What's the Word of the Week?
Here's a simple way to teach your team something new.

Here's a quick and easy way to teach your staff something new each week: Post a "Word of the Week" on the bulletin boards in your pre-op and post-op areas. The idea began at our facility after an "excision of pinguecula" appeared on our facility's schedule. It's an uncommon procedure, so we decided to post a short definition. For the record: a pinguecula is the thickening of the conjunctiva on either side of the eye, often appearing as a yellowish spot. Up on the bulletin board the term went for all to see, on brightly colored paper to attract attention. Recently, we've been using the weekly postings to define common and not-so-common abbreviations. For example, PKP stands for "penetrating keratoplasty." In normal speak, that's a corneal transplant. Now we're all familiar with the more technical abbreviation. Posting a word per week is a great way for staff to learn definitions of rarely used words or phrases. We're all trained professionals, but lets face it, we can always learn more about anatomy, new equipment or surgical techniques, especially when they pertain to specialties that aren't part of a typical case mix. The words of the week serve as constant refreshers and are an informal way to educate staff during their workday, especially those who might be afraid to ask about a term or concept they think everyone already knows.

Donna White, RN, BSN
Director of Nursing
Madison Street Surgery Center
Denver, Colo.
[email protected]

When PONV Prevention Doesn't Work
Even if you take every possible precaution, you may still see patients experience PONV in the recovery room. When this happens, take these three steps:

• Eliminate the other causes. Evaluate the patient for other conditions that could cause nausea, such as a full bladder or severe bleeding. These are often correctable.
• Examine the patient's antiemetic history. After you've excluded other causes for nausea, look at what antiemetics were used to treat the patient in the last six hours. This will give you an idea of what's not working for the patient. So, for example, if you see that ondansetron or other serotonin antagonists were given, you may want to try another class of agents.
• Consider the timing. If it's been more than six hours since the patient last received antiemetics, you may want to repeat the dose, with the exceptions of dexamethasone and transdermal scopolamine, as they last for 24 hours or longer.

Tong J. Gan, MD
Professor of Anesthesiology
Duke University Medical Center
Durham, N.C.
[email protected]

How to Define Success at Your Facility
At your next staff meeting and investor meeting, pass out index cards and ask all your staff and investors to fill in the blank in the following sentence: The way we measure success at ABC Surgical is by _________________.

Don't give any suggestions. If anyone needs clarification, ask him to consider what things staff should be incentivized to achieve. First, examine the answers for similarities. Obviously, the more everyone is on the same page, the better. Then print up all the answers and pass them out to the investors and ask them to prioritize them. From there, you should be able to construct a definition of success for your center.

Joan G. Dentler, MBA
ASC Strategies
Austin, Texas
[email protected]

Trust Your People to Do Their Jobs
Giving the staff, especially the nurses, the autonomy to make decisions throughout a patient's visit can lead to greater patient satisfaction. We don't micromanage our nurses. They're the experts in giving patient care and are encouraged to fix problems on their own. For example, if a patient taking a diuretic arrives without the results of a potassium test, the nurse doesn't need to ask me or another administrator what to do. The nurse can contact the patient's doctor's office for the results, or order the needed test. This makes the nurses feel empowered (because they are) and minimizes delays. Hiring skilled nurses and treating them like the experts that they are can lead to low staff turnover and high patient satisfaction.

Richard Fromm, MD
Medical Director
Hamilton Ambulatory Surgery Center
Dalton, Ga.
[email protected]