End Days With 5-Minute Huddles
Have managers, some randomly chosen staffers, and (at least occasionally) administrators gather at day's end to talk about what went wrong, how you can make things better and what the next day's challenges look like, says Kenny Ellinger, RN, ADN, administrator of the Surgi-Center of Central Virginia in Fredericksburg. It should be a round-robin discussion, never a gripe session, and have everybody stand — that way you're sure to keep it short.

Train Your Own Surgical Assistants
Instead of relying on a staffing agency, enroll dedicated, interested surgical technicians into an accreditation program, and have retention agreements in place once they're finished, says Patrick Guzik, administrator of Bon Secours Surgery Center at Harbour View in Suffolk, Va.

Proactively Fight Infections
Make it easier for sometimes-reluctant physicians to report SSIs, says Jill Andrews, RN, BSN, CNOR, administrator of the Central Utah Surgical Center in Provo. Break down physician-provided data on a spreadsheet and meet with an infection control specialist. Drill down to likely root causes and send reports back to the docs, who are then better equipped to keep infections to a minimum.

Turn Time Into Money
Play hardball when it comes to block time, says Amy Whisnant, MSN, RN-BC, CNOR, director of perioperative services at CaroMont Health in Gastonia, N.C. She increased target block time utilization from 50% to 70%; penalized docs who fell short; raised the criterion for additional block time to 85% utilization; and also penalized surgeons who released 33% or more of their time. The result: OR block productivity went up from 75% in 2012 to 83.3% in 2013.

Backfill Your Schedule
Schedule from the end of the block to the beginning, so you leave earlier start times open for add-ons, says Michael Pankey, RN, MBA, administrator of the ASC of Spartanburg (S.C.). He also suggests you move smaller cases into an underperforming doc's room, which opens up more prep time for big cases in the busier docs' rooms.

Dole Out Raises Based on Merit
LoAnn Vande Leest, RN, MBA-H, CNOR, CASC, chief executive officer of Northwest Michigan Surgery Center in Traverse City, judges employees by 6 performance parameters: communication and customer service; expense and resource management; initiative and problem solving; job knowledge and skills; productivity and quality of work; and teamwork. She rates them in each category on a scale of 1 (unsatisfactory) to 4 (exceptional), tallies the ratings and divides by 6 for an average score. That gives her a figure for comparing individual performances against the group.

Lean on Workflow Technology
Decrease same-day cancellations and improve patient throughput with pre-anesthesia screening technology, says Jerry Henderson, RN, BSN, CNOR, CASC, MBA, assistant vice president of LifeBridge Health in Baltimore, Md. Her facility's platform lets clinical, scheduling and financial systems communicate with each other and with physicians' offices. The system improved periop efficiencies and could increase annual reimbursements by $780,000.

Make Partnerships Work
Do your part to make the transition to corporate ownership seamless, says Jeany Roberts, RN, administrator of the Effingham (Ill.) Ambulatory Surgery Center. Set the tone by being honest and positive with your staff. Focus on the process of ownership change, not the daily tasks. Defuse rumors quickly and stay in constant communication with staff and surgeons so you understand their concerns.

Do Away With Delays
Myrna Chang, DHA, RN, CNOR, says 6 steps will help you better manage bumps in your surgical schedule. The nursing director ?at O'Connor Hospital ?in San Jose, Calif., suggests you (1) measure all case times; (2) identify the 10 longest procedures and schedule them appropriately; (3) report surgeons who have the highest number of late arrivals; (4) send letters of performance to docs with higher average case times; (5) rely on a pre-op clinic to prep patients for surgery; and (6) have charge nurses notify surgeons if delays do occur.

Know Your Case Costs
Identify the 5 highest volume procedures for each service line and the surgeons' supply costs for each procedure, suggests Susan Comp, RN, BSN, MHA, vice president of surgical services at Pinnacle Health System in Harrisburg, Pa. Assess items on the preference cards of surgeons with higher supply costs. Are there ways to reduce supply usage or increase reimbursements for top-volume and high-cost procedures?