Building a Culture of Excellence w/ Todd Currier CPA CASC CMPE

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Erik Sunset: Hello and welcome back. I’m Erik Sunset, the host of the DocBuddy journal. Here at DocBuddy, we deliver healthcare solutions that take the pain and cost out of broken workflows. Today, we’re joined by Todd Currier. Todd is a certified public accountant, a certified administrator of surgery centers, and currently serves as the CEO of Bend Surgery Center in Bend, Oregon.

Erik Sunset: And he is also on the ASCA board of directors. So very busy gentlemen, Todd, thanks for taking a little time out of your schedule to join the show.

Todd Currier: bet. It’s good to be here.

Erik Sunset: And one of the reasons we’re together today is that you have actually got a speaking slot at ASCA the annual conference taking place in Orlando next month, April 17th through 20th. If you’ve listened to the show before, you know that we here at DocBuddy are big fans of ASCA and everything that the organization does to advance the cause of surgery centers.

Erik Sunset: Todd, your speaking slot centers around building a culture of [00:01:00] excellence in your ASC. I believe that’s Thursday morning. Why is that important? Why is that important for a surgery center to have any type of culture at all, I guess, as a place to start?

Todd Currier: I guess I, I feel that the, you know, your culture really defines your center and every surgery center has their own culture, but it really, you know, it promotes your values, your attitudes you know, your standards and your norms and really helps direct your staff and the direction that your center is going.

Erik Sunset: Makes sense to me. Obviously culture is a huge part of any business. You know, you can get into the organizational psychology of it and all the different levels and layers that folks may or may not have to navigate. And certainly don’t want you to spoil your, your, your upcoming talk next month. But maybe if it’d be okay, share a couple of the, the high points or a couple of the the key takeaways you’ll hope people will leave with.

Todd Currier: Probably the, the main areas I’m probably going to be focusing on is really [00:02:00] defining your culture having creating accountability for quality of care creating the atmosphere of safety, um, you know culture over your business operations and fiduciary controls. And probably the final one is just building a strong workforce through culture.

Erik Sunset: The workforce piece is huge. You know, you can open up Becker’s ASC and see stories essentially every day of the week about all of the challenges surgery centers have both hiring and maintaining staffing. You know, how do you think culture plays into avoiding those hurdles or removing those roadblocks?

Todd Currier: Really, you know, it gets back to the, we, we put so much time and energy every single week in our work life. And so we, we need to love what we do. And I tell my staff all the, all the time, you need to love what you do and love where you do it. Cause we spend too much of our, our daily lives and. working.

Todd Currier: And so creating [00:03:00] that for the staff and having them involved in it is vitally important.

Erik Sunset: And to that point a recent guest who’s coincidentally also a speaker at ASCA next month, Nyleen Flores, certainly don’t want to paint broad strokes, but in general, she shared that, you know, if you’re looking at a similar rule between the surgery center and the hospital, that oftentimes, and again, not making any assumptions about any individual center’s compensation plans or how aggressive that is, Oftentimes the hospital will hire reimbursement for you, the individual, you know, reimbursements, maybe not the right word there.

Erik Sunset: Higher salary is the word we’re looking for. But she also pointed out that there’s a big split. There’s a very, it’s a very different animal, very different machine working in the hospital as opposed to a surgery center. You know, to my mind, it seems like there’s a lot of draw to a stronger culture at that surgery center versus maybe being more of a cog in the machine despite the higher pay at a hospital.

Todd Currier: Yeah, I think [00:04:00] everybody across the country has, has seen this as the the, the rising cost of our workforce and the competitiveness of getting them. We’ve seen in our local market, the local hospital system has had some significant raises with their staff. And you know, we just cannot chase them.

Todd Currier: And that just doesn’t work. And so having a strong culture within the center is vital. Having that, you know, that family unit, you know, a place where the staff want to come. I’ve told my staff many a times that if they have to chase the dollar, Go chase it, because it’s out there. You know, I, I can’t stop them from doing that, but if they want to stay here and be part of something that is you know, the camaraderie, the, what we’re doing for what I feel the healthcare system is is vital to the future of healthcare.

Todd Currier: And they can be part of that.

Erik Sunset: And I imagine when you get that buy [00:05:00] in maybe there’s enough data to analyze this. Maybe there’s not, but I imagine with that buy in with the staff that really cares about, about the mission. And obviously the mission we’re talking about with surgery centers is being able to deliver stellar outcomes for less costs to the patient, better experience for the patient.

