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Salary Survey - Outpatient Surgery Magazine - January 2020

Outpatient Surgery Magazine, providing current information on Surgical Services, Surgical Facility Administration, Outpatient Surgery News and Trends, OR Excellence and more.

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you streamline? Begin this process with an open mind. "When we started out, we didn't know what we were looking for," says Alicia Rock, BSN, RN, CNOR, interim assistant nurse manager at University of Iowa Hospitals and Clinics in Iowa City. "But after watching, the issues became obvious. We were able to narrow them down to things that we'd be able to influence." Spaghetti diagrams that trace each member of the turnover team's path will help you identify wasted movements that you as the conduc- tor of this OR orchestra can eliminate. Alternatively, you could ask all those involved in turning over rooms — surgeons, anesthesia providers, nurses and techs — to map out their roles in the process. "Determine which steps are 'valued' — those that generate a positive return on investment in terms of the resources or staffing involved, or cannot be eliminated without having a negative impact," says Robert Cerfolio, MD, MBA, chief of clinical thoracic surgery at NYU Langone Health in New York City. He helped lead efforts to cut average turnover times in the hospital from 37 minutes to 14 minutes, well under the 20-minute goal his team set out to achieve. Then, says Dr. Cerfolio, do whatever is necessary to eliminate unnecessary or non-valued steps in the turnover process. For exam- ple, circulating nurses at NYU Langone no longer walk to the supply room to retrieve needed supplies between cases. Instead, techs gather supplies the night before surgery and store them in case carts, which are wheeled into the OR as needed. 2. Assign roles. Just as having not enough staff show up to turn a room over is a problem, so is having too many. Yes, many hands usually make light work, but Ms. Rock noticed that too many team members mopping the floor or spraying a surface actually slowed the team down and resulted in duplication of efforts at University of Iowa Hospitals. 6 0 • O U T PA T I E N T S U R G E R Y M A G A Z I N E • J A N U A R Y 2 0 2 0

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