Bring Less Paper to Your Meetings
Here are a couple of easy ways for your facility to go green.
When we gather in the conference room, we display the minutes of our previous meeting with a laptop, projector and screen instead of printing out copies for everyone in the room. Before the meeting, we e-mail each participant the minutes for review, with a "Think Before You Print" emblem at the bottom.

We came up with this paper-saving idea when we wanted to share our facility's financials with management, but needed to secure those numbers against inadvertent public access or unauthorized distribution. The screen limited the information's availability, but also provided a way to simplify preparation for meetings.

Since then, we've also put our employee handbook on our company intranet. That way it's easier to add new details and update existing information. Sure, an employee could print it out, but the online version remains the most current one.

Debbie Hay, RN, BSN, CASC
President
Texas Institute for Surgery
Dallas, Texas
[email protected]

Give Your Joint Patients Snap-up Pants
In the recovery suite, we give patients in our total- or partial-joint orthopedic programs a pair of pajama-like pants with snaps up the middle of the leg. These prevent the uncomfortable moment of the surgeon or nurses having to lift up a gown to look at the surgical site. In the winter, patients receive flannel pants; in the milder months they get smooth cotton pants. In the summer, we give them shorts. A local seamstress custom-makes the pants, which cost about $35 each.

Angela Laux, RN, BSN, MSOLQ
Director of Quality
Orthopedic and Sports Surgery Center
Appleton, Wis.
[email protected]

Save $3 on Every Pain Case
A simple switch from lidocaine patches to Band-Aids after each of our pain procedures saved us $3 per case. We do 1,200 to 1,300 pain cases a year, so this saves us nearly $4,000 a year. When we reviewed our annual cost-per-case study with our physicians, we discovered that our pain physicians were applying lidocaine patches on the injection site immediately following all pain procedures. We now use Band-Aids and write a prescription for a lidocaine patch should patients have discomfort in the hours after the initial medication wears off.

Leah Ethridge, MHA, CASC
Management Consultant
Gulf South Surgery Center
Gulfport, Miss.
[email protected]

Let Your Staff Award Each Other Marbles For Jobs Well Done
Need a creative and simple way to recognize employees who work extra hard, are great at what they do and go above and beyond their assigned roles? Try trading marbles for prizes. Let me explain.

Whenever a member of my staff sees a colleague lend a helping hand, they drop a marble into a plastic cup with the do-gooder's name on it. Staffers carry handfuls of marbles in their pockets throughout the workday or grab 1 from a jar that sits next to the cups.

We use the plastic cups designed to store patients' dentures during procedures, but any inexpensive container would work. Note the names of each employee on individual containers and display them in a high-traffic area (in the staff lounge, for example) so they'll serve as a daily reminder that no good deed goes unnoticed. Employees trade each marble they receive for $1 toward recognition awards of their choosing. Some choose to bank marbles for high-ticket items like restaurant gift certificates or gift cards to the local mall. Others cash in their marbles piecemeal for gas cards or movie tickets. Regardless of how they choose to manage their marbles, employees are happy to know that their peers notice and appreciate their hard work.

Dianna Burns, BS, RN, CGRN
Administrator
Fort Wayne Endoscopy Center
Fort Wayne, Ind.
[email protected]

Use a Biohazard Box to Dispose of Large Items
A sharps container can fill up quickly when you put larger items such as biopsy forceps, injection needles or polyp snares in it. To save on medical waste costs, we use large cardboard biohazard boxes lined with red bags instead of the large sharps containers or red bags alone. This saves us a lot of money. It costs about $8 to dispose of a box, compared to about $15 for each large plastic sharps container. We change the box every month or 2, compared to every other week with the sharps container.

Angie Reeves, RN, BSN, CASC
Administrator
Bay Area Houston Endoscopy
Webster, Texas
[email protected]

Is Your Checklist Complete?
Pre-operative checklists and briefings have been proven to help reduce surgical errors, infection rates and unexpected delays. But the value of a checklist depends on its ability to fully prepare an OR team for surgery. Make sure that your checklist covers the entire process, from room setup until the patient is transported to recovery.

Besides prompting the verification of patient identity, surgical site and scheduled procedure, the checklist should require team members to discuss the planned approach and to ensure that all needed equipment and instruments are in the room. These steps can avert mid-procedure delays.

The checklist should also establish specimen-handling rules. Out of every 1,000 specimens handled, 2.1 are mislabeled with incorrect names, collection sites, tissue types or other details. But this error is easily preventable if it is planned in advance that a team member will read the label back to the OR team after it's been created.

This checklist for safety and efficiency should be a part of everyday life. Create a large poster that incorporates its steps and hang a copy in every OR.

Martin A. Makary, MD, MPH
Director
Johns Hopkins Center for Surgical Outcomes Research
Baltimore, Md.
[email protected]