Our facility is one of several offering internships to the local community college's surgical technology certification-program students. Students are assigned to a facility for about four weeks; during this time they

• act as a second scrub on cases;
• clean rooms and mop floors;
• assist anesthesia provider during induction;
• prepare specimens for pathological exams;
• do complete surgical counts;
• identify and report breaks in sterile techniques; and
• attach patients to the EEC monitors.

These are just a few examples. Because the surgical techs' work is considered by the school an internship that counts toward graduation credits, they work for us for free. It's a win-win arrangement: The students learn clinical skills and earn credits, and we get free help and find potential future employees. In fact, our facility has hired six graduates of the program in the last two years.

Kathleen Ranne, RN
Staff Nurse
St. Lucie Medical Center
Port St. Lucie, Fla.

To reduce your turnover times, try collecting less data
When we wanted to minimize our between-cases OR turnover times, we picked a most unlikely place to streamline: our data reports, which had grown to 25. We weren't using the information because we simply had too much.

We pared our data reports to the four we felt most integral to indicating where our turnover-time problems lay: scheduling, patient prepping, on-time first-morning starts and turnover activities. We've developed protocols around these four measures, such as having patient charts ready for surgeons at 5 p.m. the day before their surgery (a patient-prepping activity). And we've developed time indicators in every case; for example, we track surgeon, anesthesia provider and RN time spent on each case.

Now, we apply the information from every report we build in one or two ways so we can see where we can improve or assure that we are maintaining best-possible turnover times. With a data-driven process, we've reduced our turnover time significantly - down to as little as five minutes.

Anne Hanzel, RN, MSN, MA
Director of Surgical Services
Wausau Hospital
Wausau, Wis.
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Reward performance with the gift of time
Our peer-nominated employee of the month used to receive a coupon for a free car wash - nice, but not as desirable, we've found, as the two hours of pass time the winner now receives. The pass is to be used to arrive late or leave early, a decision made between the staff member and her coordinator, and we pay the employee for the two hours off.

Diana Procuniar, RN, BA, CNOR
Winter Haven Ambulatory Surgery Center
Winter Haven, Fla.
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