A63-year-old patient is having cataract surgery. The surgeon calls for the lens, and the circulating nurse, just returning from lunch, presents what he thinks is the correct lens. Without checking, the surgeon asks the nurse to open the lens container. The lens he inserts turns out to be the one…
In a busy OR, one employee who's consistently late or always wants to take off early can wreak havoc on scheduling and performance. Seemingly small conduct problems are frustrating for managers: Is it worth starting the recruitment and orientation process over again just to replace a person whose small infractions…
The average OR nurse manager is 51. Do you know where your replacement is? Though a lot of attention has been focused on the nursing shortage, not as much has been paid to the pending shortage of managers. By 2010, about 20% of current nurse leaders plan to retire, and…
Getting physicians to align with the hospital in making decisions on high-ticket items like implants is challenging. Vendors cultivate close ties with physicians, who drive many of the decisions on these expensive devices. Hospitals can be left out until it's time to write the check. Memorial Medical Center, a community…
What's the real value of your value analysis program? Most organizations say they are using value analysis teams to make purchasing decisions, particularly for products that involve physician preference and carry a high price tag. The financial impact is obvious, but value analysis also has intangible benefits because it can…
New nurse leaders not only need managers and coaches—they need mentors. A mentor plays a special role in the development of a new manager. The dictionary defines a mentor as a "trusted counselor or guide." Unlike a manager, whose role is to make sure the work gets done, and a…
Like budgets and performance appraisals, you can't avoid the word "Magnet" in today's health care world. The American Nurses Credentialing Center (ANCC) developed the Magnet Recognition Program in 1993 to recognize health care organizations with nursing excellence. Currently, 238 health care organizations in 44 states have Magnet designation. Your organization…
The Centers for Medicare and Medicaid Services (CMS) on April 13 posted its proposed FY 2008 inpatient rule, saying it will help improve the accuracy of Medicare payments for inpatients. The proposal also has more incentives to engage in quality improvement efforts. Comments are due by June 12. The rule…
The Centers for Medicare and Medicaid Services (CMS) has eliminated the requirement that surgical consent forms list the names of practitioners who will assist the surgeon and tasks they will perform. Surgeons and perioperative nurses had pressed for the change, saying they often could not know in advance who would…
When should chemical indicators (CIs) be used? What's the difference between an indicator and an integrator? What's the role of CIs in load release? OR Manager posed frequently asked questions to Cynthia Spry, RN, MA, MSN, CNOR, cochair of the working group that recently issued a comprehensive update to the…
How do you use your computerized reports on surgical supplies? Of course, you use them to monitor your usage and pricing. But there's more these reports can do—they can tell you a story that may help you reduce costs and manage inventory more efficiently. By marrying supply data with physicians'…
Third in a series of articles on improving revenue. You've made sure you're doing all you can at the front end to line up your procedures for correct reimbursement—your staff is clued in to ask the right questions during scheduling and is meticulous about insurance verification and precertification, which were…
In leadership, accountability can't be delegated, says Commander Scott D Waddle, USN Ret—and sometimes that means acknowledging a tragic mistake. CDR Scott D. Waddle, USN (Ret) "The measure of a true leader is someone who can be accountable for the actions of a team," Waddle says. Waddle will present a…
Two weeks after the Joint Commission surveyors left in December 2006, the president of Massachusetts General Hospital (MGH), Peter Slavin, MD, sat down and wrote a letter about the findings. It's not that he was boasting. In fact, he candidly said the survey was a "wakeup call," and surveyors "had…