One of the major issues that we struggle with at our multi-specialty surgery center is keeping our 100 or so operating physicians and their office staffs informed of changes in our policies, practices and routines. We considered sending out a letter to communicate such things, but decided that surgeons would view this as heavy-handed. We instead decided to create a newsletter to pass along the gentle reminders and highlight the happenings at our facility, such as new hires and new equipment acquisitions. The first issue of "Surgical Update" was nothing fancy, just a black-and-white photocopied one-pager (front and back), but the reception has been positive. I'm planning to send out our next issue right before the holidays.

Flavel Rogers, RN, MSHA
Nurse Administrator, Glasgow Surgery Center
Newark, Del.
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Fast-track cataract patients
We send cataract patients who have not received sedation directly back to their hospital room after surgery, rather than to the recovery room. The hospital saves time and money because recovery room nurses aren't tied up with as many patients. The fast-track system is for patients who receive a topical anesthetic, or a topical with up to 1mg of Versed.

Debra Mason, RN, CNOR
Director of Staff Development, Doctors Hospital
Jackson, Mich.
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Double-check allergies when mixing meds
One of our general surgeons varies his choice of antibiotics before surgery. So instead of premixing the medications, I verify with him during our pre-op time what meds he wants a particular patient to have. The meds are mixed at the time the order is obtained in our pre-op area, and then administered by an RN. This keeps costs down, because we're not throwing away medications that were mixed unnecessarily. While we do verify each patient's allergies during pre-operative teaching (a day or two before the procedure), this is a reminder for the nurses and surgeon to double-check the patients' allergies against the meds that are to be administered.

Sarah Smith, RN
Alleghany Memorial Hospital
Sparta, N.C.
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Editor's note: Double-checking allergies is just good nursing practice; nurses shouldn't need a reminder.

Saving on equipment-service contracts
We've found that with a bit of research, we can sometimes save significant money on our equipment-service contracts. For example, it would cost us an extra $5,000 a year to get the laser tube on our carbon dioxide laser covered under our service plan. But the tube generally lasts three-to-five years, and we found out that the part costs about $10,000 to replace. So over the lifespan of the tube, we've saved thousands of dollars by not making it part of our service contract.

Ross Van Antwerp, DOMPH
Medical Director
Laser Surgery Center of Maryland
Severna Park, MD
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Knockdown furniture does the job
We need to have a table or over-bed tray to put our patient charts on when patients come into the PACU from the OR. So we modified the wooden box face where we line up patients' stretchers into fold-down tables (like a wall-mounted ironing board) that will come down alongside the patients. With the exception of a few pieces of hardware, all the necessary wood is there, and the cost is less than buying a set of tables for patient bedsides. When not in use, they can be tucked back into the wall so they're not in the nurses' way in the PACU. The result: attractive, functional tables (that match the current decor) at a low price that keep patient charts and flow sheets together, reducing the chance of mixing or misplacing documents at the nurses' station.

Paul Bernard, RN
OR/PACU/Safety Officer Panama City Surgery Center writeMail("[email protected]")

Paid days off make good rewards
We do employee reviews every six months based on four criteria: efficiency, extra effort, customer comments and peer feedback. If a staff member excels in these areas, we reward her with a paid day off of her choice. Management would not approve money as a gift, so we devised this system, which employees love. The number of good reviews has gone up 22.5 percent since we began this program, which means our facility is more efficient, and more patient- and staff-friendly.

Tom Szulga
Finance & Acquisitions Beverly Hills Surgical Institute writeMail("[email protected]")