How to organize your operating environment
By Stephen W. Earnhart, MS
President and CEO
Earnhart & Associates, Dallas
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Have you noticed the advertisements for closet organizers — everywhere? There are infomercials about them, one store has an annual sale on them, and Home Depot and Lowe’s, to name only two, have aisles dedicated to hooks, hangers, clear boxes, labels, shoe holders, sweater chests, and hundreds of other items designed to help us organize our closets. I organized my closets a couple of years ago because I dreaded looking at the mess. Nor could I find clothes that I knew I had. After I organized my closet, I did my drawers as well because the result was so gratifying — instant access to things I didn’t know were there. Now imagine if you could do that with your operating room environment. Whether you are a freestanding ambulatory surgery center (ASC) or a hospital operating department, the results will be the same: control over your department via organization.
As a firm, we do many operation and process audits, which are basically scorecards and report cards about your hospital or ASC and how to "fix" common problems we uncover. However, in the course of those audits, we request many items from the client in preparation for our visit, and therein lies the tale. We have had several clients tell us that just putting that information together made them realize how unorganized their department really was. They knew they had the information, but didn’t have ready access to it. So, let’s start with organizing your operating room.
First, focus on the things that really matter and that you will use. I am a huge advocate of delegation. You have great staff working for you, so let them assist you in this process.
The most important place to start and the one that will yield the greatest information is your benchmarks. Make a list of everything you think you should benchmark for your top 10 procedures. Have a staff member sit down with the "operative report" and fill in the blanks with those benchmarks. Most of them are in there. Next, organize your findings by age group, by specialties, and by surgeon. This is much easier than it sounds (especially if someone does it for you).
Give each member of your nursing staff 10 preference cards. Tell them to update them in the computer. (I hope you are using your computer for charging and inventory control.) Print out clean, easy-to-read, updated cards. Take those new, unembarrassing cards and put them beside the op-notes for your surgeon to verify for you. (I know. I know. But you can at least try and make a note that you attempted it.)
Next, tackle your personnel files. If your human resources department does this for you — great! Move on. If not, take all the folders with Post-it notes, margin notes, and loose paper inside them and standardize the contents of each folder in the same manner. Print out the list of employees with a quick update note for yourself that includes date of hire, date of review, inservices, etc. Here is a little trick: Put a random date for each staff member for a "You are doing a great job!" meeting. This is a quick five-minute meeting in your office to let that staff member know how much you appreciate his or her help. We should do this all the time, but we get busy, it slips from our memory, and we wonder why people feel unappreciated. This is a great perk for becoming organized.
After that, organize the equipment sitting in your hallways and empty rooms. If you are a hospital-based program, chances are high that you can find someplace other than your department to hide these rarely used "must have" items. For the square footage-impaired ASCs, rent an off-site storage shed that is environmentally controlled and make a detailed inventory of what you put in there.
Your supply room is a mess. Hire someone to put up more shelves. Buy those plastic office supply lockers that Office Depot sells, and line your walls with them. Inventory what you put in there, print it, tape it to the door of each container, and make your staff update it.
Create a list of where things are. Print the list onto a rolling file of cards that you can buy in office stores, and put those cards everywhere. Don’t make staff members wait until they get into the computer to look for it and then go find it.
These are just a few suggestions. Send me yours, and I will pass them on.
(Editor’s note: Earnhart and Associates is an ambulatory surgery consulting firm specializing in all aspects of surgery center development and management. Earnhart can be reached at 5905 Tree Shadow Place, Suite 1200, Dallas, TX 75252. E-mail: [email protected]. Web: www.earnhart.com/benchmarks.htm.)
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