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Home Days in the Life

A Day in the Life: Ambulatory Care Manager

5:30 a.m.: Wake up, check work e-mails, have breakfast, then head to work.

7:00 a.m.: I arrive at work. I review the patient schedule and staffing to ensure that we have good coverage for the day. One of my techs has called in sick, so I call another tech to take over, modifying staffing assignments, as necessary, to fit her schedule (she has to leave a little early to pick up her daughter from school).

7:30 a.m.: Assess equipment issue, take equipment out of service, call service vendor, and activate backup equipment.

8:30 a.m.: Address patient complaint (he was unhappy about having to wait 30 minutes past the time of his scheduled appointment) and follow up with staff. We try very hard to stay on schedule but, in this instance, there was a software crash that wreaked havoc with our patient schedule last Friday.

9:00 a.m.: Speak to surgeon regarding equipment request to perform new procedure.

9:15 a.m.: I review a report on physician referrals by source to determine any changes, positive or negative. I notice that one physician is referring 20 percent fewer patients, so I contact her to determine why. The physician says she’s having difficulty scheduling patients for a specific test within a desired time frame. I take steps to rearrange staffing and schedules to try to accommodate the physician and regain the lost volume.

9:45 a.m.: A one-on-one meeting with a recently hired office clerk regarding work performance issues. She’s been arriving a few minutes late each day. I need to nip this in the bud quickly or the clerk won’t be long for this facility. She’s very apologetic, citing childcare issues that have now been addressed. I remind her that it’s important to be on time and encourage her to contact me ahead of time if there are issues.

10:10 a.m.: E-mail proposal for equipment purchase to financial director and executive vice president. The financial director quickly responds with a few questions about cost and various product models, and I tell him that I will gather some more info and respond ASAP. 

10:30 a.m.: Meet with contractors to discuss renovations to the facility’s waiting area and entrance. Simply said, these areas are not as user friendly as they could be, and we want our patients to be happy with their experience. On tap: an expansion of the waiting room (which will include more seating), improved lighting, a few more flat-screen TVs, and new flooring.

11:00 a.m.: Return telephone calls from physician’s office regarding scheduling and preadmission testing issues. Investigate issues and follow up.

11:30 a.m.: Meeting with staff to discuss new preadmission policy and procedure.

12:00 p.m.: This is normally my lunchtime, but today I head out to a local job fair to meet potential candidates for a few open positions. You really need to stay ahead of the curve when it comes to staffing. People retire, leave for other jobs, etc., and keeping staff numbers at the appropriate levels is important. Today, I’m looking for a few nurses and three ultrasound technicians.

1:30 p.m.: Review quality improvement documentation to prepare for upcoming state survey.

2:00 p.m.: Meeting with equipment vendor to discuss lease proposal. We’ll spend $75,000 if we purchase the equipment outright, and far less if we lease it. There are pros and cons to each approach, but leasing this particular piece of equipment will allow us to spend more funds to develop other ambulatory surgery areas that will help us grow our business. 

2:30 p.m.: Regulatory compliance is a big issue at any health care facility so I take some time weekly to ensure continuing compliance. I review, monitor, and audit the facility’s practices in terms of safety, medical records, confidentiality, employment, and a number of other areas. I also inspect the physical plant, and review equipment maintenance and repair records. We’re seeking accreditation from the Joint Commission, so I need to be extra vigilant that the facility meets all of the required standards.

3:00 p.m.: I prepare a monthly report on center’s case volume, then review the next day’s schedule and staffing. My assistant manager has a family emergency, so I’ll need to take on a few of her duties tomorrow.

4:00 p.m.: It’s budget season, so I continue to work on our facility’s budget. I look at historical trends, predicted changes (e.g., an expected increase in staff hiring, capital expenses, and reductions in Medicare reimbursements), and other factors to determine a proposed budget number, which needs to be approved by the center administrator and board of directors. Issues that I keep in mind as I work on the budget include how many new employees I’ll need to recruit, how many part-time or per diem employers (occasional workers who receive a higher rate of pay with no benefits like vacation, sick time, or health insurance) should I add into the mix, and other ways to increase productivity (performance bonuses?) and save money (energy audit at the facility, etc.).

4:30 p.m.: I take one last walk through the facility, greeting patients and staff during the process, to ensure that everything is going smoothly and that there are no issues to be addressed before tomorrow morning.

5:00 p.m.: I head home, grab a quick dinner, and then go to my son’s ballgame.

8:00 p.m.: Back home. I’m reviewing the resumes I received at the job fair. There are definitely some good nursing candidates, but we’ll have to explore other search strategies for the ultrasound technicians. I send off a quick e-mail to the human resources director suggesting that we create a job advertisement for the print media and/or Internet. I make a note to contact a few of the nurses I met today to have them come in for an interview. 

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