By Don Sadler
The first ambulatory surgery centers (ASCs) in the U.S. opened in the 1970s. ASCs have come a long way since then, with more than 6,000 facilities now performing some of the most complex surgical cases today.
Beverly Kirchner has been an ASC pioneer almost since the industry’s inception. In 1985, she left her job working as a staff nurse at the VA hospital in Dallas to open the second ASC in the Dallas-Ft. Worth area. “Baylor opened an ASC and beat us by two weeks,” she says.
Since then, Beverly has spent her perioperative nursing career working all across the ASC landscape. She is currently the chief compliance officer at SurgeryDirect, which she co-founded in 2015 as the first multi-licensed ASC in Colorado that is state licensed, Joint Commission Accredited and CMS Certified. In this role, Beverly works with ASCs to ensure that they are licensed and ready for the Joint Commission survey.
“Compliance is becoming a bigger and bigger deal in this country,” Beverly says. “Hospitals have been subject to heavy government compliance requirements for a long time and now ASCs are being just as closely scrutinized.”
Beverly started her nursing career in 1976 as a staff nurse in labor and delivery at Parkland Hospital in Dallas. “One night a woman giving birth with a midwife had seizures and was eclamptic when they brought her in. It turned out that she had a ruptured liver. Doreen Reynolds, who many will remember, was working in the main OR that night and she came running in with all the equipment and everything that was needed for surgery.”
“I helped out and decided that was what I wanted to do,” says Beverly. “While I enjoyed labor and delivery, there was nothing like the adrenaline rush of surgery and the OR. I was hooked.”
In addition to her role at SurgeryDirect, Beverly is also the compliance officer and clinical resource director at TriasMD, which is the parent company of the DISC Surgery Centers. These are purpose-built outpatient facilities focused on pioneering minimally invasive and complex spine surgery, interventional pain management and orthopedic surgery. “Last year we also started performing total joint surgeries at the DISC Surgery Centers,” Beverly says.
Sometimes Beverly says she’s amazed when she thinks about the evolution of ASCs during her 40 years working in the industry.
“When I was starting out, I never would have dreamed a robot could do a total knee replacement,” she says. “And the role of perioperative nurses has evolved from patient care and safety to almost that of electrical or biomedical engineers due to the complexity of all the equipment that’s used in surgery now. When this equipment malfunctions, we have to know what to do.”
Beverly points to a number of highlights throughout her perioperative nursing career, starting with building her first surgery center.
“This took me in a direction I never dreamed I would go and has led to an amazing career,” she says.
Another highlight has been the volunteer work she has accomplished in the perioperative community. This includes serving on the Association of periOperative Registered Nurses (AORN) board of directors and as the immediate past president of the Texas Collaboration of periOperative Registered Nurses (TCORN), which has been working tirelessly to get surgical smoke evacuation legislation passed in Texas.
Texas is one of several states considering bills that would require hospitals and ASCs to evacuate surgical smoke during all procedures. “Working on this legislation has been one of the most rewarding experiences in my career,” says Beverly. “We’ve gotten to meet the governor and testify before House and Senate committees. I’m very hopeful that legislation will be passed this year.”
Another highlight was her visit to China in 2010 to talk with government authorities about how ASCs could help deliver better care to half-a-billion citizens located in rural areas. She and her team helped design a plan for using 18-wheel trucks to deliver doctors and lab equipment to people living in these areas.
One aspect of her career that Beverly has really enjoyed is mentoring young nurses who want to advance in their careers.
“At this stage of my career, it’s not about me anymore – it’s about pouring into young nurses who are going to take my place because I won’t be able to do this for too many more years.”
Beverly believes that many perioperative nurses should focus more on their own health and taking better care of themselves, including finding the right work-life balance.
“Early in my career, if you’d have asked me about work-life balance, I wouldn’t have known what you were talking about,” she says. “I do see that a lot of younger nurses today are doing a better job of taking care of themselves and striving for work-life balance than many veterans.”
To unplug from her job, Beverly enjoys recreational reading, especially novels and articles about nature and flower gardens, which she and her husband maintain at their home.
“We work diligently to make our home a place where our kids and grandkids like to come visit,” she says, referring to her four children and 16 grandchildren. Eleven-year-old Breleigh, who was born with special needs and is non-verbal, has been “the delight of our family,” Beverly says.
One family tradition is what Beverly calls “experimental” Sunday meals: “I only cook a new recipe that we haven’t tried before, and then we decide whether or not I should cook it again.”
Beverly sees the ASC industry continuing to grow and change, especially with more complex procedures now taking place in surgery centers. “We’re sending some spine surgery patients home in three or four hours,” she says. “Technology, including AI, is going to become more and more important and nurses will need to be skilled not only in patient care, but also the ability to use this technology in the surgery setting.”
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