TEAM PLAYERS Anesthesia providers should increase patient satisfaction, enable efficiency and give your facility a competitive edge, says Jay Horowitz, CRNA.

"You know, anesthesia providers will go to after-work parties if they're invited," says Jay Horowitz, CRNA, referencing the disconnect he sees between anesthesia and surgery in far too many facilities. In fact, only 36% of attendees believed they were getting all they need from their providers.

The president of Quality Anesthesia Care Corporation in Sarasota, Fla., says promoting patient safety is just the "tip of the iceberg" when it comes to what providers should offer your facility. "They need to make themselves indispensible," he added. "Being indispensible equates to job security."

Are your providers active participants in committee meetings? Are they constantly learning new skills and helping you adapt to the demands of a competitive market? In the OR, they should ensure on-time starts, help decrease turnover times and cancelled cases, limit PONV risk, effectively control post-op pain, guarantee timely antibiotic administration and implement anti-embolism strategies. When not working cases, providers should provide input during anesthesia equipment evaluations and purchases, manage the formulary, help craft policies and procedures, sit in on management committee meetings, be active in recruiting physicians and help lead facility practice seminars.

Mr. Horowitz tells the facilities where he works cases to give out his cell phone number to prospective patients so he can answer questions they might have about the anesthesia they'll receive. The 5 minutes he spends on the phone a dozen times a week are tremendous opportunities to interact with patients and "pay off tremendously for me and the facilities," says Mr. Horowitz.

"No matter how good providers think they are, they can be better and must relentlessly improve," he says.

Communicate through change
"Who's been on a plane that's sat on the tarmac for longer than 20 minutes?" asks Pam Hudson, MBA, DM, administrative director of the Paoli (Pa.) Surgery Center. Not surprisingly, nearly all of the attendees said that they had.

"What did you need from the pilot?" asks Ms. Hudson. "You needed honest, transparent and direct information sharing." Your staff is no different. Eighty percent of the audience agreed that open communication is the No. 1 skill leaders must have to effectively facilitate change. Ms. Hudson says that's accomplished through 4 simple steps:

• Clarity of focus. What exactly are you trying to accomplish? Make sure your staff understands the "why" behind the "what."
• Accountability plan. Who owns the process and the ultimate outcome? Are the priorities clear? Surgical professionals work best with a step-by-step plan.
• Relentless follow-through. Set expectations and regularly check in with the individuals who are accountable for implementing the change. Create a spreadsheet that lists the tasks that need to be completed, due dates and the people responsible for accomplishing them. The amount of attention given to a plan should match the importance of the project.
• Celebration. Carve out time to recognize successes and define what the success means for the entire staff. Exhale and have fun when goals are met, you deserve it.

No more sticks, nicks or cuts
The three-fourths of attendees who said they had to report a sharps injury in the past year paid particular attention to Bev Kirchner, RN, BSN, CNOR, CASC, owner and CEO of Genesee Associates in Southlake, Texas, who spoke about complying with OSHA's Bloodborne Pathogen Standard and implementing a sharps safety program that works.

In order to meet OSHA's guidelines, your sharps exposure plan must describe how you implement a combination of engineering and work practice controls, ensure the use of personal protective clothing and equipment, and provide training, medical surveillance, hepatitis B vaccinations, and sharps safety signs and labels, says Ms. Kirchner.

While more than half of the audience thought a facility's leadership team is responsible for identifying and trialing sharps safety devices, Ms. Kirchner points out the opposite is in fact true. "It's the non-managerial staff members who have to be involved in the evaluation process," she says. "They must complete evaluation forms for each product tested and help select the devices you use in your facility." Only about one-fourth of attendees say they use safety syringes, shielded retractors and needleless IV systems, but only 13% use safety scalpels or blunt suture needles.