How do surgeons judge a day-surgery program?
On-time starts, quick turnover time important
Can a beautiful building, convenient parking, good location, and high patient satisfaction survey results guarantee success? Not if your surgeons aren’t happy with your equipment, staff, and turnover times, say experts interviewed by Same-Day Surgery.
How do you find out what your surgeons value and how they rate your day-surgery program as a place to do business? Simply ask them, says Cheryl E. Dendy, RN, administrative director of St. John Surgery Center in St. Claire Shores, MI. "We want our center to be recognized for best practices, and the best way to find out what our surgeons really think about our service to them is to survey," she says. A formal written survey was mailed to each of the physicians who use Dendy’s facility asking them to rank the center’s performance in a variety of areas that include equipment and supplies, scheduling, preoperative testing, staff, anesthesia services, and advisory committees. (See survey techniques, p. 62.)
The survey had a response rate of 28%, and results have been positive. Between 90% and 100% of the respondents agree or strongly agree with statements regarding well-maintained operating rooms, equipment, and supplies, as well as availability of equipment and supplies, says Dendy.
Surgeons also expressed high levels of satisfaction with the preoperative testing process that includes timely testing, quick turnaround of lab tests, and no surgery delays due to delayed testing. "One reason our pre-op testing process is efficient is that our nurses are cross-trained to perform EKG tests," says Dendy. This avoids delays in testing when a physician adds an EKG to the pre-op orders at the last minute.
An efficient pace within the operating rooms is very important to surgeons, says William J. Mazzei, MD, medical director of perioperative services at the University of California-San Diego Medical Center. Mazzei uses a combination of informal and formal discussions to evaluate surgeon satisfaction. (See survey techniques, p. 62.)
Mazzei has found that the most important issues concerning a same-day surgery program, from a surgeon’s point of view, are:
• cases that start on time;
• minimum amount of turnover between cases;
• pleasant work environment in which the physician’s needs during surgery are anticipated and met;
• comfortable, safe environment for the patient and family members.
Because Mazzei’s responsibilities include inpatient and outpatient surgery, he has an opportunity to observe differences in expectations of surgeons who work primarily in one setting or the other. The one area in which there is a difference is the expectation in inpatient surgery that the same staff will work with a particular physician all of the time, says Mazzei.
"I don’t know if it is because same-day surgery tends to be less complex and doesn’t require a specialized team, or if it is because most same-day surgery staffs are small and physicians tend to know the whole staff, but same-day surgery physicians don’t place as much importance on having the same nurses each procedure," he explains.
Dendy’s clinical staff rated high marks on skills, knowledge, and responsiveness to needs from her physicians, but the surveys did identify several opportunities for improvement. One opportunity was in the scheduling area, says Dendy.
Only 50% to 60% of the respondents agreed with the statements that block time was distributed fairly and adjusted appropriately. Written comments on the surveys expressed a desire from many physicians that block time be freed up sooner than the current one week in advance, she says.
"Finding a way to free that time so other physicians can take advantage of it without disrupting the schedules of physicians that have the time block will be a challenge, but we are looking at ways to handle it," she says. "We currently have four operating rooms and have submitted a certificate of need application to add a fifth room, but approval will take time."
Surgeons want to post their cases in a timely manner, says Mazzei. "Most of our physicians want to schedule a case within a week."
Surveys are good ways to document what is important to your physicians, says Dendy. Even when you have a vocal medical staff, surveys provide hard data that might be needed to make changes, she adds. "The best thing about this survey is that it gives physicians a chance to make comments that will be read." The physicians at her center have complained before, but their complaints have fallen on deaf ears, she says. "Now I have written proof that these are things that affect our satisfaction ratings."
The information is presented to various groups, including the president of the hospital and the hospital board, she explains. "If we can take action on one of the suggestions made to improve our service to surgeons, we will further improve our relationship with our physicians."
For more information about determining physician satisfaction, contact:
• Cheryl E. Dendy, RN, Administrative Director, St. John Surgery Center, 21000 Twelve Mile Road, St. Claire Shores, MI 48081. Telephone: (810) 447-5015. Fax: (810) 447-5012. E-mail: [email protected].
• William J. Mazzei, MD, Medical Director of Perioperative Services, University of California-San Diego Medical Center, No. 8770, 200 W. Arbor Drive, San Diego, CA 92103-8770. Telephone: (619) 543-5720. Fax: (619) 543-5424. E-mail: [email protected].
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