Image by günter from PixabayAmbulatory surgery center (ASC) operators can break the firefighting cycle of last-minute staffing by using data, forecasting and a ready bench of familiar, flexible clinicians.
And utilizing third-party staffing solutions doesn’t just fill gaps; smarter staffing can also minimize full-time employee turnover and save facilities tens of thousands of dollars annually – and millions over time. Medely executive Phil Galligan explored these and other staffing topics during a recent ASC News webinar.
“You get a call that a nurse isn’t coming in, or surgical tech all of a sudden can’t make it, and suddenly the entire schedule for the day is in jeopardy, right?” Galligan said.
While a few cases can be delayed, or in worst-case scenarios canceled altogether, constantly reacting to staffing gaps masks the deeper issue: ASCs are too often operating with fragmented, outdated approaches instead of building forward-looking workforce strategies.
Medely, a service that connects health care facilities with nurses and allied health professionals, aims to solve that problem by offering both credentialed short-term staff and tools for scheduling, credentialing, and workforce management.
“Most ASCs run staffing through a combination of … spreadsheets, group texts, phone calls, smoke signals – you name it,” Galligan, Medley’s vice president of sales, said during the webinar. “It’s fragmented, it’s opaque, and you don’t really have any sort of visibility into your actual contingent labor needs until you’re already in a situation where you need it.”
A major issue for many ASCs, he noted, is basic visibility.
That lack of visibility is costly. Facilities underestimate their true labor needs by as much as 63%, Galligan said, meaning more than half of ASCs are relying on unplanned contingent labor reactively rather than strategically.
Hidden costs of reactive staffing
Postponed or canceled procedures immediately hurt cash flow. But the real damage accumulates in the form of turnover, burnout and administrative overload.
Nationally, RN vacancies hover around 9.6%, with surgical technologist shortages also growing, Galligan pointed out. Multiple staffing surveys have revealed that nurses often leave their jobs within the first year (one survey found that 33% of nurses leave after the first), underscoring how fragile retention has become.
ASCs are not immune to that. Some centers report labor expenses rising 15% to 20% year-over-year as they scramble to cover gaps with overtime and premium agency shifts.
When experienced clinicians walk out the door, the financial hit is significant.
“The average cost being around $61,000, when you add up the cost that goes into recruiting, to hiring, credentialing, and then you layer in lost productivity,” Galligan said.
What’s more, replacing lost staff members is a slow, time-consuming process.
“On average, it takes about 83 days to fill that role,” Galligan said.
While that process is playing out, cancellations continue to produce immediate revenue loss.
“Each canceled case right now costs an average of $3,800 in lost revenue,” Galligan said.
Administrative load on nurse leaders accelerates the spiral, he added.
“Most of the nurse managers that we talked to did not go into health care to push paper,” Galligan said. “These are the leading causes for burnout, which we know leads to costly turnover.”
Macro headwinds make action urgent
Long-term trends will intensify staffing pressure for ASCs.
“By 2031, 1 in 5 Americans will be over 65,” Galligan said.
At the same time, an estimated 900,000 RNs are expected to retire over the next decade, while U.S. nursing schools reject over 78,000 qualified applicants annually due to faculty and capacity shortages. Meanwhile, demand for surgical procedures is climbing as patients live longer with more complex health needs.
That’s not to mention payers looking to shift care into lower-cost settings.
“The future of staffing, it’s not about scrambling harder,” Galligan said. “It’s actually about preparing smarter.”
What does preparation look like? It’s not simply filling every full-time slot and stretching existing staff with overtime. Instead, ASCs need to forecast demand, account for seasonality, and proactively build a pool of vetted, flexible clinicians who can scale with patient volumes.
“Being fully staffed actually isn’t ideal anymore,” Galligan said.
The ideal is balanced, he emphasized.
“[Seasonality] surges, they’re not a surprise. They happen every single year,” Galligan said, urging ASC leaders to post shifts early and cultivate a vetted pool of preferred clinicians.
Some ASC leaders resist flexible staffing out of fear of unfamiliar faces in the OR. But Galligan noted that a well-managed bench doesn’t have to mean inconsistent staffing; it can mean a reliable network of clinicians who are already credentialed, onboarded, and familiar with the facility.
Even if operations feel stable today, Galligan advised building resilience now.
“Now is the perfect time [to think about proactive staffing],” he said. “If you wait till the pain hits, you’re too late, you’re scrambling. Patients are frustrated, you’re stressed, your staff is stretched thin, and then revenue starts to leak.”
