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INSIDE THE CURRENT ISSUE |
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Operating Room |
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Uneasy economy shakes up OR salaries by Jeannie Akridge I t appears that economic pressures may be catching up even to highly skilled, and highly paid operating room management professionals. Respondents to the Healthcare Purchasing News 2010 OR Management Salary Survey reported slightly lower average salaries overall than in 2009, rounding out at $75,310 compared to $77,890.Nearly 30 percent of respondents claimed the title OR director/manager, and this continues to comprise our largest group of survey participants, although fewer than the 40 percent who held this title in 2009. Salaries for OR directors/managers were also down considerably from 2009 figures, at $80,657 compared to $90,382. More participants hold the title of surgical services directors/managers (26.4 percent compared to 13.7 percent in 2009), however their average salaries were also lower than in 2009 – $86,543 versus $94,107. Still, surgical services directors/managers were the second highest earners for 2010. The highest paid respondents hold the title of clinical director/coordinator (3 percent of respondents), earning $89,800 on average.
It stands to reason that in a shaky economy, those with business acumen and financial skills would fare well. In fact, OR business/financial managers benefited from a hefty 15 percent increase in their average salary. The third highest earners for our 2010 survey, OR business/financial managers earned $83,708 on average compared to $72,614 last year.
On par with respondents to HPN’s 2010 Supply Chain Management Salary Survey (August 2010), OR materials managers/ coordinators also benefited from a slight pay increase, reporting an average salary of $55,667, compared to $52,750 in 2009. There were also more OR materials manager/coordinator respondents in 2010 – 21 percent versus 15 percent. Another group who saw salaries edge upward were surgical instrument coordinators. Although still the lowest paid among OR management survey participants at an average of $52,667, this represents a $10,000 increase over 2009. Reflective of the overall flat to downward trend in salaries, fewer respondents reported receiving salary increases in 2010 – 57 percent compared to 64 percent in 2009. At the same time, 35 percent reported that their salaries remained the same in 2010 versus 28 percent from the previous year. For those receiving salary increases, the average amount of the increase was also slightly less than for 2009: 3 percent versus 3.5 percent. Confidence in job security has also taken a hit with 42 percent of respondents claiming to be "very secure" in their position, compared to 44 percent in 2009. Ten percent say they are "somewhat insecure" in their current position versus 7 percent in 2009.
Regionally, those working in the Pacific states fared the best, and this is consistent with years past. However, it should be noted that salaries for respondents in this region were nearly $10,000 less than in 2009 – $81,143 compared to $90,795. In fact, salaries were down in all regions except the Northeast where 2010 respondents averaged $77,906, up from $72,734. When it comes to OR management, women typically outnumber men and it’s also one field where women command higher salaries than men. For our 2010 survey, we found even fewer men working in OR management – 23 percent versus 26 percent. Average salaries for male respondents were also lower than for their female peers at $71,526 compared to $75,314. Breaking it down further, when we look at what titles our male survey respondents hold – nearly a third (31 percent) are OR materials managers/coordinators and 21 percent are OR directors/managers. Fifteen percent of male respondents are OR business/financial managers, compared to just 4 percent of female respondents holding the title. It should also be noted that of the 7 percent of total OR business financial/manager respondents, half of those are male. These positions are also ones where men earn higher salaries than females; male OR business/financial managers pulled in average salaries of $84,167 compared to $78,800 for females, and male materials managers/coordinators earned $59,417 versus $53,792 for their female counterparts.
A snapshot of women’s titles shows 30 percent are OR directors/managers, 29 percent are surgical services directors/managers and 18 percent are OR materials managers/coordinators.
Purchasing power Nearly all of HPN’s OR management salary survey respondents (96 percent) are involved in some way with purchasing equipment and services at their facility, with just over half (52 percent) having the authority to either approve/authorize purchases or recommend/specify. Top product areas for which supplies are purchased continues to be OR supplies/equipment, surgical instruments, drapes and surgical gowns. Rounding out the list for top purchased supplies include: Custom procedure trays, gloves and surgical tables. Perhaps a nod to an increasing focus on safety in general, and in particular patient safety in the OR, a few product areas for which more respondents claim purchasing responsibility: sterility assurance products, patient temperature management, pressure management systems and patient lifts.
