Just think of the time you'd save if your eye surgery patients arrived at your facility already fully dilated. By using the 2-step process I describe below, we've cut the average patient's arrival-to-discharge time from 2 hours to a little more than 1 hour.

1. Give patients dilating drops at their pre-op assessment. When patients come in for their pre-op assessments, sell them dilating drops at your cost. Patients' prescription insurance plans often cover the nominal cost of the drops (generic drops only cost us $10 for the 3 vials needed to dilate a patient).

2. Tell patients to self-administer the drops. Instruct them to do so when they wake and before their drive in on the day of surgery. They've already been self-administering antibiotic drops on the day before surgery, and will have to put in drops in the days after it, so it's not something beyond their ability.

Having patients self-administer the drops lends another layer of safety to site verification protocols. If a patient's eye has difficulty dilating, due to their use of tamsulosin (Flomax) for prostate disorders or other conditions, you'll know immediately when they arrive undilated, as opposed to wasting 45 minutes of pre-op time watching nothing happen.

Dilation is a time-consuming process, requiring repeated attention from your nurses and a minimum of 45 minutes — a wait that's frequently longer than the case itself. Having patients dilate themselves can really save lots of time.

Sandra Yeh, MD, president, CEO and founding partner of Prairie Surgery Center in Springfield, Ill.

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