Cultivating a Positive Culture for Sustainable Growth

Speaker 1: Welcome to the Process Breakdown podcast, where we talk about streamlining and scaling operations of your company, getting rid of bottlenecks, and giving your employees all the information they need to be successful at their jobs. Now, let’s get started with the show.

Chad Franzen: Chad Franzen here, co-host of the Process Breakdown Podcast, where we talk about streamlining and scaling operations of your company, getting rid of bottlenecks, and giving your staff everything they need to be successful at their job. Past guests include David Allen of Getting Things Done. And Michael Gerber of the E-Myth and many more. This episode is brought to you by SweetProcess. Have you had team members ask you the same question over and over again and this is the 10th time you’ve spent explaining it? There’s a better way and a solution. SweetProcess is a software that makes it drop dead easy to train and onboard new staff and save time with existing staff. Not only do universities, banks, hospitals, and software companies use them, but first responder government agencies use them in life or death situations to run their operations. Use SweetProcess to document all the repetitive tasks that eat up your precious time.

Chad Franzen: So you can focus on growing your team and empowering them to do their best work. Sign up for a 14 day free trial. No credit card required. Go to sweetprocess.com. That’s suite like candy, S-W-E-E-Tprocess.com. Dana Karanik is the chief operating officer at Associates for Women’s Medicine, the largest obstetric and gynecology group in Syracuse, New York, where she oversees administrative functions including operations, management, process improvement, strategic planning and development. Dana is an accomplished operations executive with 25 years of experience in a fast paced and goal driven medical field. She consults regularly with executives and managers from a variety of fields to help create synergistic solutions to world impacting problems. Dana, thank you so much for joining me today. How are you?

Dana Karanik: Good. My pleasure. Thank you for having me.

Chad Franzen: Hey, so can you just give me kind of like a broad view of Associates for Women’s Medicine?

Dana Karanik: Yes, we’re in central New York and we have four locations. We have just under 20 providers here, that’s physicians and non providers. And within our four sites, we have multiple ancillary services. We have what we call one stop shopping. So our patients have the ability to have all of their services here while they’re being seen. And that includes our own central lab. We have an office space surgery center. We have our own billing, things like that. So we’ve grown over the years and we’ve been in the Syracuse community for many years.

Chad Franzen: So you have four locations. Can you tell me more about what you do then as COO?

Dana Karanik: I oversee the operations here. So all the office settings, all the ancillary services, like our central lab. We have our own lab where we run about 86% of everything we collect in the offices. And that allows us for a quick turnaround time. And it allows for us to get the results faster and treat those patients faster. We have our own office based surgery. It’s a triple AHC accredited surgery center where we can do surgeries right in our office where our patients feel comfortable. They come in, they have their surgery, they recover right in our suite and then they go home. We have our own imaging and we’re able to do ultrasound, we’re able to do bone scans, bone densities here, things like that. So it really is convenient for our patients.

Chad Franzen: Can you tell me more about the one stop shopping that you mentioned and what all goes into that?

Dana Karanik: So over the years, we’ve had services here that we’ve expanded on. We’ve added some services. So within the last few years we added 3D mammograms and 3D breast ultrasounds. And we have two sites now. So we started with one site and that was successful and our patients really loved it. And so we just opened up a second site this past fall and it happened that it timed well with Breast Cancer Awareness Month in October. So we’re able to give the best services available on what I would consider best practices for our patients here. So if there’s a service or maybe a surgery we want to do in our surgery center, I work closely with the board here and we talk about some of the ancillary services. Or maybe some of the things that we want to bring to the practice or expand on. And we talk about it with the board and then we set up a team here. It is collaborative. We do things together here. And I work with the different departments and the different teams here to help develop what we want to bring or what we want to expand on.

Chad Franzen: What are some of the challenges associated with having multiple sites and maintaining kind of consistent operations?

