitable, how much each instrument costs, and what each minute of operating room time equates.

The most inefficient centers withhold financial information like it’s top-secret; therefore, staff possess no context regarding why certain decisions get made—or why efficiency even matters.

People stop wasting supplies because they know the cost. They stop booking cases that lose money instead opting for educated decision-making. They find ways to work smarter because they’ve been informed why it matters.

The most inefficient centers treat financial information like it’s a state secret; therefore, their staff has no context regarding why certain decisions get made—or why efficiency even matters.

What This All Means

The difference between efficiency and incompetency isn’t one easy fix; instead, there’s some magic combination of multiple small decisions made operationally that are either compounded into excellence or manifest mounting dysfunction.

The centers that make this happen usually have someone focused on operations who has both insights into clinical research alongside business acumen—and authority—to create changes based on uncomfortable short-term findings but ultimately beneficial long-term adjustments.

Everyone knows they’re running inefficiently at best—the question remains whether people are willing to dive into real numbers by challenging assumptions and making operational adjustments that make them stand apart from the rest.