A Planning Playbook for Opening a New Orthopedic ASC
The ASC market continues its rapid growth. In 2023, roughly 116 new ASCs opened in the U.S., many of which were orthopedic-specific in nature....
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By: Diana Procuniar
Published: 10/10/2007
When new facilities open in your area, you have to work smarter to keep your doctors' business. Here's what worked for us.
Susan Roland, RN
Administrative Director
North Florida Surgical Pavilion
Gainesville, Fla.
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First Come, First Served for Vacation Time
We all know that vacation days are worth more to some employees than a pay raise, and scheduling those precious days off is a top priority. One of our center's nurses grew so tired of being left with her second or third choices for days off after senior staff took first dibs on vacation time that she approached us with the idea of developing a first-come, first-served policy. Her ideas was to hang a dry erase board in the staff lounge that displays the year's calendar and tracks vacation requests.
Staff still submit vacation request forms before initialing the corresponding days on the community calendar. That creates an internal checks system for keeping track of vacation time: The calendar is in place for everyone to see and the request forms serve as written backup if someone decides to tamper with the big board.
When conflicts arise between employees who want the same days off, we have them discuss the matter and decide whose plans are more easily changed. In the end, we stick by the first-come first-served policy, and conflicting vacation requests always seem to be resolved. If you decide to implement this system, be sure to display the next year's calendar by September or October. Your employees will appreciate the opportunity to plan early for their time off so they're free for family vacations or their kids' school holidays.
Carolyn Skaff
Executive Director
ASC Durango at Mercy Regional Medical Center
Durango, Colo.
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Memo to Staff: This Is How We Do It
When nurses from several different facilities come together under one roof, they all know how to do everything, but they all do it differently - including how they practice and define infection prevention. No matter how long your nurses have been doing things their own way, here are five tips to get your entire staff on the same page.
Remember, consistent infection control practices help reduce infections. Although your staff is experienced in surgical procedures and instrumentation, not every employee will be experienced in cleaning ORs and anesthesia equipment - this includes the BP cuff, the EKG cables, the pulse oximeter cable and the finger sensor - between cases. One area of care that may not be completely understood by even the most seasoned personnel is the importance of consistent infection control practices. Everyone thinks they know what the proper infection control practices are. They base their knowledge on previous places of employment. These preconceived beliefs might lead to inconsistency in infection control practices. Now's your chance to train every employee in your facility's infection control practices. You want hand washing, cleaning between cases and cleaning the facility at the end of the day to be done consistently by everyone. Have all cleaning products and equipment available to demonstrate use, reconstitution and disposal. Have staff practice live in the OR after the trial run of cases.
Debbie Comerford, BSN, CNOR
Consultant
Facility Development and Management
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Managing Hyperglycemia in Surgical Outpatients
Studies have shown that glucose intolerance and hyperglycemia commonly arise from surgical stress. Here's a sample, simplified approach to managing hyperglycemia in surgical outpatients, which we'll define as patients who are planning to go home on the same day as their procedures and who aren't already in a monitored setting where more comprehensive, ongoing diabetic management is taking place:
The A1c value is an index of mean blood glucose over the past two to three months. This number is weighted to the most recent blood sugar levels. The HbA1c test result reflects the past 30 days as about 50 percent of the A1C, the preceding 60 days as about 25 percent of the value and the preceding 90 days as about 25 percent of the value. The body is continuously destroying and replacing red blood cells, so it doesn't take a full 120 days to detect a clinically significant change in HbA1c after a significant change in mean blood glucose.
Adam F. Dorin, MD, MBA
Medical Director
Grossmont Plaza Surgery Center
San Diego, Calif.
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