Surgery centers seeking answers to improving efficiency could tackle staff cross-training and a communication improvement initiative. Any improvement in these areas can create a better team environment and improve productivity, says Jeany Dunaway, RN, CASC, administrator at Effingham Ambulatory Surgery Center in Effingham, IL.

Dunaway offers these suggestions for making these improvements work:

• Cross-training. “Cross-training allows staff to take accountability in several areas and improves morale, productivity, and job satisfaction,” Dunaway says. “For example, if you are a scrub nurse in the OR, and you’re also a circulating nurse, you understand better what that role is of that person on your team who is working with you. You take more accountability, and you work better with that person on your team because you know what that role requires.”

Cross-training also is very helpful from a workflow standpoint, especially for smaller ASCs. For instance, when Effingham ASC places staff on maternity leave, there are cross-trained staff to fill in, Dunaway says.

An ASC could require staff to be cross-trained. Or, the surgery center could make opportunities for cross-training available to whoever is interested.

“If employees are interested in another role, they come to me and let me know that,” she says. “I will have someone who has a lot of experience serve as a mentor and train the employee as time allows.”

Sometimes, the staff member’s cross-training desire does not fit the surgery center’s current needs. When this happens, there can be a compromise. An example is when Effingham ASC scrub nurse in the operating room wanted to learn post-op work, Dunaway recalls.

“We couldn’t do that for a few months because we were too busy,” she says. “So I told her that I realized she hadn’t gotten to train in the post-op area yet, and it was because of staff being out on maternity leave.”

The key is to acknowledge the request and use a common-sense approach to explain why the request would need to be postponed. Cross-training mentors can be any employee who is skilled at the job and at teaching. For example, a scrub technician could teach the RN how to scrub. “Some people are good at their jobs, but they’re not the best teachers, so it goes by experience and instincts,” Dunaway explains.

• Communication. “If everyone feels they are being communicated to and are part of a team, then the team is more effective and more efficient,” Dunaway says.

Dunaway maintains an open-door policy for people to speak with her about any issue, and the ASC holds a monthly staff meeting. She also places the meeting’s agenda in a communication book so that people who are not there every day can look at the book to see what meetings were about. Daily huddles are important for maintaining communication among staff.

“The nurse that does pre-op calls, anesthesia, and someone from the pre-op OR and post-op all meet together daily to talk about the next couple days of patients,” Dunaway says. “They discuss arrival times, patients with any potential problems, like someone who has a difficult airway, and they make sure we’re bringing patients in within a reasonable time.”

If someone sees a potential red flag, the person might say there isn’t enough time for a case, and the team will have to adjust.

“It’s a good overall look at our patients and procedures, every afternoon, and it’s pretty much [about] 4:00 when we’re done for the day,” Dunaway says. “We find that’s the best time because not everyone is here at 6:30 a.m. when the OR starts.”