24 Sep Top 10 clever ideas seen in the OR by Interim Directors of Surgical Services
In our 2020 Road Warrior series, we featured a sampling of our interim Directors of Surgical Services (DOSS) who spoke about their experiences at various hospitals. Among the fantastic content we have curated in these conversations are 10 clever solutions to some of the most common issues faced in ORs today.
1. Charlie Wade: First utilization of drive-thru COVID testing using closed down banks
Drive-thru testing for COVID is now common in many places, but when the pandemic initially hit, healthcare organizations were scrambling. Charlie Wade happened to be on assignment in the Alaskan town where a hospital was one of the first to implement testing using then closed bank drive-thrus.
“I was amazed that the hospital came up with this. It was way before the government got involved or shut down the borders as far as containing the disease went.”
2. Glenna Montgomery: Using timers to gather data on surgical prep dry times for OR Fire Safety
One risk of OR fires is improper disposal of surgical skin preps, which contain a flammable alcohol solution. Glenna Montgomery says that one facility she worked in, there was a timer in each room and after they finished the prep, someone would hit the timer for the manufacturer’s suggested drying time. The surveyor could see clear evidence that they were following the manufacturer’s suggested drying time.
“This was a simple solution, but a really great idea. Instead of having a guesstimate, we had clear data to show the surveyor.”
3. Joanie Guy: Consequential initiatives driven by the heads of surgery or anesthesia
The chief anesthesiologist’s performance is measured, in part, by FCOTs. The success or failure of block utilization largely falls on the shoulders of the chief of surgery. Allowing them to be the primary lead on a change or initiative gets higher utilization and buy-in from staff.
“It’s a very clever way to achieve change quickly and increases the chances of success.”
4. Karen Callahan: Proactively developing a permanent Periop 101 education department
For most hospitals, Perioperative 101 will come in the form of a short-term program implemented reactively when the need arises. However, having a permanent department like this at your facility would produce a consistent stream of properly trained OR nurses immediately available to take over if someone leaves or retires.
“Running a perioperative education department has always been a dream of mine back when I worked full-time at an organization.”
5. Marta Konrad: Using the Kamishibai Board system to track FCOTs
Prompt FCOTs are essential to any OR that doesn’t want to be in a constant state of catch-up all day. It requires the perfect dance between everyone involved in making sure the first surgery of the day begins on time. How to keep organized? Marta Konrad used Kamishibai boards to track daily FCOTs by room and by surgeon. Kamishibai is a form of Japanese storytelling from the 12th century that relies on visuals to communicate. The boards are based off of this technique, and are used as a visual management tool to keep track of routine tasks that need to be done throughout the day, week, or month. Ideal for an OR.
“The staff had fun and it got very competitive.”
6. Melanie Scott: C-Suite in morning huddles
Executives may feel their presence is rarely needed in the trenches, especially in the OR where one can easily feel like they are in the way if they don’t have a job to do. But at one of her most challenging assignments, Melanie Scott was surprised to find the CEO in the morning huddle every day.
“Our stats were at 100% some days. Keeping people in the loop keeps people engaged.”
7. Michelle Seburn: Labeling supplies with their price
When a nurse chooses supplies, they may choose from two that work similarly and use preference cards to make the final decision. But Michelle Seburn says that she has seen that when the price was front and center, the cheaper product was chosen.
“The hospital saved money hand over fist and brought transparency and awareness to the staff so they would choose the less expensive product if it would work.”
8. Paul Giles: Creating a physical barrier to better prevent accidental entering of sterile area
Paul Giles once saw a magnet overlayed with yellow strip placed across one door, another magnet attached to the other door, and it slid across the door at about eye level. This created a visible barrier for people to see and know not to enter the OR to prevent contamination.
“You need to give people a clue. Just like the caution tape on roadways.”
9. Sue Silcox: Interim book of accomplishments
Interim DOSS positions are challenging, to say the least. What if you had a manual at your fingertips to reference? Sue Silcox created a book with notes about the staff, surgeons, anesthesia, administration, identified processes, and accomplishments. Interims can review this with the permanent DOSS, who can use this information to inspire their own decisions.
“I think it’s very important to share what you have accomplished during your tenure.”
10. Tom Callan: Consistently updating the C-suite in writing
It seems simple, Tom Callan found that leadership was quite responsive to using written communication to inform about problems. They love knowing what needs to be done, with timelines on when and how they will be addressed.
“Surgical services is a dynamic environment, so you must communicate up and down the chains of leadership.”