Erik Sunset: Potentially less burnout for the provider. You have this win win win where all parties concerned win at the surgery center, um, that those patient outcomes and patient satisfaction are higher. This is kind of a long walk for a short drink of water that one of the, one of the hurdles that ASCs as a whole face is just awareness.

Erik Sunset: You know, in my life, my family asks, what, what do I do? What kind of things are you working on? And we started talking about the surgery center. And a lot of times the question comes back, like, what do you mean? I’m not sure what a surgery center is. And then it’s, oh, well, you need to understand this about it.

Erik Sunset: So do you see that staff, this is coming back to the central point, the staff buy in, the culture that you create, delivering better patient outcomes and making the ASC [00:06:00] something that people recognize and that they would choose to have procedures performed at.

Todd Currier: Oh, definitely. And we’ve actually created, we expanded in 2022, we expanded our operations. And so we, we. We had a significant hiring and our staff expanded significantly. And one of the fears we had was the losing our culture, losing what we had spent 25 years building. And so we created, we call it the Culture Club. So it’s a staff ran club that helps create those, create that environment that benefits them the most. I sit on it, but I’m, I’m just every, just another member of that club, you know, they, they have their own president, they, they get to decide, like what external activities we’re going to do, what internal activities we’re going to do.

Todd Currier: And, you know, To try to promote the, that, that [00:07:00] positive experience as an employee.

Erik Sunset: What are some of those activities that get people the most excited, be it internal or external?

Todd Currier: wEll, not associated with culture club, but annually we do a employee appreciation week to where the leadership team does you know, we do an early morning breakfast, the breakfast sandwiches for everybody. And we do a barbecue lunch during that week. And we, we. Give out just nominal little swag items and we have a sunday ice cream sunday day.

Todd Currier: So something different every single day of the week. The other things we’ve, we’ve done is just you know, the get togethers for the nonprofit walks. We’ve looked into Habitat for Humanity crew to help out on a given day. And a bowling night was a huge, huge hit and then we do a summer barbecue also.

Todd Currier: So, it’s something Seems like every single month there’s something new that we’re doing. Most recently [00:08:00] was when we expanded our building, we have a lot of bare walls. And so we live in an area with a lot of great outdoor activities and, and scenery. And so we, the staff has sent like 150 different photos.

Todd Currier: And, and we’re getting those printed and put it, put up on our walls.

Erik Sunset: That’s, I mean, that’s a dedication to culture. You won’t find, I imagine at most surgery centers or maybe even most organizations and at a Ruby a little bit, the real question here, Todd, are you the one manning the smoker for the barbecue lunch and barbecue days?

Todd Currier: Of course, I have my apron and I got my spatula,

Erik Sunset: You’re all over it. That’s fantastic. Well, let’s, let’s steer our conversation back to back to sort of ASC operations. For, for many reasons, ASCs haven’t always been the most eager to adopt new technology. I know that’s not the case with with Bend Surgery Center, [00:09:00] but without a Medicare mandate or Medicare penalty rather to ASC.

Erik Sunset: And just, it’s, it’s starting to happen, but it’s lagging behind practices in the hospitals. Obviously we all know that. For what you’re, for what you’re doing and for what you see. You know, what are some of the key areas that technology augments your operation? This could be managing block times and staffing, ensuring case profitability.

Erik Sunset: The surgery center, despite how well things are going and how things are trending it’s still getting squeezed in a lot of different directions, whether it’s staffing or declining reimbursements for a particular procedure. So how, how do you view technology at your center?

Todd Currier: I view it as a, it’s the necessary evil in some senses because we went to electronic records about 3 years ago. We’ve actually did quite well and adopting it and, and it’s been working, but now, now we’re in that phase of really [00:10:00] tweaking it to make it truly beneficial and more efficient for us. And so when I look at the necessary evils, you need to go down that road, but also It has to work for you.

Todd Currier: It’s, you know, the analogy is like like Microsoft Excel. It’s like, you know, you use about 10 percent of what it’s capable of doing. And so really. Getting into it. We got a lot of, there’s a lot of great products out there and it’s just maximizing the use of those. And that’s, we’re really in that phase this year.

Todd Currier: We’ve made it a strategic planning opportunity for us to, to take our software and, and push it to the next level. The extent it’s supposed to be used,

Erik Sunset: I think that’s really key. And you may not, may not know this about me, Todd, but I spent a lot of my career in Electronic health records for the practice setting primarily, but that what you just outlined is paramount that you can buy it, open it up and use it out of the box. But how are your workflows adapting to the software when it [00:11:00] really ought to be the other way around, even when your workflows change software should be serving you, you shouldn’t be bending to it.

