Every ambulatory surgery center needs a professional, dedicated staff to provide excellent patient care and operate efficiently. Successful ASC leaders are thorough in recruiting and hiring employees who are the best fit for their team, and modeling the culture they want to see in the organization.

But despite these efforts, there will still be times when an employee is not working out, and an involuntary termination is the best course of action. This is a delicate situation that can cause financial strain and employee stress for an ASC. Research suggests that a single termination, poorly handled, can cost $80,000 to $125,000 in legal fees and severance, compared to expenses of $5,000 to $10,000 when managed properly.

The following human resources best practices will mitigate risks associated with involuntary terminations.

Have direct conversations about performance and behavior.

When an employee is not meeting expectations or is behaving in an inappropriate way, management must step in and address the problem early on. A direct, private conversation with the employee should focus on specific examples of what is happening, and what needs to change going forward. Is there a reason for the employee’s behavior? Has something, such as a new work process or a problem at home, triggered this change? Leaders in the organization are responsible for starting this conversation, exploring possible solutions, and setting next steps.

Follow a progressive discipline process.

Progressive discipline is designed to bring unacceptable behavior or poor performance to an employee’s attention and outline the changes necessary to avoid involuntary termination. For example, if a manager notices an ASC employee who has a problem with arriving for work on time or missing shifts, this process might look like this:

  • First incident: Manager clarifies job expectations and responsibilities, and issues a verbal warning about the consequences of missing work
  • Second incident: Manager pulls the employee aside when the employee has arrived at work 40 minutes late, emphasizing that this is the behavior that must change, and documents the issue in writing, using a formal written reprimand
  • Third incident: Manager involves human resources and a determination is made as to whether an Employee Consultation or a final formal written reprimand is the next step. (In some situations, a suspension or demotion may be warranted)
  • If an Employee Consultation is scheduled, the employee and manager will have the opportunity to review the fact. After consideration of facts, a decision is made regarding involuntary termination.

Diffuse the impact on remaining employees.

When an involuntary termination is necessary, it’s important for leaders to take proactive and professional actions to make the transition as seamless as possible. The conversation that ends the staff member’s employment should be brief and respectful; it will not be a surprise, as it is a culmination of many previous steps and conversations. Immediately after a termination, management must inform the remaining staff of the change and prevent rumors from spreading. Leaders need to be prepared with a plan – answering questions, sharing what they need from employees in the short term, and showing that they are working to fill the vacancy as quickly as possible.

Learn how MedHQ uses its expertise to help ASCs mitigate HR risks.