Home Issues OR Manager [May, 2009]

Getting the staff's buy-in for Lean

When Pam Murphy, RN, director of surgical services at 144-bed Piedmont Newnan Hospital in Newnan, Georgia, first heard a Lean presentation, she says, "It made sense, because we are so process driven. The whole focus is, 'What is touching the patient, and what is value added?'" Piedmont Newnan's ORs were…

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By: Pat Patterson
May 1, 2009
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The recession and the nursing shortage

A year or so ago, managers were worried about recruiting nurses and replacing veteran staff. Suddenly, with the economic downturn, it's a different story. Nurses are asking for more hours. They are willing to work overtime and even take call. Some are postponing retirement. Peter Buerhaus RN, phD ,FAAN What…

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By: OR Manager
May 1, 2009
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With elective surgery down, ORs reduce hours, try to avoid layoffs

The recession is bringing changes in OR staffing. Managers who have seen elective surgery fall are asking staff to reduce their hours and trying to avoid layoffs. Vacant positions, once hard to fill, are evaporating. Some veteran nurses are postponing retirement. Major elective procedures in orthopedics and spine could decline…

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By: Pat Patterson
May 1, 2009
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The diary of one OR's kaizen event

If you could huddle for 5 days with a few people who really understand your patient flow and you had the resources, what could you achieve? A team at Integris Southwest Medical Center in Oklahoma City took that approach and came up with a surprisingly simple and inexpensive tool to…

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By: Pat Patterson
May 1, 2009
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Using Lean to steer a department

When a perioperative nurse was recently promoted to be the OR's clinical coordinator, she inherited a department badly in need of coordination. The OR manager was frequently out of the department at meetings, leaving no one to coach the team. Not an experienced manager, the coordinator needed a way to…

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By: Pat Patterson
May 1, 2009
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Lean methods for weeding out waste

What can a surgical services director learn about running the OR by working at a forklift factory? During 2 weeks in Japan in 2004, Sandra Saltzer, RN, MPA, had a chance to tour 3 factories and actually work in one. At the time, she was director of surgical services at…

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By: OR Manager
May 1, 2009
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Lean thinking: Lessons of Toyota to help improve surgical services

Special focus: Lean in the OR Page 11: How to have a leaner OR department Page 13: Getting staff's buy-in for Lean Page 16: The diary of one OR's kaizen event Page 18: Lean methods for weeding out waste Page 21: Using Lean to steer a department What could a…

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By: OR Manager
May 1, 2009
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How to have a Leaner OR department

There's plenty of buzz (and confusion) about "Lean health care." Many wrongly assume Lean is simply applying Toyota lean manufacturing tools to health care. Unfortunately, many approach it that way. At the University of Tennessee, we define Lean health care as "…the application of concepts, tools, and management prescriptions to…

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By: Charles E. Noon, PhD
May 1, 2009
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Further changes for 2009 standards

On March 26, the Joint Commission issued a further revision of its 2009 standards. The revision, among other things, removes specific language about OR supervision and circulating duties that had appeared in a Jan 5 draft. The Joint Commission said the changes were a result of its negotiations with the…

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By: OR Manager
May 1, 2009
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Prominent postop pain researcher accused of fabricating study data

Scott S. Reuben, MD, a well-known anesthesiologist and researcher on postoperative pain, has been accused of fabricating study results. Based on its investigation, Baystate Medical Center, Springfield, Massachusetts, where Dr Reuben was a researcher, has asked medical journals to retract his articles, according to the March Anesthesiology News. Dr Reuben…

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By: OR Manager
May 1, 2009
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Time to be proactive in down economy

Like their hospital and physician practice counterparts, ambulatory surgery centers (ASCs) are feeling a financial pinch. Or are they? So far, the effects of the recession have manifested in different ways for ASCs, and hard data on nationwide trends are hard to find. "It's too early to tell," Cathy Head,…

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By: Paula DeJohn
May 1, 2009
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Device reprocessing makes inroads in ASCs

There are 3 ways to handle used disposable medical-surgical devices: throw them out after a single use (as the manufacturer recommends); reprocess them according to strict Food and Drug Administration (FDA) guidelines; or hire a specialty company to collect, reprocess, and return them. The first option is expensive, compounding the…

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By: Paula DeJohn
May 1, 2009
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AORN updates recommended practices

AORN offered updates on 3 of its recommended practices for 2009 at its annual Congress in March in Chicago: high-level disinfection cleaning and processing of flexible endoscopes surgical hand antisepsis. The first 2 recommended practices appear in the 2009 Perioperative Standards and Recommended Practices book. The third will be issued…

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By: OR Manager
May 1, 2009
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