A great way for your schedulers and coders to appreciate how they impact the health and wealth of your facility is to let them spend a day in your ORs. Nothing will open their eyes more than observing a series of cases.

Your scheduler will get to see how her schedule affects turnover. Once she sees how long it takes to move equipment between cases, she'll think twice before she schedules a right shoulder procedure between two left shoulder procedures. Your coders and billers will better understand what they're billing out. Take orthopedic implants, for example. They may not realize that a patient coming in for a fracture requires a plate as well as four screws. Having seen such a case, however, they'll know how to bill out the case from the chart.

Even if it's just once a year, get your front-office staff away from their desks and into the ORs. You'll infuse them with a sense of ownership in what they do.

Katrina Holmes, RN, BSN, CNOR
Administrator
Ambulatory Surgery Center of Stockton
Stockton, Calif.
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Where to Find a Great Receptionist
You can teach people most anything, but you can't teach them to be nice. When looking to hire a new receptionist, I don't place an ad in the newspaper. I'll look to recruit someone from my local service industry, such as a hotel concierge, high-end retail store associate or a restaurant hostess. One of my recruits is now a medical practice administrator. Most of the people in these industries also have good computer skills, which are easily transferable to a medical practice's computer system.

Yvonne Martin, MBA
Business Management Group
Newbury Park, Calif.
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How'd You Know My Name?
Here's a quick and easy way to impress patients. Ask your receptionist to attach to each chart a sticky note that recoreds what the patient is wearing. This way, whoever picks up the patient can walk right up to her and say, "Mrs. Scott, we're ready for you to come on back now."

Ann Geier, RN, MS, CNOR, CASC
Vice President of Operations
Ambulatory Surgery Centers of America
Norwell, Mass.
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Make Your Pre-op Histories More Complete
Nothing is more frustrating than having to cancel or delay surgery because of an incomplete pre-op history. We've created and distributed a one-page form to our physicians' offices to prevent this problem.

The form asks patients about previous conditions, surgeries and how they've reacted to anesthesia. With a lot of these questions, if the answer is yes, it spurs us and the anesthesiologist to special cautions or tests. Each question is numbered, and the numbers correspond to those on the nursing chart, so we can easily transfer that information.

We encourage patients to fill out the form at their physician's office, and then fax it to us or bring it during pre-admission. It's made our pre-op histories more complete - we get more information when they're filling out the form than when we're just asking them questions on the phone - and it helps the anesthesiologist know that everything's going to run smoothly on the day of surgery.

Nanette Hirschi, RN
Director of Nursing
Idaho Falls Surgery Center
Idaho Falls, Idaho
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Basket Full of Benefits
Once a month, we put together gift baskets and deliver them to the doctors who do their cases here, as well as the doctors we're trying to recruit. If we're out there, visiting our doctors' offices on a regular basis to bring a little something for them and their staff, they won't forget about us.

One month, we brought baskets with coffee beans and muffins; another month, tea and afternoon snacks. Over the summer, we brought goodies in a beach bag. We always include a clever thank-you note with it. For instance, when we brought a basketful of graham crackers, chocolate and marshmallows, the note said, "We were glad to host your cases, please bring s'more."

Our staff have seen the results of the deliveries, and they're quite creative, so they're always thinking of new ideas or picking up good deals at Sam's Club or the dollar store and putting the baskets together between cases. Then I, or someone from my management team, deliver the baskets to introduce ourselves. We're delivering to about 35 offices now, and we've found that doctors and their staffs really look forward to the baskets. We spend about $5 on a basket. For 35 baskets, that's $175 a month.

Melba Willis, RN
Administrator
Northridge Surgery Center
Madison, Tenn.
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Keeping Track of Your Staff's Time
Like most startup facilities, we hired a payroll services company when we opened in 1999 to distribute our employees' salaries and to collect their taxes. Many full-service payroll companies can also provide you with a wide range of human resources functions. But I wanted to track the hours my employees worked myself, in order to stay on top of their eligibility for certain benefits as well as the amount of personal time and sick time they'd earned and taken.

With the help of our management consultant, I designed an Excel spreadsheet that compiles my employees' hours and calculates them for me, so I can easily print out the numbers and see who's up for what at a glance. I knew how I wanted the program to look and what I wanted it to do, but without our consultant's help, I'd still be staring at empty boxes. Now Excel and I are good friends.

With a staff of only 16 , this is just a lot easier than having to supply the payroll company with every little detail, then having to call them every time I wanted to check eligibility. I'd rather keep the records, and the control, myself.

Kristine Bedford, RN
Clinical Director
Endoscopy Center of Marin
Greenbrae, Calif.
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