Keeping it simple…a strategy for managing the daily adventure

Managing surgery is if anything, an adventure.  No producing widgets for us.  Every day brings something new.  It is definitely not for the faint-hearted or weak kneed. Even the most organized can feel overwhelmed at times.  Some days it may feel like you are drowning in paperwork as you try to remember what you may have forgotten with all the THINGS that have to be kept up.  Typically there is no time to entertain that nagging thought as the next challenge comes through the OR doors. I thought I would share my strategy for keeping It simple.

Keeping it simple just means breaking everything down to manageable tasks.  I like to think of the tasks as categories.  I define my work by categorizing everything.  One way to categorize all the stuff we need to track can be thought of in terms of  the 3 “T”s:

TEST IT

TRACK IT

TEACH IT

TEST IT:  Start by making a list of everything you test to keep everyone safe and the facility in compliance.  Once that list is complete, determine HOW you test it.  I’m sure there is a log or form you utilize. Then determine HOW OFTEN you test it (daily, weekly, quarterly, annually), and WHO tests it (you, a staff member, a service vendor?)  I bet there is a long list, right?  Once your list is complete, Organize the list, the forms, the who’s and the when’s  in a binder or an electronic file in a way that makes sense to your brain.  Here are some examples of the TEST IT list:

• Drills (Fire, Code, Disaster, Alarms)
• Generator
• Safety (OSHA,, facility safety)
• Infection Control (Hand washing audits, safe injection observations)

You get the idea.  If there is a system or process that needs to be tested to ensure it is working,  put it on this list.

TRACK IT:  Next, make a list of all those things that need tracking in your facility, how you do it, who does it and how often, just as you did with the test list.  Some things to consider:

• Incidents/Variances
• Infections
• Benchmarking activities
• Temperatures (OR/fridge/freezer)/humidity
• Patient satisfaction
• Employee injuries
• Licenses

Same process.  If it needs tracking, add it to the list. Determine the who and when for each item tracked.

Now, to the final “T”-TEACH IT.

This list should include all things to teach and train  those who work in the facility.  Some of those “things” are universal, and some are specific to specialty or equipment.  Teachable tasks include:

• New Hire Orientation
• OSHA/Exposure Control
• Fire Safety
• QAPI
• Risk Management

I use my TEACH IT list in my employee and credentialing files as an audit checklist to ensure that all training is complete initially and annually, customizing it to the individual.  It stays handy for new hires since often teaching needs to be complete within 30 days of hire.

When you have the “3 T” lists complete, use them to REPORT IT.  If you have facilities that are large enough, this may be divided to appropriate committees.  Include it in your Governing Board agenda.  It shows your reporting up process for regulatory compliance, and serves as a blueprint for effective communication to your board.

The last part of the strategy, and the key to making it work, is to MAINTAIN IT.  Establish a reminder system that includes those daily, weekly, quarterly and annual reminders so that it doesn’t fall off your radar.  Include anything that needs updating or that expires.  It can be as simple as an appointment on your Outlook calendar (Cindy’s PPD due), or you can utilize some of the great project management software out there that is free.  Then utilize it.

Whatever your process, just remember to keep it simple.  Managing surgery is complicated enough.