Same-Day Surgery Manager

Please take note: Top surgeon irritants

By Stephen W. Earnhart, MS
Earnhart & Associates
Austin, TX

Seemingly, no one is happy with his or her block schedule at the hospital or the surgery center. After spending too much time on this issue with our own centers and hearing about others concerns, it is, quite honestly, irritating that such a simple process can be such a conundrum for most everyone.

In its simplest application, block booking is merely a reservation. Like any fine restaurant, you want to make sure your valued customers have a table (in this case, an operating room) available to them when they arrive.

There are some surgeons who are abusing the system by not utilizing this free service, and there are some surgical services personnel not following their own guidelines. Blocking posting of cases works! However, you must adhere to established parameters to make it fair and rewarding for all.

No one hates memorandums more than I do. Why write it when you can say it? However, there are times when you need to circulate the same message to all at the same time. Everyone's policies and procedures on block time are different (though I don't know why — heavy sigh). You need to refresh them, share them, and then, most importantly, stick with them. This complaint is one of the most common ones I hear from surgeons. Make it go away!

Consider these other top irritants for surgeons:

• Rude staff members.

As incredible as it sounds, this issue is a significant one with surgeons, and, according to the surgeons, it is getting worse! I have read in recent articles that customer service in general is declining, but in healthcare! Apparently so. While there are effective measures you can take to eliminate rude staff members, most are illegal.

One method that does seem to work is to get the name(s) of staff members from the surgeons that (they feel) are rude and confront the individual. I've done it several times this month. Each time the staff member is surprised, not defensive. While it doesn't seem like it is a personal issue toward the surgeon, it is perceived to be. Making the individuals aware of the matter seems to help a great deal.

• Preference cards.

Really? The majority of "operational and process audits" we do for hospitals and surgery centers always reveal problems in this area. Almost all surgeons interviewed have a problem with this area. (No, not your center.) They claim that they are not asked to sit down and review their cards and that when they change their preference for a case, it is not noted for the next case. There is, surprisingly, a strong resentment toward facilities not paying attention to this rather basic management tool.

• Missing instruments.

You cannot blame the surgeons for being upset when they stick their hand out and ask for something that should be in their tray and it is not there. Avoid telling them that you did not pick their case or that someone forgot. Consider instead telling them it was stolen by parties unknown and the new one just arrived. Seriously, this problem, according to surgeons, has become a significant area of irritation.

• Staff hanging around (while they are waiting to start their case).

I do have empathy for the surgeons. They are impatiently waiting for their case to get started or getting the patient in the room at least, and they see "crowds" of staff just hanging around. Again, this issue is one that is growing for them. Sometimes "out of sight" is a better place to meet.

• Turnaround time.

Whether any of us like it or not, turnaround time to the surgeon is from the time they leave the room until the time their next patient enters. It's not fair, but perception is reality. I have documented turnaround time (their example) of 25 minutes and then asked the surgeon how long it was. Their answer: 45 minutes, they say with conviction. Not an easy fix by any standard. We might have to punt on this issue.

Best recourse is, once again, to let everyone know the definition of turnover time. Post the results in the lounge, or distribute them to the surgeons.

• Delayed start times.

Enough said. [Earnhart & Associates is a consulting firm specializing in all aspects of outpatient surgery development and management. Contact Earnhart at 13492 Research Blvd., Suite 120-258, Austin, TX 78750-2254.
Web: Twitter: @SurgeryInc.]