For a Calm, Quiet Waiting Room, Try Pagers
Patients and their families will appreciate a discreet, vibrating pager.

The waiting room can be a worry room: With every door that opens and name that is called, a patient is on edge. We've found a simple way to eliminate this anxiety. When we're ready to bring the next patient back to pre-op, our receptionist doesn't yell out her name in the waiting area anymore — she pages her and a sleek device about the size of a TV remote vibrates and lights up for 15 seconds. Patients appreciate this dignified approach and our efforts to respect their privacy. This is 1 less thing to get anxious about.

For about $1,300 we bought 15 pagers, plus a charger base that's kept at the reception desk, from a wireless paging company (www.hmepagers.com). We started off with restaurant-style square pagers, but they vibrated non-stop, which rattled some patients.

When patients register at the front desk, we hand them a pager and make a note of their name and pager number. When the nurse tells the receptionist to bring the next patient back, the receptionist keys in the number, presses call and the pager goes off. We ask the patient's friend or relative to hold on to the pager; then we can let them know it's OK to visit the patient in pre-op before surgery. We also page the patient's companion when the surgeon is ready to consult after the surgery. The post-op nurse then returns pagers to the reception desk.

In a time when privacy is paramount to our patients, calling out last names in a room full of people is an antiquated way of getting someone's attention. It is also an interruption when trying to read a magazine, watch television or visit with others in the waiting room. Every time a name is called it seems to add anxiety to the waiting process ("Are they calling me this time?"). No matter how nicely our staff tries to call out the last name, it is just plain annoying.

Matthew S. Johnson, MBA, CASC
Administrator
Northeast Missouri Ambulatory Surgery Center
Hannibal, Mo.
[email protected]

Use Clear Trash Bags
Occasionally we found things in regular trash that shouldn't be there, such as bloody items, sharps, recyclables and papers with confidential patient information. In order to keep these things out of the trash, we started using clear trash bags. If everyone can see what's being thrown in the trash, people are more likely to dispose of waste properly. At first we got complaints from staff because the trash bags were pretty unappealing when you could see everything inside. But that's exactly the point. A clear bag protects the waste handler because he can see if there's something dangerous in the bag. He can also spot anything that shouldn't be there. Clear bags cost a bit more, but they're worth every penny because we're providing a safe, healthy working environment for staff.

Tung Thanh Nguyen
Operations Manager
Department of Waste Management and Environmental Health and Safety
University of Washington Medical Center
[email protected]

Bare Below the Elbows
Monroe Hospital in Bloomington, Ind., which has a near-zero rate of hospital-acquired infections, provides laundered scrubs for all staff and prohibits them from wearing scrubs outside the building. Scrubs and uniforms are fomites, or inanimate objects that can transmit micro-organisms from place to place. Science shows that many microbes can survive on fomites. MRSA has been cultured from linens 56 days later, hepatitis B virus has been shown to survive up to 7 days and the norovirus has been shown to survive up to 72 hours.

Triage Regional Patients
Have patients amenable to regional anesthesia present 2 hours before their case and speed them through admissions to give the regional anesthesia service adequate time to perform nerve blocks. Mark the day's schedule to highlight block candidates so your receptionist can alert the clinical staff as soon as they present for surgery. Treat block candidates like VIPs, shuttling them to the front of the waiting room's line to start their blocks as soon as possible.

Edward R. Mariano, MD, MAS
Associate Professor of Clinical Anesthesiology
University of California
[email protected]