Scrub Incident

Q: There are always those “special surgeons” who choose to wear scrubs from outside the facility. It can be interesting when one needs to confront these surgeons and discuss the multitude of reasons for changing scrubs. However, sometimes the discussion doesn’t go anywhere, and the surgeon fails to change scrubs. Does this warrant an incident report? The patient is directly compromised due to the failure of the surgeon to change scrubs.

A: Yes, we do have some who refuse to adhere to our policies and change scrubs. This is most noticeable when it is a different color than ours! I have always said, “you would look so nice in some of our blue scrubs” or “ can I help you with the scrub dispenser?” It doesn’t always work. We do not have an infection issue. I can control the staff who actually are employed by our organization, but cannot control the physicians.

A: We have surgeons that will wear scrubs from one of the other internal hospitals. This is against policy. It is difficult to correct this practice. They do not wear scrubs from other institutions.

A: Yes, I believe it requires an incident report because it is a potential for injury to the patient and not current best practice. This is the only way the behavior can be tracked and addressed via a peer group.

Block Schedule

Q: How do you calculate your block utilization? Our blocks are 8 hours only. Is 7 hours a reasonable time to use for your denominator or lower? What do you use for benchmarks?

A: We use the amount of block allocated to the surgeon or surgical practice. If they are allocated a 10-hour block we use 10 hours and if they are allocated 8 hours we use 8 hours. We also look at and report block utilization in three ways:

  • Adjusted utilization defined as wheels in of first case to wheels out of last case of the day divided by the amount of allocated block
  • Raw utilization defined as wheels in to wheels out of every case added together
  • Out of Block time defined as amount of time used outside of their reserved block.  We review and report this as the number of minutes out of block divided by the allocated block.

The other thing we do, is to allocate the reserved block to a practice. The practices allocate block from the practice block for new surgeons before requesting additional block.

A: We have Meditech and we have had issues with this as well with many reports since we went live in 2010. Nothing much improves with each update but I am told that hopefully in this next one, it will be better. Turnover time is a horrific manual process if you have Meditech.

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