You might be surprised by how many older people in your community would love to volunteer at your facility. Our eye center's 40 volunteers help us give patients extra-special attention. They answer questions, escort patients inside the facility and to and from their cars, serve as hosts in waiting rooms, assemble post-op eye-care kits, collate informational packets and help out with mass mailings. Besides the practical benefits, the volunteers give us word-of-mouth marketing and improve our bond with the community.

If you're interested in starting a volunteer program, consider the following:

• Meet each volunteer in person. A volunteer must be a "people person" who's comfortable around strangers. You'll know at your first meeting.
• Run a background check. Our HR department runs a criminal background report for all prospective volunteers and a DMV report for those who will drive our patient shuttle. Each volunteer fills out an application that asks for previous job and volunteering experience and preferred times to volunteer.
• Define and assign tasks. No one likes to stand around waiting for something to do. Our volunteers do essential adjunct duties that complement our staff's service. They each have specific responsibilities that are not routinely done by employees.
• Get to know and reward your volunteers. Make them part of your family. We offer lunch and gift cards and occasionally host dinners where they can get to know each other. We also host an annual luncheon honoring all our volunteers and acknowledging those who have given our center and our patients exceptional service.

Lois Babcock
Volunteer Coordinator
St. Luke's Cataract & Laser Institute
Tarpon Springs, Fla.
[email protected]

Running Late? Communicate With Your Patients and Their Loved Ones
If you are running behind schedule, there is one thing you must do for your patients and their family members, and that is keep them informed.

Let's say we have 2 doctors running rooms. Dr. A is on time, but Dr. B is running late. The waiting room is starting to fill up and some of Dr. B's patients are seeing other patients who arrived after they did being escorted into pre-op. Someone has to go out and make an announcement: If you are with Dr. B, he has been delayed, and we'll take you back as soon as possible. We usually set the front desk secretary to the task. (She hates to do it, but the possibly anxious, possibly frustrated patients want to know what's going on.)

Or let's say our 9 a.m. patient isn't ready to go at 9 a.m. and we switch her with our 9:30 a.m. patient. In the rush and busyness of a surgical schedule, it can be easy to lose sight of concerns outside of the perioperative process. But has anyone told the patient's escort, waiting outside to provide a ride home, that she'll be waiting a bit longer? They should have. We make it our nurses' responsibility to notify family members if the schedule changes. We'll even take cell phone numbers if they'd rather step out in the meantime.

In fact, we have a rule that if a case is running more than 35 minutes off-schedule, we'll ask patients in pre-op if there's anything we can do to help coordinate things for them: tell their escort, call their ride, make a phone call.

Information is a little thing that doesn't cost us anything. It's customer service, and this is a business: You want everybody on your side. And we've found that simple things like communication make a big difference.

Marion Auld, BSN, MBA
Clinical Director
Endoscopy Center of Santa Rosa
Santa Rosa, Calif.
[email protected]

Go Electronic With Staff Self-Evaluations
Our department conducts every employee's review at the same time of the year, which is convenient for getting them done all at once, but can be a nightmare to organize. One way we've improved the process is by having our employees submit the self-evaluation component of the review materials electronically. I e-mail the form to every full- and part-time employee (in rich text format, so they don't need any particular software to open it if they choose to fill it out at home instead of on our workstations). Electronic forms speed the task for the employees, who then e-mail them back to me.

I forward the forms to the nurse educator and charge nurses — without having to photocopy or print and deliver several of each — so everyone gets a chance to review them in their own time. Then I project them from a laptop computer onto a screen in the conference room where we meet to discuss each employee's self-evaluation and our own impressions. As efficient as electronic forms are, this face-to-face time is essential. The group discussions after our individual readings frequently bring more meaningful information to the evaluation process than our initial readings did.

Going electronic with our evaluations created some concerns at first. But 3 years in, it's saved us time and paper and even helped to get our less-digitally-savvy employees on board with the technology that's changing health care.

Charlotte West, MPH, RN, CPAN
Director, One Day Surgery/PACU
Children's Hospital of Alabama
Birmingham, Ala.
[email protected]

Malignant Hyperthermia Bag of Supplies to Go
If you have a malignant hyperthermia (MH) event in your facility, after you begin treatment and stabilize the patient, you'll have to transfer the patient to the emergency department of a hospital. Keep in mind that because of the rarity of MH, the hospital emergency team might not be immediately familiar with how to treat the disorder. To save valuable time, create an MH kit that you send to the hospital along with the patient. Keep a 9 x 14-inch canvas tote bag in the drawer of your MH cart. Before the patient leaves the facility, put all the drugs and supplies needed to treat MH (dantrolene, heparin and sterile water) into the tote bag, along with the treatment protocols published by the Malignant Hyperthermia Association of the United States (www.mhaus.org).

Billie Carney, RN
PACU Supervisor
Fairfield Surgery Center
Fairfield, Conn.
[email protected]

Color Code Your Clean Endoscopes
As long as flexible endoscopes have been reprocessed within 5 days of use, it's OK to use them, says AORN, which last year revised its recommended practices for cleaning and processing flexible scopes and no longer requires reprocessing immediately before use. But keeping track of when each scope was reprocessed can be time-consuming and confusing when you're reprocessing dozens every day. We've come up with a simple solution: Attach a colored paper clip to the lip of the biopsy channel of every scope after it's been reprocessed. Each day gets a different color. We found variety packs of paper clips ($7.60 for 250) with 7 colors. We created a flip chart that tells the reprocessing department staff which color scopes hanging in the cabinet need to be reprocessed that day. Each reprocessed scope gets a new colored clip and the old clips go to the business office, where they're reused.

Frank Visciglia, PCT, Nancy Torres, RN, and Catherine Kean, RN
Danbury Hospital Endoscopy Center
Danbury, Conn.
[email protected]

Take Advantage of EMR User Groups
Whether you're an early adopter or just getting started with electronic medical records, there's always something new to learn about this emerging technology and how to make better use of it to maximize efficiency, cost savings and patient care. Many EMR vendors sponsor user groups to give their clients opportunities for continuing education and networking with other professionals using the same system. These programs vary from vendor to vendor: The company may host a national meeting once a year, quarterly or semi-annual meetings in different parts of the country, regional seminars or a combination of these events.

A large user group meeting will typically have a few general sessions, and then more targeted sessions for different types of users (for example, clinical vs. business office staff). In between lectures and presentations, you'll have the chance to network with other administrators using the same system. I often come away from these meetings with contacts for users in my region and specialty, so we can continue to bounce ideas off each other and share our victories and frustrations with our EMR systems. In addition to the meetings, most vendors have some type of online user group as well, where you can start discussion threads, share ideas and participate in webinars.

Converting from paper records to EMRs is an ongoing process and a continuous learning experience. I've found it's worth the extra money and time it takes to get involved in user groups that can help you get the most out of the system you've got.

Stephanie Diem, RN, BS
Clinical Director
Washington Square Endoscopy Center
Philadelphia, Pa.
[email protected]