The Business of Surgery 
Although hospital performance from January to April 2025 outpaced the first 4 months of 2024, according to Kaufman Hall’s June 2025 “National Hospital Flash Report,” many surgical departments remain under intense financial pressure. Labor and supply costs continue to rise, while surgical services are especially vulnerable to inefficiencies like labor…
Once limited to hospital inpatient settings, total joint surgery is increasingly common at ambulatory surgery centers (ASCs) across the US. What is not so common is performing these complex procedures without the benefit of an onsite sterile processing department (SPD). And yet, that is exactly what we have accomplished at…
Editor’s Note: This page is a companion piece to the main article, Centralized sterile processing cuts costs, complexity for four ASCs. Implementing offsite sterilization is a major project. At Total Joint Specialists, our journey began gradually, growing in scope over time as the team became comfortable with the process…
Perioperative leaders often have to make critical decisions, not just in the middle of an operational crisis but also somewhere in the edges—the routine but still high-stakes moments where leaders need to adjust resources or absorb costs under tight constraints. The economic margin for error continues to narrow, and many…
Editor’s Note: This page is a companion piece to the main article, Emergency preparedness: Identifying essential supplies for unplanned surgical events. While the main article outlines the principles of emergency readiness and supply preparation in the OR, the posts below offer a closer look at two key implementation areas: Supply…
While most emergency surgical procedures are carried out uneventfully and safely, the OR is also a place where potentially life-threatening and least-expected instances can arise. Emergencies such as malignant hyperthermia, intraoperative cardiac arrest, and anaphylaxis can catch OR leaders and staff off guard. Perioperative teams need proper and adequate preparation…
Editor’s Note: This page is a companion piece to the main article, Proper planning prevents OR construction, renovation cost creep. It brings together four focused updates on OR and ambulatory surgery center (ASC) construction and renovation: Regulatory shifts: The Joint Commission's updated safety and sustainability requirements for hospitals and ASCs, including new…
How would you describe the ideal OR? Whatever the answer, the chance to reimagine and reshape the perioperative suite can be among the most exciting projects of a perioperative leader’s career. However, OR construction and renovation also can be among the most daunting projects of a perioperative leader’s career. Just…
When Betsy Grunch, MD, FAANS, FACS, FCNS, board-certified neurosurgeon known on TikTok and Instagram as @Ladyspinedoc, watched a viral video of a surgeon berating an OR nurse during a livestreamed procedure, she was incredibly bothered by the shameful display. She took to her popular platform and spoke out against that…
Takeaways • Different types of ASC leadership structures can be adapted to meet organizational needs. • Regulations, accreditation standards, size, and ownership types are examples of factors influencing the leadership structure. • Ongoing success of the ASC leadership team depends on factors such as governing body diversity and strategic planning.…