Todd Currier: correct?

Erik Sunset: Kind of in an interesting aside to this, that in the past few months we had a guest, Dr. David Norris, who is all about empowering physicians to be better business leaders for their own practices. And he had a really interesting view of capturing ROI from a technology expenditure, and I’ll try to do him justice on the quote here, but he kind of looked at me and cocked his head and said, like, Return on investment.

Erik Sunset: This type of technology doesn’t sit on my balance sheet. It sits as a line on my P and L I’m paying for it. So I need to be sure that I’m getting the most value out of this expense rather than trying to get a return on investment out of it, because technically I can’t you know, in the purest financial sense of the term I just need to be sure that it does everything that I want it to do.

Erik Sunset: [00:12:00] So in the, in the culture of excellence that you’ve created, Are you going through each stakeholder on, on some sort of cadence and saying, folks at my front desk, folks that are doing scheduling folks in my billing office, what are your workflows and can the tool better serve you, or what do we need to do to make it more impactful in your day to day?

Todd Currier: I think you just hit it on the head. It’s it’s going to each granular level and and finding out what is working for them, what is not working for them, what would be their ideal and where we are today. And, and really taking it at that level and saying now, now we need to start modifying some of it’s us, you know, we’re just ingrained in, in old ways.

Todd Currier: And so just because you got it on, it’s electronic now, we’re still thinking and processing things in our, in our own mannerism. the old way. And [00:13:00] so it’s, it’s funny when you sit down and you do take it to that granular level, stuff starts to pop out. And it’s, you know, why are you doing this? Well, because that’s what we’ve always done.

Todd Currier: I was like, what do you realize the, The technology is doing that also. We don’t need to redo what it’s already doing.

Erik Sunset: To that point, you mentioned Excel, which you didn’t ask me, but if you had maybe the most perfect and complete software ever, ever written, and to your point, you know, we’re still doing things the old way. Well, Excel’s at least it used to, I don’t know if it does anymore, but F1, open up that help window and ask it for for whatever it is you’re trying to do. And speaking of old way versus new way, one of the, one of the things we chatted about before we hit record was around optimizing anesthesia services for your facility. And there’s a lot, a lot of facets to that. How does technology help there? What are some of the things that you do to ensure you’ve got it?[00:14:00]

Erik Sunset: Successful partnership with your anesthesia team, a

Todd Currier: far as technology goes, it’s really looking at our utilization. And we have a very strong relationship with our anesthesia providers. We have a single group, external group that we utilize. And we work, we’ve been working very hard with them because just like Everybody and across the nation, there’s a shortage.

Todd Currier: But part of that shortage, you want to, the providers you have, you want to maximize their time. And so we’ve been working with them for the last year and a half and probably meeting on a monthly basis every month, every two months just to look at our block time utilization, look at, you know, how, how can we squeeze out more efficiencies not only for them, you know, but honestly for us too.

Todd Currier: They, if we maximize anesthesia time, we’re also maximizing our staff time. So there’s times that we will consolidate rooms, two rooms into one that way we can reduce the number of [00:15:00] anesthesia providers we are required to have and but it’s also, It helps in our staffing also. So, so having that cohesive partnership with them has been vital.

Todd Currier: And technology is important in that because it, you know, that block utilization is, it’s really key to determining which providers, which surgeons are not utilizing their block time. Maybe you need to give up some block time, some that are using more. And we need to, we need to find ways to add additional rooms for them.

Erik Sunset: hundred percent. I mean, at the end of the day, to keep the lights on the ASC has to be a profitable business while delivering excellent patient outcomes. We don’t ever want to lose sight of that, but it is still a business at the end of the day. Right.

Todd Currier: Correct.

Erik Sunset: So continuing down our sort of list of bullet points here, one of the hottest topics for the last six months, it feels like actually it feels like a lifetime now surrounds AI. In healthcare and it [00:16:00] takes on a lot of different a lot of different functionality. You have some EHRs now that are embedding chat GPT into their products.

Erik Sunset: You have NYU using AI to give structure to unstructured handwritten notes and making that something that you can analyze now. So a lot of different paths that it’s taking and even more paths that it will take, what kind of thoughts do you have on AI?

