Yes, Infection Prevention Disasters Still Happen
In Oklahoma, an anesthesia provider once filled a syringe with sedation medication to treat up to 24 sequential patients, according to Clifford M. Gevirtz, MD, MPH, medical director of Somnia Pain Management in New Rochelle, N.Y. The end result: 102 hepatitis B and C infections and a $25 million settlement.

For years, says Dr. Gevirtz, anesthesia providers have used single pre-loaded syringes on multiple patients or single-dose vials for more than 1 syringe. Those days are over. "Single-use means the syringe can go into the vial only once," he notes. Thanks to recent hepatitis outbreaks, the federal government is acutely aware of proper infection prevention practices, so now more than ever is the time to prepare for a Medicare audit.

"The most common problem is breaking bad habits," says Dr. Gevirtz, adding that healthcare providers have infected hundreds of patients and scared thousands more because they cut corners to save time or money. When you discover errors or breaches in protocol, report them. Hiding the error will attract regulators and malpractice lawyers, says Dr. Gevirtz. "If you bury it, you're going to bury your clinic with it."

Discretion Is the Key to Effective Discipline
Performance management is often a bigger staffing challenge for surgical facility leaders than hiring and firing. While the latter are (ideally) cut-and-dry, one-and-done tasks, performance management should be ongoing, says Ann Geier, RN, MS, CNOR, CASC, vice president of operations for ASCOA (Ambulatory Surgical Centers of America). She recommends discretion when dealing with disciplinary problems: Speak with employees in private, listen to their side of the story, record all the facts and bring a witness if you anticipate trouble. Never correct or reprimand employees in front of others or when tempers are hot. Develop a corrective action plan with the employee, schedule a follow-up evaluation and give the employee a copy of the written documentation from your meeting. Finally, always try to end the discussion on a positive note. Your ultimate goal should be to foster staff improvement, not animosity.