Outpatient Surgery Magazine - Subscribers

Accreditation Dings - August 2013 - 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 9 of 130

Page 10 EDITOR'S PAGE Dan O'Connor How Do You Define an On-Time Start? Set your watch to patient-in-room time to deliver you from delays. It is surgery's chicken-or-the-egg question: How do you define an ontime start? How you set the clocks at your facility goes a long way in determining whether your cases go off as scheduled throughout the day or if you're always playing a harried game of catch-up. Which are you on? • Arrive time. When the patient's wheeled into the OR. • Anesthetize time. When the patient's on the table and ready for anesthesia. • Incise time. When the surgeon makes the first cut. Arrive, anesthetize, incise. How many minutes separate each of these 3 events? You're really scrambling if you and your surgeons are working in 2 different time zones — your surgeons going by incision time and the rest of your team working on patient-in-room time. "Our policy defines surgery time as incision time," says Dianne Appleby, RN, MBA, administrator of the Menomonee Falls (Wisc.) Ambulatory Surgery Center. "We put this into our policy for the very purpose of having a unified understanding of the parameters." Ms. Appleby is in the minority. Our online poll last month of 230 readers found that 70% of you define on-time start as the time the patient is wheeled into the OR, 24% as time of incision and 3% as when anesthesia is started. The 2% that don't measure on-time starts might realize that the problem with being on time is that there's nobody there to appreciate it. And 1% tell time by some other method. "We use patient-in-room time due to the variables of anesthesia and prep," says Steve Lickar, RN, nurse manager of the Puget Sound Surgical Center in Edmonds, Wash. "Some patients are difficult to intubate, and others require special prep and positioning. Using the admit time into the OR as the start time helps us with our scheduling and

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