Todd Currier: I see it being very integrated in the future. You know, the future for some of it is now. I, I think where we, where I personally am is I’m still kind of at the wait and see point. I think I, I have other software right now that I’m really trying to maximize. But I’m, I have a very keen eye on this because I, I do feel that there’s gonna be some great benefit in the future.

Erik Sunset: Yeah, it’s, it’s interesting. I, I fall into a similar boat, I think with some of the physician documentation tools out there, [00:17:00] when they’re embedded in an EHR, what, what will take the physician less time is in a, in a practice based setting or in a hospital based setting, these technologies they’re asked and demanded to use in some cases.

Erik Sunset: Is there a number one cause of burnout? So what will take less time? This is kind of what I wrestle with. You click the button, you get the AI generated note. You don’t have to go proof it because ultimately your name’s on it, doc. You’re signing that this is complete and correct, or you just do the documentation and how you’ve always done.

Erik Sunset: Without AI. So we’ll, we’ll see, but it’s really, I think it’s particularly interesting because in a space that doesn’t traditionally love any type of new technology, healthcare is just flocking to AI.

Todd Currier: Correct. And I, I agree. It seems like that’s this mad rush towards it. But then I guess I want to see what the fallout is from it.

 

Erik Sunset: I know everybody’s closely tuned into that. And then Todd, if [00:18:00] you’re on the mountaintop there in Alaska, a long day of fishing and you could shout top of your lungs. One thing that everybody in every ASC could know that you said, what would it be?

Todd Currier: I think it just goes back to the basics is that you build your your center on safe quality care. You build it off your volume and you treat your staff right. Things are going to go quite well for you. buT, you know, tight, you get back to the basics of, you know, we provide we have a great story to tell, you know, that’s ASCA right there.

Todd Currier: Is that, you know, we have a great story to tell go out there and tell it, tell it to your staff. Tell it to the community, tell it to your doctor just routinely that, you know, we are the. epitome of to me, to me, we’re the epitome of healthcare reform. You know, we, we provide a great product at a cheaper price in a, in a, you know, it’s safe quality [00:19:00] product for price for the payer, cheap price for the patients and everybody, and the satisfaction, patient satisfaction is great.

Erik Sunset: I’m with you. You know, that’s the three P’s of the ASC equation, the patient, the provider, and we’ll even throw the payer a bone, you know, usually left out on the cold there, but everybody wins. It’s a, and it’s badly needed, badly needed. As you said, this is the reform everybody’s asking for. It’s time to embrace it. Well, Todd, what what didn’t we cover that we should hear? I

Todd Currier: You know, I anxious to see everybody at ASCA, it’s always a great conference to get everybody together. It’s the camaraderie of our peers. It’s the vendor representation. So it’s a great time. If people haven’t signed up, they should go. I would, I would plug that just for that reason I’ve been going for the last 16, 17 years, and it’s something that I enjoy [00:20:00] every year, just whether it’s the classes, the seminars, and or just the, the meeting the peers, because I think we all learn a little more from each other every time I go.

Erik Sunset: think that’s a really interesting thing about the ASCA annual conference as well. Having seen a wide swath of health IT shows and different specialty association shows, you know, the whole spectrum, everybody really does go to ASCA to get better now, HIMSS was this past week in Orlando, and that can be.

Erik Sunset: Just overwhelming. And that’s turned really into just a vendor fair. I didn’t make the trip this year, so maybe I shouldn’t have an opinion about this past week’s show, but the texture of ASCA’s annual conference is a cut above the rest. And if you haven’t already, we’ll include this link in the show notes, but it’s ASC association.

Erik Sunset: org and you’ll be able to find where to register and where you can get housing, Gaylord Palms in Orlando this year, which is a great venue as well. Well, Todd, as we [00:21:00] wrap up, where can our listeners connect with you? Are you big on any social medias?

Todd Currier: I’m on LinkedIn. I guess, just under my name, I’m holding a nice brown trout. That would be me. And also, if you were to contact Ben’s Surgery Center, tcurrier at bensurgerycenter. com I’ll be happy to communicate with anybody out there, because I think working together, we all learn.

Erik Sunset: That sounds fantastic. Well, Todd, thank you again for joining us. And on behalf of the entire DocBuddy team, thank you for listening. Be sure you’re subscribed on Apple Podcasts, Spotify, and YouTube. So you always get the newest episodes of the show. And until next time, I’m your host, Erik Sunset. We’ll talk soon.

Todd Currier: Thank you, Erik.