Dana Karanik: So what we do is we get together at the minimum once a month as a leadership team. And we talk about everything that goes into the practice, what we’re working on, maybe what is going to be delayed a little bit like COVID. With everybody else, we’ve had some things that have been delayed. Sometimes projects get behind a little bit because of multiple different reasons, whether it’s COVID, whether it’s staffing, could be a billing issue, could be a supply issue. So we do work together and try to work through them. Right now, we are going to be bringing in-house COVID testing. I know the government’s trying to get some testing out to everybody’s home. With our organization, we have over 100 employees. So it’s one of those things where it helps us keep our employees safe. It keeps our employees here, if we’re able to do the testing in-house.

Dana Karanik: So that’s something new we’re working on right now. So there’s some challenges with supplies, for sure, trying to make sure our lab manager has what she needs in order to bring something new into our laboratory. And it could take on average six to nine months to bring something in or expand something during our development, during our conversations. And again, we work collaboratively. So we work together to try to bring whatever it is we want to do into a effective addition to our practices here. And it makes it easier for not only our employees, our patients, but also our providers that see our patients every day.

Chad Franzen: Do you have like training manuals, things like that, documentation? I know the jobs that most people do probably are bigger than what you would read in a manual, but do you have things like that to cover [crosstalk 00:06:57],

Dana Karanik: Absolutely.

Chad Franzen: Branches?

Dana Karanik: Yep, absolutely. We have policies and procedures. We have a lot of guidelines, practice guidelines, clinical guidelines that we do. We have a physician advocate within our practice that helps us update our guidelines. We follow the typical guidelines, like for example, ACOG guidelines. We take a look and see what their most recent bulletins are, what the updates are and they work together to update what we currently have so that we are competitive. And we are again, doing what we call best practices here and try to be proactive so that we’re bringing the best care to everybody.

Chad Franzen: How has COVID kind of changed the way you guys run your operations?

Dana Karanik: Like everybody else, we have challenges with people that are out, especially right now with the surge, with the Omicron variant. So that’s been a huge challenge for everybody involved. So trying to keep everybody healthy, trying to update again, our policies, trying to stay current with the current CDC guidelines, near state Department of Health, those guidelines and updates can come out daily. So it’s a challenge to stay ahead of the curve and try to stay compliant with that. And we have a great compliance officer. It’s one of our managers that’s here in the practice. And so we talk frequently and collaborate and get those notifications out to all of our staff in the practices. And so it’s been a big challenge. In the beginning, our patient volume dropped. So it was a different story almost two years ago, whereas now we’re busier than ever, but we’re still dealing with the shortage of staffing. So that, just like everybody else has been a huge challenge.

Chad Franzen: How do you divide your time between kind of, the medical field is associated with kind of responding to emergencies, but you’re also kind of coming up with ways to deal with future problems. How do you kind of divide your time between those two things?

Dana Karanik: That’s a great question. That is a big challenge. I’m a registered nurse. That’s the base of my education with a business background as well. So I honestly rely on my training as a nurse, that you triage things. So we’re trained as nurses to triage things. And so whether it’s critical, like your critical care in the hospital, or you’re trying to juggle all these different projects and things that come up. So it is a delicate balance to try to juggle what’s urgent, what’s not. You can be in the middle of something that’s urgent and then suddenly be out of that and then go back to, okay, what projects did I have? What was I working on? What do we need to get through today? And you put in the hours that you need to. So it’s definitely not a eight to five job some days, sometimes it’s longer, sometimes it’s after hours. And so, it’s really utilizing the people around you. So having good managers in place, having good process in place where you have that collaborative and that teamwork approach, where you can really try to manage everything and get things done.

Chad Franzen: Can you tell me kind of about your career development, starting as a nurse and to the point where you’re in this position that you are now?

Dana Karanik: Yes. So I started right out of high school, going to a typical university for business. And then really found that the business world at that time several years ago was not really my passion and what my interest was. And there was a nursing shortage at the time actually, and the nursing field comes and goes with shortages and not having shortages. And so there was the hospital here that had their own program. So I did enroll and completed my education and went to work at the hospital for several years. And I was doing home care after that. So I did that for several years when my children were younger and continued education, continued learning, certifications, just expanding my knowledge base. And through the years as this company expanded as well, I was able to learn and grow with the company and to meet the needs of what our needs were.

