OR Manager - January 2018 - 18

Success Stories
The following " success story " describes the PEER initiative at
Geisinger Medical Center, which has involved staff in making
decisions to improve processes and communication.
OR Manager periodically publishes success stories like this from
nurse leaders or other healthcare providers who want to share
their experience with our readers.
Recent examples include:
* " Improved communication tools put PACU visitors at ease "
(November 2017, 21-23)
* " Efficiency efforts improve staff satisfaction with turnover
time " (October 2017, 21-23)
* " Electronic scheduling system radically improves OR workflow "
(August 2017, 25-27)
* " Efforts to improve FCOTS may reduce overutilized OR time "
(July 2017, 2425, 30)
Would you like to share a success story from your facility?
Please contact Elizabeth Wood, Editor, OR Manager, at ewood@
accessintel.com; 301-354-1786 or visit www.ormanager.com for
a copy of the Author Guidelines.
All contributed articles are reviewed by our clinical editor and editorial
advisors, and upon acceptance are edited for style and clarity.
Peer initiative cultivates a better OR culture
A
nyone who has experienced a
major restructuring knows how
stressful and disruptive it can
be. New leadership brings change and
uncertainty, and often includes new
roles and responsibilities for staff.
While everyone tries to adjust to the
" new normal, " teamwork and efficiency
may suffer.
When Geisinger Medical Center in
Danville, Pennsylvania, underwent a
series of leadership changes in both
the surgical suite and the hospital, it
became clear that the culture needed
to be reexamined. That self-analysis
resulted in the Professional Engagement
and Employee Relations (PEER)
initiative, which paid off in a team with
a high esprit de corps that actively participates
in process changes to create
a more effective organization.
" PEER allowed us to till the soil
to gain staff input and involvement, "
says Courtney Gorgone, MBA, BA,
SSBB, administrative director of surgical
services for Geisinger Health
System. Gorgone recently shared the
story of the program's success with
OR Manager.
Plethora of changes
In 2015, a plethora of changes took
place at Geisinger, beginning with
a new chief executive officer, which
meant different directions and different
goals. There were also leadership
changes at the department level, including
the surgical suite.
18
OR Manager | January 2018
" We were all of these floating parts
without a deep connection to each
other, " Gorgone says. " We weren't
talking effectively with each other, and
that really affected engagement and
our ability to work as a team. "
The interim structures put into
place helped pull people together, but,
Gorgone says, " We weren't really growing,
and we weren't making changes
from an efficiency perspective or from
a developmental perspective. "
A steering committee of stakeholders
from administration and surgery
met to discuss how to identify and
address root causes for the lack of
effective teamwork. Members of the
committee were the chair of the surgical
institute, director of anesthesia,
administrator of anesthesia, associate
vice president of quality and safety,
manager of surgical scheduling, chief
certified registered nurse anesthetist,
associate vice president for surgical
services, and Gorgone.
After a few meetings, the committee
decided they needed to hear directly
from staff. " We wanted to talk
to every single person in the surgical
suite, including anesthesia providers,
nurses, surgical technicians,
surgeons, central supply staff, and
environmental services staff, " Gorgone
says. The total was more than 900
people, making a single group or oneon-one
meetings unfeasible.
That's where PEER, which began
with open group forums, came in.
Clear
communication
put an end to
misconceptions.
Multidisciplinary approach
The steering committee recognized that
grouping participants by role, such as
nurse or surgeon, could lead to " us vs
them " conversations and play into professional
silos; instead, they chose to
have multidisciplinary group forums to
solicit input. This approach would also
break down the hierarchical structure
so familiar in the OR. " For example, you
would have surgeons talking to environmental
staff about communication and
teamwork, " Gorgone says.
Attendance at
the 1-hour meeting
was strongly encouraged, but not
mandatory. To facilitate participation,
each person was scheduled for a group
during a time that fit his or her schedule-including
surgeons. This enabled
leaders to plan ahead for coverage.
Meetings were held at 6 am, lunchtime,
5 pm, and later
in the evening. The
meetings started in February 2016 and
ended in April. Reports were generated
in May and presented in June and July.
Structuring the event
" We wanted to be sure the meetings
didn't turn into complaint sessions, so
we needed to prepare and think about
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OR Manager - January 2018

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