Your biggest frustrations, and solutions that work
By Stephen W. Earnhart, MS
CEO
Earnhart & Associates
Austin, TX
A reader responded to my column on getting patients in 45 minutes before surgery. Her response: "What is the name of your planet? Do your nurses wear their caps with their nursing school pins on it? You need to get real. Patients must be at our center at least three hours before surgery two hours for a 7 a.m. start time and even then we have a hard time getting everyone ready. You need more realistic expectations!"
My response: "I am sorry to hear you are having such a difficult time with your surgery program. It might be time to look at your processes. Do you have enough staff? Are you calling patients the day before surgery to remind them about the time? Are you gathering past health information days before surgery? Are you ordering tests before the day of surgery? With some effort, it is possible to significantly reduce your preop time."
Here are some more concerns I have received recently:
Question: Many of our anesthesia providers routinely eat and drink in the operating room during cases! I know I am not alone when it comes to this; at conferences, others tell me they have the same issues. What works?
Answer: We let them eat and drink during cases if they wish. We let them know that it is not acceptable and you run the risk of contamination or spilling of hot coffee during the case. We then leave it up to them to decide if they wish to proceed. Oh, I almost forgot: They need to give us a check for $25,000 to cover the fine if they get caught!
Seriously, this is not something that can be tolerated at all. Barring them from the operating room and reporting them to the medical director should take care of it. If not, take it to the head of their anesthesia group and let them know they are violating their contract with the facility and it will be terminated with cause.
Question: Which is less expensive: outsourcing our billing or doing it in-house?
Answer: From a strict dollar amount, doing it in-house is cheaper. From a frustration factor, outsourcing is cheaper. From a regulatory perspective, outsourcing is cheaper. From a "distraction from your core business" perspective, outsourcing is cheaper.
Question: How often does the average surgical or ambulatory surgery center have medical executive meetings? We have been open six years and have them every month, and I think it is redundant. Whatever you tell me, I am going to send the e-mail to our medical director, as she wants to know also.
Answer: You should meet as often as you think you have real issues to consider. I would think that being open as long as you have and if you have an effective communications log book, then quarterly meetings should be adequate.
Question: I am having a fit with seeing staff members' texting on their phones while at work! It drives me crazy when I look around the conference table and see people with their hands under the table, fingers twitching everywhere. It took me a while to figure out just what the heck they were doing down there! I really don't know what to do. I have tried everything I can to make they understand that this is not acceptable in our department. What are others doing?
Answer: Prying fingers off texting phones is next to impossible. Believe me; you are not alone in your complaints and concerns. It seems as if whatever rule you put into place just doesn't work. I gotta tell you, sometimes it seems like the easiest course is to just ignore it. That certainly is not what you want to hear, but it is an issue that is very difficult to resolve. Anyone have any ideas they can share? [Earnhart & Associates is a consulting firm specializing in all aspects of outpatient surgery development and management. Contact Earnhart at 13492 Research Blvd., Suite 120-258, Austin, TX 78750-2254. E-mail: [email protected]. Web: www.earnhart.com. Tweet address: Earnhart_EAI.]
A reader responded to my column on getting patients in 45 minutes before surgery. Her response: "What is the name of your planet?You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
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