Today I am the administrator of Physicians Surgical Center in Lebanon, Pa., a bustling facility with a staff of 25 that cares for 100-plus patients each week. But my ORs weren't always filled, or even built, for that matter. I was hired in April 2005 to manage a center that was still under construction and scheduled to open four months later. I didn't have a desk, a co-worker or even a clue as to where to start. Only one thing was clear: I needed help.