Every cataract surgeon likes his microscope, foot pedals and stretcher height positioned just so. To expedite room setup and turnover in our 1-OR eye center that handles about 2,800 cases annually, we place colored autoclavable instrument tape on the floor to mark the exact spots where each of our 10 ophthalmologists wants his equipment. This way, the surgeon can enter the room and sit right down without first having to reposition equipment or adjust the stretcher height.

In the top photo, the room is set up for a left eye cataract. Note that the locations for the microscope and phacoemulsification foot pedals are bounded by green tape. We assign each surgeon a color. The orange, yellow and blue tape you see are to mark other surgeons' preferences. We also use the tape to identify each of our surgeons' instruments.

To get the stretcher height correct for each surgeon, we mark the surgeon's preference with the tape on a metal yardstick. When you do this, make sure that each mark corresponds to a spot on the stretcher that doesn't move.

This is a simple idea, but you'll be amazed at how much more efficient it will make your room set-ups and turnovers.

Lisa Galloway, RN
Clinical Director
Snowden River Surgery Center
Ellicott City, Md.
[email protected]

CMS Shared ASC Waiting Room Announcement Nothing New
The official CMS position paper concerning waivers for shared waiting rooms in ASCs was much ado about nothing, says healthcare facility planner Bill Lindeman, AIA, NCARB, president of WEL Designs in Tucson, Ariz. Here's what hasn't changed.

• CMS still requires complete separation of all elements of an ASC from any other function or occupancy. "Unfortunately," says Mr. Lindeman, "some authorities surveying for CMS have in the past let shared waiting rooms slip through."
• CMS still has a waiver process for physical environment standards that aren't achievable — "as long," says Mr. Lindeman, "as such a waiver would have no adverse effect on patient health or occupant safety."

All the recent CMS announcement did was state that only facilities existing at the time of the announcement could ever apply for a shared waiting room exception. "This effectively created a special class where waivers would no longer ever be an option," says Mr. Lindeman.

25 Uses for Your Mayo Stand Covers
Recycling ideas from the Mid-Atlantic Surgery Pavilion in Abderdeen, Md.

1. Potato sack races
2. Sleeping bag
3. Slip and slide
4. Rubber skirt
5. Halloween costume
6. Cast cover for showering
7. Collapsible fish tank
8. Rain collector
9. Wrapping paper
10. Superman cape
11. Car floor mat
12. Windshield sun visor
13. Sled
14. Santa's bag
15. Curtains
16. Crab placemat
17. Litter box liner
18. Kite
19. Weather balloon
20. Whoopie cushion
21. Motion sickness bag
22. Animal coffin
23. Porch awning
24. Broken window replacement
25. Use it to cover your Mayo stand!

Expand Your Circle of Influence
All administrators need to get involved in the community and become well-known to friends and acquaintances, who'll then feel free to call you asking for a referral to a physician or surgeon (of course you recommend those physicians and surgeons that support your facility). I have probably referred about 50 people to the surgeons who work here, and I was glad to do it. The people asking appreciated it and the surgeons seeing the patients did as well. Too often administrators never get out of the building to see anyone other than their employees and the physicians. Get into the OR and have conversations with the surgeons about how things are working for them. Ask them what you can do to make the place easier for them to use.

Stuart Katz, FACHE, CASC
Executive Director
Tucson Orthopaedic Surgery Center
Tucson, Ariz.
[email protected]

Borrowing From Other Physicians' Block Times
Borrowing from a surgeon's sacred block time is an effective way to capture additional cases that would otherwise be performed elsewhere. At our physician-owned surgery center, we don't hesitate to ask a surgeon if we can borrow an hour or 2 from his block in order to accommodate another surgeon — regardless of whether the surgeon plans to use his block time (we have a 72-hour block-release policy). Our philosophy is that we'll return the favor down the road when he needs to add a case some Tuesday at noon. It's like the theory, "You scratch my back, I'll scratch yours." As the competition for cases heats up, remember that it doesn't hurt to ask to borrow time from time to time.

Robbi Robinson, RN
Nurse Manager
Commonwealth Orthopedics
Fairfax, Va.
[email protected]

Publish a Newsletter
A homemade newsletter is a great way to keep your staff informed about what's going on at your surgical facility. We distribute ours, "The Surgery Center Tidbits," with our bi-weekly paychecks and direct deposit notifications. We also keep copies in department binders for per-diem employees or for those who didn't work that pay period. You or someone you assign can serve as the editor, gathering bits of information, such as dates of accreditation surveys, recent case volumes and the agenda for the next staff meeting. We also include a motivational quote or story about teamwork. It's a good idea to print your newsletter on brightly colored paper to distinguish it from any other documents.

Donna H. Smith, MT, CASC
Administrator
The Surgery Center
Oxford, Ala.
[email protected]