Keep Connections With Colleagues on Your Radar
Spring is the season for conferences and live events, which can go a very long way toward revitalizing your outlook....
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By: Sharyn Davis
Published: 10/10/2007
Innovative Safety Lessons
Lessons Learned from A Nuclear Power Plant
Sometimes the best advice comes from an unlikely source. Gary Yates, MD, medical director of clinical effectiveness for Sentara Healthcare in Norfolk, Va., discovered the key to improving the safety of his hospital from administrators of nuclear power plants. His innovative approach to safety improvements landed Sentara Norfolk General Hospital the 2004 American Hospital Quest for Quality Prize, awarded by the American Hospital Association.
"The traditional belief is that a high degree of awareness coupled with education will change behavior," says Dr. Yates. "We took the opposite approach by identifying specific behaviors that needed to improve, and found ways to change those behaviors."
To begin the process, Dr. Yates performed a diagnostic test to judge the strengths and weaknesses of his staff. He found the usual suspects: less-than-adequate communication, lapses in attention, breakdowns in following safety policies already in place and a failure to recognize high-risk situations.
Once the problem areas were identified the staff of the hospital were responsible for developing behavior based expectations (BBEs). For instance, the staff at Norfolk General developed the following solutions to the designated problem areas:
Dr. Yates warns the success of BBEs is dependant on monitoring the staff to make sure the guidelines are being followed. He says it's a good idea to assign managers and directors with leadership potential to provide daily oversight of the program; this creates a grassroots feel to the program being rolled out and makes the staff feel it is the employees initiating the changes instead of something coming down from management.
Most importantly, says Dr. Yates, give your staff the tools they need to succeed. "As a leader, you need to be clear as to what needs to be focused on and give the staff tools that help. Without tools, you're just asking them to be more vigilant, and that won't work."
Improving Efficiency
Small Hospital Hands Out Big Bonuses To All After Surgical Volume Increases
Everybody gets a check. That's what happened at Bryan W. Whitfield Memorial Hospital in Demopolis, Ala., when management was able to increase the number of outpatient cases it hosts. Within a year, outpatient cases jumped from 38 percent of overall surgical volume to 52 percent. All full-time employees got a $1,000 bonus, while all part-time employees received $500.
The mastermind behind the lucrative percentage flip and the gain-sharing program is Mike Marshall, CEO of the Tom Bigbee Healthcare Authority. Mr. Marshall came to BWWMH from HealthSouth Corporation with 18 years management experience in not-for-profit and for-profit hospitals. When he moved to Demopolis he found a hospital barely surviving on the blood, sweat and tears of the staff; today the facility is an example of a successful small-town hospital.
A key component of the turnaround involved Mr. Marshall's ability to increase surgical volume - in particular cases that could be done on an outpatient basis. Here are three ways he improved outpatient volume:
By Daniel Cook ...As reported in October's Hospital OR Monitor, crowded hospitals may look to scheduling elective surgery on weekends to maximize case efficiency. "It's a trend based on demand and surgical volume," says Ron Czajkowski, spokesman for the New Jersey Hospital Association. "A number of our hospitals are looking into night and weekend elective surgery for the sake of patient convenience and also as a means of increasing revenue." Robert Wood Johnson Hospital in New Brunswick, N.J., has realized a 10 percent increase in surgical volume over the past year, says Lorraine Butler, RN, MSA, CNOR, and the hospital's vice president of perioperative services. "Non-high-volume docs who don't have block times during the week are able to schedule their cases on Saturday, and patients don't have to miss work after having a minimally invasive procedure done." ...Merritt, Hawkins & Associates, a Texas-based physician search firm, asked 4,000 hospital CFOs how much revenue physicians generated for their hospitals in 2003. Based on inpatient and outpatient revenue from patient referrals and procedures, orthopedic surgery generated the most revenue for hospitals, with $2,992,022; general surgery ranked fifth at $2,446,987.
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Strange But True
One night, a patient and his girlfriend got into a heated argument, resulting in the girlfriend's stabbing him with a steak knife. Luckily for him, it didn't cause any major damage. But the girlfriend waited for us outside the OR because she wanted the knife back to complete her set.
Garnett Irby, RN
Nurse Manager of Surgical Services
Loris Healthcare System
Loris, S.C.
Can you contribute a funny quote or a strange but true tale? If so, please e-mail associate editor Daniel Cook at "[email protected]").
Do You Know What Makes Your Nurses Tick?
Fourteen hospitals in New York are using online surveys called Nurse Engage to improve staff satisfaction and retention. The survey, which takes about 15 minutes to complete, asks nurses questions designed to measure their trust, pride and loyalty in their facilities, nurse managers and peers; the survey doesn't ask questions with respect to salary or benefit satisfaction.
The premise is that by better understanding engagement issues, facilities will have a more satisfied staff, which is a key link to retention.
"We're very excited to participate," says Stephanie Von Bacho, MS, RN, the director of nursing accreditation and advancement for the University of Rochester Medical Center at Strong. Ms. Von Bacho used letters to staff and her hospital's internal Web site to spread word about the survey. "This will help us retain staff during a national nurse shortage, and we also hope it will turn into a recruiting tool."
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