Q: Go Home Early

On slow days, often the same people want to leave early. One system is to have those that want to leave early put their names on the board. Those who don’t put their names on the board are then the ones who stay. Is it rude to put your name on the board frequently? Some people are not good at finding stuff to do, and they admit it.

A: Seems to me the people who don’t put their names on the board don’t want to go home early. They probably need the money. I don’t think it is rude to be a frequent flyer. Guess they can afford a smaller paycheck. If the people who stay have to make busy work, have a check-off list for things to do and if it’s all done.

A: We had the same concerns here and the staff came up with a point system. I post a monthly calendar in the break room. If they want low census on a certain day they sign up for it. If it is a low census day, the people signed up get it first and get points. If there is no one signed up, then the person with the lowest points has to take low census. The staff really likes the system, and usually there is always someone that wants low census. This way it is fair, and the points are different for the type of FTE you are. Let me know if you want the policy and point system.

A: We use a numbering system that is used for call coverage and leaving early, and it works great for us. Call is “assigned” with this system, so those that allow staff to sign up for call won’t be able to utilize this system without modification.

A: Here is a simplified example of how this works: There are separate lists for each group of employees (circulators, scrub nurses). Each employee within each group is assigned a number – say one to seven. A daily grid is posted with the person at the top of the list being on call and the person at the bottom of the list going home first. On Monday, person No. 1 is at the top of the list, and therefore on call. Person No. 7 is at the bottom and allowed to go home first. On Tuesday, person No. 1 is moved to the bottom and all others move up one position with person No. 2 now being on call. In this manner, the person on call is the first person allowed to go home the following day. The numbers rotate from top to bottom daily. Anyone electing to surrender their position in the list to go home early is simply skipped over, and the next person is offered to leave. I can explain in greater detail if requested.

Q: Unicompartmental Knees

I am presently researching unicompartmental knees in an ambulatory setting.  Does anyone out there do them, and if so, how do you recover and what is the length of stay? Any other information you feel is pertinent would be much appreciated. Thanks in advance!

A: Did they go home same day or stay 23 hours or admitted after procedure?

Thanks!

A: I too am researching costs, recovery times, etc. for a surgeon interested in doing them at our center. Is anyone currently doing them in their center?

How is your reimbursement vs. costs associated with the procedure? How long do they generally stay in post op before discharge? Are there any complications that have been encountered after the patient goes home? Thanks for any help.

A: We have been doing them for a few years. They are done first thing in the morning and are discharged by 4 p.m., if not sooner. They receive a block preoperatively for a comfortable recovery. I can fax a doctor’s preference card to you if this would be helpful.

A: I too would be interested in seeing a preference card if you would be so kind as to email it to me at lkulikowski at mwsmg.com. Thank you.