Vice President of Clinical Strategies
I am obsessed with Top Gun, and now, Top Gun: Maverick. Not necessarily about Tom Cruise (but, yes), but how he created a team from a group of egos, and they created a plan for a highly complex procedure with costly equipment to accomplish a joint goal. This is what we do in surgery every day. The “feel good” moments at the end of the movie happen with each OR case when we know our team has done an excellent job for the patient. But, what the film doesn’t have, is that this mission is happening in multiple operating rooms simultaneously, all needing the right staff, equipment, and supplies that may not be available.
How can we support our teams to attain the best possible outcomes in each OR, for each case, day after day? Here are some tips with some Top Gun lessons woven in.
Photo Courtesy of Scott Garfield for Paramount via Everett Collection.
Overcoming Supply Chain Issues
The ever-increasing supply chain shortages continue to plague the ASC industry. Many items have come back in stock now that the COVID emergency has become a slow simmer, but medications remain challenging to obtain. Careful planning and coordination between schedulers and material management need to occur. Utilizing your inventory management system and scheduling software is vital to successful outcomes. If possible, run reports for the weeks ahead, leveraging your preference cards to ensure enough supply on hand to meet the needs of the coming surgeries, up par levels as necessary. Work with your primary vendor to ensure your regular order is protected in the warehouse.
While Maverick got to choose his team from a pool of eligible cadets, finding and affording quality staff is very difficult in our world. By the end of this year, the American Nurses Association estimates that 500,000 nurses will retire. There are not enough new nurses in the pipeline to bridge this gap. We must consider how we can encourage nurses to keep working. Flex-time and part-time may help, but we should also consider mentor programs where we can tie an experienced nurse with a new grad to the OR nurse to decrease the physical load on our older nurses without losing their extensive knowledge base. Some centers have successfully opted for four-day work weeks. Creative approaches to ever-changing staffing needs are no longer optional.
Educational and Training Needs
Maverick thought he would have months to train his team for their mission, and then it was cut down to weeks. Sometimes it certainly feels like we’re operating in a similar reality of uncertainty and time crunches. However, encouraging and funding the advanced education needs of current staff members will improve your existing team and ultimately assist in recruiting new staff. Consider this your two-way dogfight football game – you’re managing one piece of the puzzle while another is off and running simultaneously. Allowing a Scrub Tech to pursue a nursing degree or a nurse to obtain an RN First Assist certification will enhance outcomes and loyalty. In addition to higher education, each center must provide training and retraining on an ongoing basis for all old and new equipment. Ensuring all personnel knows how each tool works and how to troubleshoot it is vital to a smooth-running surgery center.
Rewards for Success
The patient’s good outcome is fulfilling, but we can look further at the love languages to find ways to celebrate the daily positive results in your ORs. (Can someone copy Mr. Cruise’s team on this part?)
- Words of affirmation: It is essential to give staff positive, encouraging words, and share their value. Nurses constantly encourage patients; now, you get to encourage the nurse.
- Acts of service: We are so busy being of service, providing care, and going above and beyond for patients that we don’t always do a good job of taking care of ourselves. Gifts for this love language include ensuring they take their breaks and lunch, and giving a pedicure or manicure gift certificate would also be appreciated. Help them help themselves.
- Quality time: many nurses have outside interests and hobbies that they love but don’t have any time to enjoy them. Ensure your perioperative staff take their PTO, not just when their children are sick. Have a monthly raffle for a “leave early day,” a free PTO day, or no late call.
- Gifts: If receiving gifts is their love language, then they are usually the ones giving gifts to everyone else. What is something meaningful that you could give them? Think recognition, gift cards, front row parking spot.
- Physical touch: Nurses have physical contact with their patients all day long – examining them, holding their hands, and making them feel better. If a nurse’s love language is physical touch, you can hire a masseuse, give a spa day, skincare, a bath bomb, or bubble bath would be a great gift.
Consistent quality requires a robust process. Not one dictated by the administration, but a collaborative approach to care, scheduling, room assignments, education, policies, and procedures. Support for all team members must be a daily commitment.
Pilots try to make everything as low a cognitive load as possible to allow them to focus on the task at hand. They don’t have to think about each step as it is a habit. In fact, “don’t think, just do” was Tom’s message to Rooster. They can count on each other and those who clean and maintain their million-dollar planes. Materials management, sterile processing, business office, and registration are all responsible for making the mission successful. We count on them and need to recognize their contributions.
We need to provide the best software possible to achieve consistent results and the highest standards of care. Everyone has a stack of tools they utilize to do their daily tasks. We need to make these tools work with each other and for us. The Top Gun pilots were the best in the world and had the best possible equipment and training. We need to give our staff the same. And if we can all get an appointment with Tom’s aesthetician, it wouldn’t hurt.
- Image at Top of Page: Marca
- Tom Cruise Salute: Giphy