case and who was in
the OR for it. So we
could go ask them,
"Okay, why didn't
you do this? What
happened? Where did this process break down?" Checkoff sheets for
the OR can help here.
The overall consensus was that pretreatment was causing a slight
increase in OR turnover times. We got some pushback, and implemen-
tation was hit or miss across all specialties. Our surgeons needed
some gentle prodding, too.
Refine the process. We needed to reinforce the process and fur-
ther promote buy-in and dedication. We needed to stress that
this is a matter of when, not if. So we pulled everyone together to say,
"Okay, guys, this is not an option. This is what has to be done, and
you have to make it happen. It doesn't have to be the way we initial-
ly started it. We can change things up, whatever works for you."
Personalities in the OR can be aggressive at times, but after they
saw they had a voice in how things would be — that it wasn't just
going to be dictated to them, that they could decide what would work
best — their attitudes changed. And then the results of our continued
audits changed. It was a drastic improvement: Point-of-use pretreat-
ment now has zero effect on our turnover times. Staff participation
has a lot to do with that efficiency improvement. We'd also reempha-
sized to our surgeons that the process couldn't succeed without their
support.
Change the culture. Just as striking as the clinical improve-
ments were the cultural ones. There is now an increased appre-
7
6
S E P T E M B E R 2 0 1 9 • O U T PA T I E N T S U R G E R Y. N E T • 2 7
Each morning, everybody establishes
their pretreatment roles for the day.
Somebody's the loader, somebody's the
sprayer, somebody's transporting the cart.
