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…
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…
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…
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…
Toward an effective code of conduct
Some facilities have had a code of conduct for years, and managers say it works well. At others, nurses still are too intimidated to remind physicians to wash their hands. In a lively discussion at the Managing Today's OR Suite conference in October 2008 in Washington, DC, it was clear…
Does your staff understand delegation?
An RN is circulating on a case when near the end, the surgeon hands the scrub technician a suture and tells her to close the wound. In another situation, the next case requires medications to be drawn up, and the surgical technologist (ST) offers to do this while the RN…
How to keep shared governance alive
Shared governance (SG) has become a hallmark on the journey to achieve Magnet status by demonstrating exemplary professional practice. SG is an integral part of Magnet hospitals, which achieve this status through the Magnet Recognition Program. The American Nurses Credentialing Center developed the program to recognize organizations for nursing excellence.…
Spot at-risk behavior, intervene early
Patients can be the eyes and ears for detecting physician behavior that poses a risk to patient safety, a Vanderbilt group has learned. Over 10 to 15 years, Vanderbilt has developed a model for addressing inappropriate behavior that relies on unsolicited patient complaints as an early warning system for at-risk…
When a staff member needs to improve
Sixth and final article in a series on performance management. This article completes the series on performance management, published monthly since June 2008. The first article gave an overview of the performance management process. The next 4 articles covered the job description, initial competencies, orientation, goal setting, on-going competencies, coaching…
Staff evaluations: More than a formality
Fifth article in a series on performance management. Elements of performance management Job description Initial competencies Orientation Goal setting/ performance planning Competency assessment Coaching, mentoring, and recognition Performance evaluation Self-evaluation Peer evaluation Performance enhancement plan. This article builds on the first 4 articles in this series, published in the June,…
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