Laurie Hartline, RN, business manager, Mercy Medical Center, Canton, OH, has worked in the OR environment for 28 years, starting out as a nurse and moving her way up to OR coordinator, scheduling manager and finally an OR director for 15 years, before transitioning to her current position as an OR business manager three years ago. With approximately 300 beds, 15 main OR suites, 3 minor procedure rooms, and 2 CVOR suites, Mercy Medical also features a robotic surgery suite. Hartline’s involvement in purchasing at Mercy includes "gathering product information; chairing products committee; negotiating contracts; implementing product usage – all working closely with OR management, surgeons, and Materials Management," she explained. When it comes to maintaining her OR budget, "The biggest challenge is trying to keep prices neutral or with a minimal increase," said Hartline. "Most companies think that they should automatically increase prices every year. Another big challenge is the vendor/surgeon relationship. Since the economy has taken a turn for the worse, vendors have really been ‘buddying up’ to the surgeons and we find more surgeons are using different products due to the ‘buddy effect’."
What does Hartline believe to be the toughest challenge for OR management professionals today? "Keeping spending down," she said, adding that "a majority of surgeons who work in not for profit facilities are not interested in procedural costs." "The cost of physician preference items and implants, and lack of reimbursement plus increasing lack of insurance coverage," are all key concerns, she said. Scope of responsibility
No doubt OR management professionals wear many hats. When asked which functions report directly to the OR director in their facility, PACU (84 percent), sterile processing (79 percent) and outpatient surgery (74 percent) continue to lead the list. In addition, more than half of respondents manage endoscopy services (68 percent), decontamination (59 percent), OR/surgical services purchasing (59 percent), ambulatory services (54 percent), OR supply distribution (52 percent) and anesthesia services (51 percent). Nearly half of respondents also are responsible for pre-admission testing and central services (each 49 percent). A new category on our survey this year, OR environmental services falls under the direction of 29 percent of respondents. Along with wide ranging responsibilities, these OR management professionals also have extensive interests. Popular topics for which they’d like to see more coverage in HPN include OR charge capture (57 percent), OR equipment (44 percent), and a new category of OR sustainability piqued the interest of 40 percent of respondents. Two other new topics – surgical case scheduling and tissue tracking were each selected by 34 percent of respondents. Also high on the list of interests were surgical instruments, OR suites, inventory control, surgical instrument tracking, patient safety solutions and supply chain management. Technology continues to gain foothold in the OR. Our 2010 survey found a few more respondents utilizing instrument tracking/utilization programs (25 percent versus 21 percent in 2009), automated OR inventory management programs (27 percent, up from 24 percent), as well as software-based infection tracking programs (40 percent versus 37 percent). A majority (78 percent) of respondents utilize a surgical case scheduling software program. Nearly 90 percent of respondents utilize some form of a surgical checklist for patient safety.
At Mercy Medical, Meditech is used for scheduling and documentation,
Lawson for charges and inventory, and ABACUS for instrument management in
CSP. In the near future, Hartline noted her facility is looking at
implementing electronic anesthesia documentation. Looking forward as more OR management professionals near retirement, in addition to a scarcity of OR nurses in general Hartline lamented the lack of younger OR personnel having interest in OR management. Indeed HPN’s OR management salary surveys consistently reflect a veteran group of highly experienced respondents with an average of 19 years tenure in the OR. Encouraging though, while the largest group of respondents (37 percent) have more than 25 years of experience in the OR, our 2010 salary found a few more respondents with less than two years of experience (3.4 percent vs. 2 percent). Likewise, the average age of respondents dropped by one year, from 53 to 52 with slightly more respondents in the 26-30 year old age bracket (2 percent versus 0.5 percent in 2009). 
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