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OSM560-April_DIGITAL_Layout 1 4/5/13 2:31 PM Page 99 LASER FOCUS Finding the Procedural Balance A t Columbia (S.C.) Eye Surgery Center, we do more than 4,000 procedures a year in 4 ORs and 1 laser room (soon to be 2 laser rooms, when we add laser cataract), so we need to be on our toes at all times to maximize performance. Here are some tips for efficiently managing laser procedures alongside the bread and butter of cataract. • Set up block times and "open" times. We schedule the laser room out for block times in either the morning or afternoon. If the room is blocked out for morning, we leave it open in the afternoon, and vice versa. Some of our surgeons can do up to 25 cases in a block. During the open times, the physicians are able to slide in patients from the clinic on the same day as their exams or follow-up appointBLOCK AND TACKLE With open blocks, Columbia ments. Alternately, if the surgeon isn't going to Eye Surgery Center lets surgeons bounce to the laser room between cataract cases in the OR. use a whole block, he can schedule in during the open period on a day that's convenient for the patient. If the surgeon happens to be doing cataracts that day at the ASC, he can duck over to the laser room and take a couple minutes to do an SLT or a YAG while the last case is being turned over and the next patient prepped in the OR. • Be flexible and be ready. Most of the time, the surgeons go through our scheduler, so we know who's coming and when. In the morning, we print the schedule for the day, in case there have been any changes, so we can plan in conjunction with OR procedures and run the laser room with multiple physicians during any given open stretch. Sometimes, we only get a couple hours' notice — for example, when a patient's been seen on the clinical side and can stick around, they might go out for lunch then come back in to the ASC side for the laser treatment. Occasionally, though, the physician will just show up with a patient. It's fine when we have only 2 patients scheduled for an open period, but when it's 10, we have to be creative. We do our best to accommodate these patients because they're elderly, and they often rely on someone for transportation and help reading paperwork. Some days, it's kind of hairy. But this is surgery. "Be flexible and be ready," is the motto. If we can't slide a patient in, the clinic side takes care of scheduling the laser procedure for the future. — Lisa Waters, RN A P R I L 2 013 | O U T PAT I E N T S U R G E R Y M A G A Z I N E | 9 9