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4 Tips to Shape Positive ASC OR Culture From AAAHC Treasurer Frank Chapman

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Frank ChapmanFrank Chapman, MBA, AAAHC treasurer and COO of the Ohio Gastroenterology Group, offers four ways to foster a positive operating room environment in ASCs.

A positive environment is the foundation of a healthy, productive workplace. At ambulatory surgery centers physicians, nurses and clinical staff spend the majority of their time in the operating room. Frank Chapman, MBA, treasurer of the Accreditation Association for Ambulatory Health Care and COO of the Ohio Gastroenterology Group, offers insight into what makes a positive OR culture and how to get there.

1. Focus on the patient experience. High patient satisfaction is a hallmark of the ambulatory surgery center industry. Patient experience begins at registration and ends with discharge. At each point of service team members should remember the patient as the focus of their jobs.

"When individuals get caught up in repetitive activity they can forget that they are dealing with sick, scared patients," says Mr. Chapman. "When you lose that connection the patient experience is diminished." A common focus on the patient and the care they receive in the OR, and throughout the center, builds an atmosphere of teamwork and promotes a positive attitude.

2. Hold all team members accountable. The OR can be a stressful environment. How smoothly that environment operates depends largely on a strict schedule. "A positive OR experience is being able to count on everyone on the care team," says Mr. Chapman. Physicians can start cases late, which throws off the entire day's schedule and places increased pressure on staff to get the ASC back on track.

If members of the nursing team or clinical staff are absent, the present members of the care team have to pick up the slack and shoulder their added responsibilities. Efficient ASCs are run on tight time schedules with little excess staff. Team members of a constructive OR uphold their responsibilities and can rely on their peers, and superiors, to do the same.

3. Encourage mutual respect. A hierarchical approach to OR relations is counterproductive to an effective culture. Whether it is physicians, nurses, techs or any clinical staff member, no one should view their level of training as reason to look down on another team member. "If you don't have mutual respect among all members of the care team the OR experience starts to break down," says Mr. Chapman.

Physicians and nurse leaders may be unaware of relationships causing friction in the OR, but if an individual is identified for lack of respect, clinical leadership has a responsibility to draw that team member aside and address the issue.

4. Utilize collaborative care team evaluations. Accreditation in healthcare requires peer review This level of review is effective for the evaluation of provision and quality of care, but often misses the minutia of relationship issues between team members at all levels. "Collaborative care team evaluations are good at identifying deficiencies in respect of performance that may not come out in another situation," says Mr. Chapman.

Collaborative care team evaluations, also known as 360 degree reviews in the business world, give OR team members the opportunity to evaluate one another. For example, a nurse or tech will be able to comment on a physician's performance in the operating room and vice a versa.

This type of review, while not a primary evaluation tool, is a helpful companion to evaluations required by accreditation surveys, such as annual competency testing. The results of the collaborative care team evaluation can be used to create a baseline image of intrapersonal relationships in the OR and a stepping stone towards correcting any issues impacting the overall culture in the OR and surgery center.  

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