Best practices to improve surgery center efficiency from a New York ASC's director of nursing

The COVID-19 pandemic has emphasized the importance of efficiency in the surgery center setting. Jill Trotta, BSN, RN, director of nursing at Hudson Valley Ambulatory Surgery Center in Middletown, N.Y., shared some best practices her center has implemented.

Question: What are some best practices you've initiated at your ASC?

Jill Trotta: Amidst the challenging times of the COVID-19 pandemic, the nursing staff at Hudson Valley Ambulatory Surgery Center collaborated to accommodate new policy changes and effectively decrease the projected workload. The reality of intense cleaning and the possibility of an increase in wasteful procedures inspired the nurses to solve these problems creatively. The nurses generated a simple solution and utilized clear plastic tote containers to hold necessary emergency patient supplies at the bedside — easy sanitation of the bins between patients and keeping supplies at the bedside without fear of cross-contamination has increased efficiency and simplifies the workflow.

Past practices included an IV kit that traveled with the nurse during admission phases. The nurses have since created a patient-specific bin the day before surgery and now only bring single patient supplies to establish and discontinue IV access. Individual IV bins allow the nurse to don personal protective equipment once rather than leaving the bay to retrieve supplies, cutting down on the waste of valuable PPE supplies. We have also discovered a supply company that supplies individual tissue boxes and single-use rolls of tape to reduce waste and costs.

To reduce the risk of further cross-contamination, we have patients admitted to the same bays they will recover in. Each patient can properly social-distance and is isolated from others. The nurses hung transparent plastic shower curtains on the cloth curtains inside the bays, allowing quick and easy sanitation between patients.

We are incredibly proud of our nurses' ingenuity and ability to think outside the box to create new best-practices and accommodate patient safety and patient-centered care. Efficiency and sparing resources is a vital aspect of running an ambulatory surgery center. The nurses realized a need for slight changes to increase productivity and decrease waste to keep the convenience of an ambulatory setting a priority for patients, physicians and staff.

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