When our scrub techs have packed a load of instruments that have been through the autoclave, they use a date stamping gun - like in a grocery store - to mark the packs with the processing date and load number. They set the stamping gun to print the load number and the date and just sticker everything. Click, click, click, done. That's a lot of time saved for the tech, since he's not in the back writing on every package. Handwritten information could be illegible or get smeared, so this technique also avoids a lot of potential mistakes. Plus, it provides a convenient tracking methodology for instruments: It's easy to identify the patients and procedures from which they came. And it's confidential, so it's HIPAA compliant.

Cynthia A. Burciaga, RN, BSN, MBA-HCM
Director of Nursing and Perioperative Services
Littleton Day Surgery Center
Littleton, Colo.
writeMail("[email protected]")

Ahh...10-minute chair massages for staff
We've arranged for a massage therapist to visit our center one day a week and offer 10-minute chair massages to our staff. It started as a joke on a busy day when someone said, "We ought to have a massage therapist around here." It turned out, someone who works in our office has a daughter who's a massage therapist. She comes 11 a.m. to 3 p.m. on Wednesdays, our busiest day. Staff sign up for appointments, and somehow we manage to get them away from their work for 10 minutes to a room downstairs when their time comes.

It's a great stress reliever. You see people moving 100 miles per hour all morning, and then they come back from their massage more relaxed. It's also interesting because the scheduling promotes teamwork. People swap appointments, or give theirs up if they think that someone else badly needs a break. It's also a boon for employee relations. With all the money you spend to orient and train your staff, it costs you a big chunk of change if people leave because they feel that their employer didn't care about them.

We pay our massage therapist $20 per hour. I doubt you could find someone for that rate (our therapist's mother works here). But you don't need a massage therapist in the family to obtain these benefits. Our therapist also works at a rehabilitation center, so you can probably get a recommendation on one from a rehab facility that you've referred your patients to.

Sandy Berger, RN, MSN, CASC
Director of Nursing
The Center for Surgery
Naperville, Ill.
writeMail("[email protected]")

When it comes to your OR schedule, think vertically
The concept of "vertical OR scheduling" offers OR staff and anesthesiologists much more efficient use of their time. It means, whenever possible, stack cases one on top of the other in the same OR rather than open-ing another room.

For instance, if two surgeons request a 7:30 a.m. block and you only have a couple of procedures that morning, see if you can schedule cases at 7:15 a.m. and 8:15 a.m. in the same OR instead of opening up two rooms. Or if case schedule requests from different surgeons only overlap by 15 minutes or 30 minutes, stack them consecutively as "follow cases." That way you're using one room and one team from the morning instead of staffing two rooms for a short period of time.

Success with this scheduling model requires a modest amount of flexibility from the surgeons. However, we've found that physician-owners were willing to consider the adjustments when they realized the cost-saving implications.

Mary Ryan, RN, BSN, CNOR
Administrator
Tri-State Surgery Center
Dubuque, Iowa
writeMail("[email protected]")