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O.R. Clinician Crunch Eases with Information Technology

O.R. Clinician Crunch Eases with Information Technology

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Hospital administrators who think they have problems filling staff vacancies should consider the Ochsner Health System in New Orleans, whose work force still hasn't recovered from Hurricane Katrina in 2005.

"Staffing since Katrina has been a challenge," says Judith Landry, unit director of surgery at the system's flag­ship, 473-bed Ochsner Medical Center. "We're still not fully staffed, and staffing seems to be very fluid, not just here but within the city." Ochsner Medical Center was one of just three New Orleans hos­pitals that remained open throughout the crisis, so it attracted nurses and techni­cians from other institutions who were suddenly unemployed. Now that their home institutions are reopening, many are returning to their former positions. Some hospitals are offering a wage pre­mium of up to four extra dollars an hour, or signing bonuses of $12,000, to lure them back, Landry says.

And many New Orleans residents are giving up on the area entirely, frustrated by high crime and the slow pace of res­toration. Healthcare workers, with their highly portable skills, are prime candi­dates for relocation.

More than money

Though Ochsner has taken some steps to raise compensation for clinical staff, it still isn't able to compete for employees solely with money, Landry says. It has three secret weapons, though. First is a stable work environment. Second is a "family" atmosphere and a sense of home that lead to high employee satis­faction scores (in 2005 a local business journal named Ochsner as New Orleans' best place to work). The third is the most advanced technology in town.

Landry's department runs 22 O.R.s and a staff of 150, handling 50-60 pro­cedures per day. The medical center is a transplant center for heart, lung, liver, kidney, and pancreas, and has more than 750 clinical research trials going on at any given time. Ochsner is a leader in robotic surgery, one of only six training centers in the world for procedures using the Da Vinci surgical robot.

"Our hospital is top-notch in the city, and people are interested in being around our technology," Landry says.

Since the late 1990s, the department has had a surgical information system from SIS, Alpharetta, Ga. The system automates administrative and clinical processes for surgical departments. Among other things, it tracks patients through each step of the surgery pro­cess, automates the anesthesia record, captures vital signs from patient moni­tors, stores surgeon preferences, and builds supply lists for each procedure. It automatically captures charges as a byproduct of nursing documentation. It allows the hospital to provide a patient-update terminal in the surgical waiting room, so families can track the progress of their loved one through surgery and recovery. And it allows Landry and her colleagues to analyze performance data such as whether procedures started on time, how long they lasted, and which supplies were used.

"SIS makes it easy to document everything," says Landry. "It's a positive in bringing in new nurses and keeping them. Whenever we have nursing stu­dents do rotations through here, they're very impressed and like our technol­ogy within the department." It's one fac­tor that influences where they ultimately decide to apply for jobs.

Although New Orleans is a particularly tough healthcare labor market, hospitals in other areas are also having trouble keeping their surgical support positions filled. Nursing shortages in the O.R. are even higher than those in the nursing

"SIS makes it easy to document everything. It's a positive in bringing in new nurses and keeping them. Whenever we have nursing students do rotations through here, they're very impressed and like our technology within the department." -Judith Landry, Ochsner Health System, New Orleans

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field overall, and surgical technicians aren't available in the kinds of num­bers that can fill the gap. When staffing becomes a problem in the O.R., good IT can make a difference.

Attracting the technogeeks

Southeastern Michigan, the home of Detroit's Henry Ford Health System, has been ravaged by the troubles of the automotive industry. A steady proces­sion of nurses have departed the area, following spouses laid off by automakers or the legion of local businesses that depend on them. The system struggles to replace them. But sometimes, tech­nology is its ace in the hole for attracting the "technogeek" crowd.

"The people we're trying to tap into are the younger generation-the ones who are always texting and instant-messaging, and who are challenged and thrilled by technology," says JoAnn Adkins, administrator of the service line for surgical services at flagship Henry Ford Hospital, a 903-bed facility that boasts a number of high-tech services, including one of the leading robotic sur­gery programs in the United States.

"I happen to be a seasoned nurse," Adkins says. "I was around when we had to sharpen our own knife blades. But I believe the high-tech world is truly where you need to be, and you can't be afraid of it."

Henry Ford also uses a surgical information system from SIS. It's been installed for six years, though Adkins says her department is just now starting to take full advantage of its capabilities. "We're now computerizing documenta­tion throughout the network so that we can readily recall information and start standardizing practice. That's critical, especially with high-tech equipment."

Henry Ford's O.R. staffing level is the highest it's been in four years, partly because of the buzz created by the high-tech environment. "We've been able to hire talented people," Adkins says. "A year ago, we didn't hire people into the O.R. without specific experience. Now we hire for talent and individual skill sets. And we hire those who are excited and willing to learn. We have towers of equipment that require individuals to understand how to get them to function at the same time. The computer is one of the entry level skills."

The ease of tracking and documen­tation represented by the SIS system is taken for granted by the younger generation, who can't imagine working without access to that data. "They're used to an environment where they're documenting at the same time they're doing other things," Adkins says. "The system really helps recruiting."

Impressing students

Sometimes a hospital is fortunate enough not to have an O.R. labor shortage, like Mansfield (OH) Hospital, part of the MedCentral Health Network. The 326-bed facility sits halfway between Cleveland and Columbus. It serves as a training site for several nursing schools and medical technician programs, including a surgical tech program that gives them what O.R. director Linda Nelson calls an "overabun­dance" of surgical technicians. "It's a ratio we'd like to keep," she says.

Although many future nurses and techs pass through the halls of Mansfield, they wouldn't clamor to stay if the hospital didn't offer cutting-edge technology, high quality of care, and the sense of being part of something spe­cial. Although the hospital has had auto­mated O.R. management for almost a quarter century, it recently boosted its technology profile by upgrading to new O.R. software from SIS. Student nurses and technicians who are exposed to the system find it easy to use, and the knowledge it gives about surgical cost, time, and turnover is part of the overall quest for quality that makes Mansfield an attractive employer.

Many nurses come to the region as trailing spouses. Mansfield is in a good position to compete for them, Nelson says. "If I were being transferred to Cleveland or Columbus or elsewhere, I most likely would select a facility that has computer­ization," she says. "For me, seeing overall competence, immediate data for decision making, and good outcomes are certainly some of the most important concepts. But I wouldn't want to be somewhere that didn't provide the tools to assist me in doing the analyses needed to perform my current role. I cannot imagine returning to a paper world, especially when data is imperative for making the business deci­sions in healthcare!"

Surgical Information Systems offers a com­prehensive, fully integrated perioperative and anesthesia information system that captures all clinical, administrative, and financial data on every patient event from surgical scheduling through transcription. The results are improved work flow and communications for increased patient safe­ty, revenues, and operational efficiencies. www.SISFirst.com.

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