OR Excellence Awards – Employee Safety: Safety and Satisfaction Go Hand in Hand

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By investing heavily in the well-being of its staff, Knoxville Orthopaedic Surgery Center is improving the care of its patients.


At the heart of Knoxville (Tenn.) Orthopaedic Surgery Center’s full-circle approach to top-quality patient care is a very simple philosophy: Take care of those who take care of the patients. “I feel like it’s my ultimate responsibility to make sure my staff are safe and happy,” says Beth Russell, MSN, RN, CASC, the facility’s executive director. “But honestly, you can’t have one of those attributes without the other. Safety and happiness go hand in hand.”

It’s this big-picture commitment to the well-being of its staff that ultimately led to Knoxville Orthopaedic Surgery Center being chosen as this year’s winner of the OR Excellence Award for Employee Safety. One of the many examples of the facility’s level of commitment to safety is illustrated by recent changes made to the workstations of its business, administration and front office staff members.

When a few employees in the business office complained about their backs hurting, Ms. Russell says she looked at the chairs they used — which were in place when the center opened eight years ago — and decided it was time for an upgrade. “We immediately replaced all the chairs, and that made a huge difference for several people,” she says.

Despite the new furniture, one staffer was still struggling with neck pain and a lot of headaches, something she had been working on alleviating with a physical therapist from the physician’s office that was connected to the surgery center. The physical therapist suggested that the employee take a closer look at her work area. “She thought that sitting in front of the computer could’ve been causing her strain,” says Ms. Russell. “So, we asked the physical therapist to assess the ergonomics of her workstation.”

The physical therapist made some basic adjustments — such as raising the employee’s computer monitors so she wasn’t looking down at an angle — and the results were so immediate and so pronounced that Ms. Russell thought, We need to do that for everybody. As a result, the physical therapist wound up spending about eight hours at the surgery center, looking at everyone’s workstations and making suggestions on what could be done ergonomically to improve the comfort of the entire administrative staff. “We added some standing desks, elevated some monitors and even got footstools for a couple of people.” Implementing all the physical therapist’s recommendations took about a month — but it was well worth the effort. “It was a huge staff satisfier,” says Ms. Russell.

Keeping Complacency at Bay
Honorable Mention
OPEN TO SUGGESTION Many of the safety initiatives at CHRISTUS Spohn Alice Hospital are the direct result of suggestions staff made to leadership.  |  CHRISTUS Spohn Alice Hospital

Every three months staff at CHRISTUS Spohn Alice (Texas) Hospital are surveyed on a variety of topics. One of the recurring questions in each survey is: “How safe do you feel?” It’s an open-ended question that gives staff the opportunity to not only voice any concerns they may have, and also to offer their suggestions on how those concerning situations can be remedied. “Leadership is open to any suggestions from associates based on the surveys,” says Norma C. Escobar, BSN, CNOR, RNFA, director of surgical services at CHRISTUS. “We empower a culture of safety every single day — there is never a time when we’re complacent.”

Increased security. After the massacre at Robb Elementary School in Uvalde, which is located about three hours from the hospital, CHRISTUS decided to bolster its security and active-attacker training. In addition to arming its security personal with handguns, the facility limited the public entrances during nights and weekends, added an associate-only entrance keypad and created coded-entry for specific departments such as perioperative services. “We also brought outside law enforcement agencies in to hold a three-hour educational course on active attacker emergencies,” says Ms. Escobar. The facility also hosted a realistic active attacker drill where their security manager donned a red T-shirt, signaling that he was the active attacker and playing out various potential scenarios. “It was intense, but we wanted staff to be prepared,” says Ms. Escobar.

Sharps safety. Years ago, Ms. Escobar was the victim of a needlestick while working on a case involving an HIV-positive patient. “It was terrifying on a personal level, but it also inspired me to make sure something like that never happened to anyone on my team,” she says.

CHRISTUS made sharps safety a top priority and implemented precautionary measures such as a no sharps zone, where sharps are placed safely on a magnetic pad that prevents inadvertent hand-to-hand passing, and the use of safety needles in the OR. The dedication to sharps safety has paid off. “I was recently talking to our occupational health nurse about the last time we had a sharps injury, and she couldn’t think of a single incident,” says Ms. Escobar.

Smoke evacuation. CHRISTUS understands the dangers harmful smoke plume in the operating room, and that’s why its electrocautery units are fully equipped with evacuators that must be used during smoke-generating cases.

Ms. Escobar credits the success of her facility’s employee safety initiatives to a true partnership between leadership and the frontline safe. “To keep your staff safe, you need to have full transparency from administration,” she says, adding that, for their part, leaders must also be willing to implement the protocols staff truly believe will make them safer. After all, who knows more about the day-to-day safety risks in surgery than the staff on the front lines?

Jared Bilski

Ergonomically sound workstations are only one of the safety-focused initiatives Knoxville rolled out for its staff. The ortho-only surgery center also has a robust sharps prevention program that takes OSHA’s guidance and expands upon it. The program starts with new staff, who receive sharps education within their first couple weeks of employment (experienced staff also receive refresher sharps training on an annual basis). Ms. Russell says the training includes a computer-based learning program and then more in-depth in-person training where staff receive hands-on instruction on how to use and employ specific sharps safety items and practices, including blunt suture needles and a neutral zone in the OR to eliminate the hand-to-hand passing of sharps.

You could offer all the safety training in the world, but if it doesn’t resonate the right way with staff, it’s simply not going to stick. Knoxville is aware of this challenge, which is why the facility’s leadership is always looking for newer, more effective ways to educate staff. “We had an education session about bullying prevention training, but it didn’t hit right with our staff,” says Ms. Russell. So they flipped the tone of bullying education. “Instead of focusing on the negative things our staff shouldn’t do, we began focusing on the more positive behaviors they should be emulating in the OR,” says Ms. Russell. That subtle shift was just what was needed to get the training to stick.

All the programs Knoxville Orthopaedic Surgery Center has in place will no doubt evolve over time because the facility’s leadership is constantly looking for ways to improve the health, safety and well-being of their standout staff. In fact, Ms. Russell is quick to point out that the ortho center’s physician-owners trust her and her management team to do whatever is necessary to take care of their employees. “We work for a fabulous group of physicians who always put their staff first,” says Ms. Russell. “Our owners know they have the best place in town for patients to undergo surgery, and that’s only possible because they have the best staff, so they want us to do whatever it takes to keep them safe.”

Ms. Russell has strict marching orders to take care of those who take care of the patients — and she takes that responsibility very seriously. OSM

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