Archive ORX Session Previews 2016

Resuscitating a Dying Surgical Center

You'll learn many do's and don'ts from this amazing turnaround story.

Carol Cappella, RN, MSN, CNOR

OR Excellence
Carol Cappella, RN, MSN, CNOR Carol Cappella,
RN, MSN, CNOR

Speaker Profile

  • More than 30 years of experience in acute care hospitals and health systems.
  • Experience includes 20 years as surgical facility leader.
  • Worked as a consultant before taking on the challenge at the Delray Beach Surgery Center, where she serves as clinical director.

In 2009, the Delray Beach (Fla.) Surgery Center was on its deathbed. It had been sold several times and was on the verge of foreclosure. But the prospective new owners recognized that there was still potential — in the right hands. They recruited Carol Cappella, RN, MSN, CNOR, to bring it back to life. In her OR Excellence presentation "Resuscitating a Dying Surgical Center," Ms. Cappella will explain how she embraced the challenge and helped turn the previously moribund facility into the thriving center it is today.

  • Fortuitous phone call. In 2009 I got a phone call from the potential new owners, asking whether I wanted to come to Florida and help revive the Delray Beach Surgery Center. They were contemplating trying to revive it, but knew they needed a clinical director to help them. Coincidentally, I'd bought a condo in Delray Beach a couple of years earlier, but hadn't moved there yet. I thought, Wow, it seems like this is meant to be.
  • The challenge. The center wasn't really being managed by anybody. They had a management company that came down once every quarter, but nobody was really watching it. There were issues with supply management, inventory, getting bills paid and getting money in because there was no real oversight. Plus they had very poor contracts providing terrible reimbursement. On top of that, it was a hoarders' paradise. You couldn't walk down the hallways, because there was so much clutter. The business office was boxes and boxes of files. Every drawer was filled with piles of paper. Every nook and cranny was stacked to the ceiling with boxes. And a lot of the employees weren't qualified to do the jobs they were doing.
  • The potential. There was opportunity beyond belief, but I knew I had to get through all the muck to find it. They had a great market and great volume — in 2009, they had about 3,000 cases. My first priority was to keep the schedule going, to maintain the status quo while I figured out how to de-clutter the place and get the supplies I needed.
  • The process. I don't think I breathed for about 6 months. It was tough getting the building up to standards. Every room had a sink, and we had no money, so I would come in every weekend and take the cabinets and the sinks out, and re-patch and repaint the walls. I remember thinking, I could go back to being a hospital administrator and make a lot more money, but I knew I could have a better quality of life here.
  • The payoff. We started in May, and the following December we finally signed all the papers for the new ownership. At that meeting, the owners said they'd like to give me a Christmas bonus, but would I mind if we gave the physician-partners dividend checks instead. It was a way to show that we were really turning things around. Even though the checks were meager, their faces when I handed them the checks were a revelation. It was the first time they'd gotten them in years. They knew we weren't in the dog days anymore.
  • The present. We now have 30 employees and we did 4,188 cases last year. We've added spine and sports medicine and brought in more partners. We've started doing total joints, and we're looking to see whether we can expand further. OSM
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