Outpatient Surgery Magazine

OR Excellence Awards - September 2020 - Subscribe to Outpatient Surgery Magazine

Outpatient Surgery Magazine, providing current information on Surgical Services, Surgical Facility Administration, Outpatient Surgery News and Trends, OR Excellence and more.

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Page 54 of 71

explore any unusual answers or give explanations. Most of the staff have developed their own scripts, from the admitting staff to the pre-op nurses to the OR staff. While it sounds the same all day, it is not rote." You'd be hard-pressed to find quicker in-and-out turnarounds in surgery than you will at high-volume cataract facili- ties. While these straightforward procedures aren't usually difficult for your clinical staff to perform, making sure the machine is well-oiled and keeps cranking as efficiently as possible every day is chal- lenging. We spoke to those on the frontlines and assembled these helpful hints that might help — when you have a quiet moment to contemplate them, of course. 1. Avoid delays Orchestrating a successful day of cataract surgeries requires precise adherence to scheduling. "A key factor for performing high-volume cataract surgery is to be prepared and don't delay your OR start time," says Susan J. Sawyer, RN, administrator at Tampa (Fla.) Surgery Center. "My top surgeon can perform a four- to five-minute cataract extraction with intraocular lens implantation. It's the team's job to keep the train moving." With her center performing eight to 10 cases per hour, she stresses that it's important not only that everyone knows their specific roles and tasks, but that they stay focused throughout the day. Smart scheduling also helps, according to Ms. Sawyer. She suggests performing expected easier cases first and putting complicated cases at the end of the day, where they won't jam up the schedule if they take longer to complete. Newsom Eye in Tampa, Fla., often does nine cataract procedures per hour, but with the huge variety of specialty lenses that require viewing topography and marking, and minimally invasive glaucoma procedures, the team generally plans for eight per hour. "On the rare day where we perform straightforward procedures with standard lenses, we could easily do 10 or 11 per hour," says Mr. Horowitz. "We try to start Dr. Newsom out with the more basic cases and add complexity after he warms up." 2. Don't get caught understaffed This is an even more urgent matter in the midst of the COVID-19 pandemic. "Don't be afraid to over- staff during peak performance times," says Ms. Sawyer. "PRNs work four to six hours a few days a week in my facility, and when they're here it's always crunch time. It's so important due to call offs now more than ever. Many of my nurses are being requested for mandatory overtime at local hospitals due to the healthcare worker shortages and possible exposure and quarantining." Being properly staffed is not only important to keep the day moving, but it's also beneficial to the employees who are working that day. "Working short-staffed is not only a patient safety issue, but it creates burnout," says Ms. Sawyer. "You will lose great people, and having to hire and retrain is not very cost-effective." A jack-of-all-trades, all-hands-on-deck mentality separates great eye centers from merely good ones. Especially now, when staffing is even more chal- lenging due to the pandemic and the economy, the ability for one employee to perform multiple tasks is a huge benefit to a busy cataract facility. "It's invaluable to have employees cross-trained so that when there's an individual out, there is always someone else who can step in," says Dana Cowart, COT, administrator at Newsom Surgery Center of Sebring (Fla.). "There's not a day that goes by that we don't have to make some type of adjustment to our staffing schedule." Mr. Horowitz works with staff who are cross- trained to work in pre-op, the OR and post-op. S E P T E M B E R 2 0 2 0 • O U T P A T I E N T S U R G E R Y . N E T • 5 5 "Having staff who can recognize and step in to deal with the little differences that can clog the system is invaluable." —Jay Horowitz, CRNA

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