Managing the Red Zone-Part III

Today’s post is the final in our series covering Management of the Red Zone in ambulatory surgery center development.

Planning in the Red Zone
If this were an ideal world and everything was perfect, we could generally rely on our time-line to help us complete the project in an orderly manner. The world, however, isn’t perfect, and rarely, if ever, is the best of time-lines. The successful coach learns quickly how to adjust his plays in the Red Zone when scouting reports prove unreliable during the game. When we are about to enter the “Red Zone”, it is time to stop and determine how well we have achieved our objectives and whether any adjustments must be made.

When entering the “Red Zone”, it is time for the principals on the development team to meet, assess their progress to date, and develop a detailed plan to finalize the project. At a minimum the meeting should include the developer, the architect, the general contractor, the equipment planner, the interior designer, and the Center Director.

The General Contractor is the key player in this meeting and should be asked when the Certificate of Occupancy will be received. The general contractor should be told that the ASC will be scheduling equipment deliveries, hiring staff, and purchasing services based on this date. The date must be accurate and we will expect him to jump tall mountains or hire added staff, if necessary, to meet the date he gives us. Some would say this date is a function of the dates stipulated in the construction contract; however, we don’t mention contract dates at this meeting, and prefer to ask the contractor to commit to an absolute date. We have generally found that a contractor will impose a more demanding date on himself than if we impose an artificial date on him.

In certain circumstances, it may be advisable to offer economic incentives if the contractor can accelerate the schedule. Once we have the absolute date for the C.O., we have our eye on the project goal, and we can identify all remaining key tasks and their required completion time, in order to successfully cross the “Red Zone”. A list of items to be checked is provided as Illustration 1. This meeting and our identification of all remaining tasks becomes our “Red Zone” plan, which should be typed and distributed to all participants.

Red Zone Management
Just as the head coach is in charge of his team, one person should be charged with maintaining the plan and communicating changes to all participants. Each participant must understand that any deviation from the plan must be immediately reported to the person charged with maintaining the plan. The person in charge likewise has to communicate all changes to all participants, and devise a means of overcoming any obstacles that may cause the plan to fail.

Once the plan is distributed to members of the team, weekly conference calls (or more frequently, if necessary) with all team members can reinforce the process, and keep the plan alive.

Our Experience
We have used the Red Zone management method for the past three years, and have finished ninety percent or more of our projects on time. We have learned:

1. Early focus on the completion of the project leads to consensus building and on-time job completion.
2. We are able to eliminate the development of most crises’ near the end of the project.
3. We have been able to achieve better planning among all members of the development team.
4. Working capital budgets are met and pro-formas are generally not exceeded.
5. Medical partners have a higher degree of satisfaction in the process.
6. General Contractors like the process and honor their commitments.
7. The ASC opens on time, sees patients rapidly after opening, and receives reimbursements from patient care early in the process of center opening.
8. We dramatically reduce the time needed to fully develop a center, and thereby, save substantial resources as a result.
9. We cross the “Red Line”.

And as today’s successful football team can only be successful by consistently scoring from the Red Zone, today’s successful ASC was likely coached during the development process by a team that understands the value of Red Zone Management, a team that knows how to cross the Red Line.

Submitted by Fred Ortmann, President, CEO