Dana Karanik: So in our area, we have had expansion. We didn’t start out with four locations. We started off with one and then we expanded into two. And then our hospital was asking us to expand into another area where there was a need for an OBGYN practice. So just meeting the needs of our community has helped us grow, helped me grow in the field. And I’m very active with Medical Group Management Association here in Syracuse locally, and also at a state level for New York state. I recently joined that board. So I’m able to help with some of the initiatives that we have. So that and through ACOG, doing some best practice projects for them. And it’s really helped me here, and traveling when I can. With COVID you can’t travel so much, but being able to travel and going to conferences, bringing some of the education, the pieces there, bringing them back to the practice here, just continued learning all the way along.

Chad Franzen: What was it about the medical field that was so attractive to you and has that changed? Are there new things about it that are attractive to you now?

Dana Karanik: Yeah. I come from a clinical background. So my father is a physician and my mother was a midwife. She was the first midwife actually in New York state. And so it just was in my blood and in hearing my family with that medical background. And my mother actually talked to me and said, there’s a real need to have nurses here. Maybe you would consider it. And so she’s the one that kind of prompted me to look into it. And then I really just loved it from the start. And as my career has grown and I’ve gotten back into business again, COVID is really what helped me ignite my passion for nursing again, because when the governor asked for nurses and physicians that haven’t been doing it actively to respond to the call to be available to volunteer, I volunteered.

Dana Karanik: And so I started giving COVID vaccines just to get us at a better place. Because at the time, a year ago you couldn’t get the vaccine and people were scared and people were dying. And so I got back into patient facing, giving vaccine, things like that and just reignited my passion again for nursing. And so, as the pandemic drags on, there’s still that need for nurses to give vaccines and I’m doing actually COVID testing now after hours. Because again, there’s just not enough tests out there. There’s not enough need.

Chad Franzen: What kind of back, or do you have like lines backed up to get tests right now?

Dana Karanik: Yes. Yes. It’s hard to find tests. And yes, it can get backed up for sure. People are traveling again. Like in the very beginning, about a year ago when we were doing the vaccines here in Syracuse, people were traveling from New York City. People were traveling down from the borders close to Canada. Same thing’s happening with the testing. People are traveling a half hour, hour away to get testing done. Some of the pharmacies have them but they sell out quickly. Trying to get at home testing can be a challenge with the supplies. So yeah, it does get backed up.

Chad Franzen: I have one final question for you, but first, if people wanted to find out more information about Associates for Women’s Medicine, is there a place where they can do that?

Dana Karanik: Yes. Our website is afwomensmed.com and also we have a Facebook page Associates for Women’s Medicine.

Chad Franzen: My final question, how do you guys maintain kind of a positive culture in the midst of just what I would imagine is kind of some days that can be very, very exhausting? How do you keep people’s spirits up and maybe their energy at a place where it should be?

Dana Karanik: That’s a great question. Really leaning on each other if we start to feel down or frustrated. If we get a positive comment from a patient, one person will receive it, whether it’s just in person or on the phones, through our website. Someone, no matter who it is, will send an email out to everybody saying, I just got this compliment from this patient and it just goes out to everybody. Having some fun days, like a potluck day, having silly things like ugly sweater day, just doing small things like that. Having lunches, doing the things that you can do to try to get you through, having something positive somebody sent out. If we have an SU day, taking picture and sending it to everybody. So sometimes it could be the smallest thing that we do here that just tries to keep us going. And just knowing that we’re giving good patient care, just really knowing that we have a great group here, that we really give good care. And that’s what keeps us motivated.

Chad Franzen: Sure. Hey, Dana, it’s been great to talk to you and I really appreciate you sharing your insights and everything that you guys do over there. Really appreciate it.

Dana Karanik: Thank you for your time. I appreciate it.

Chad Franzen: Thank you. So long, everybody.

Speaker 1: Thanks for listening to the Process Breakdown podcast. Before you go, quick question. Do you want a tool that makes it easy to document processes, procedures, and or policies for your company so that your employees have all the information they need to be successful at their job? If yes, sign up for a free 14 day trial of SweetProcess. No credit card is required to sign up. Go to sweetprocess.com, sweet like candy and process like process.com. Go now to sweetprocess.com and sign up for your risk free 14 day trial.

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