Council Improves OR Practice at Hospital for Special Surgery

Nursing Spectrum—August 10, 2009

When perioperative nurses at Hospital for Special Surgery in New York City encounter a practice or policy that can be improved, they don’t just complain about it. They fix it.

Recently, the hospital has employed a shared governance structure that relies on staff nurses themselves to spearhead improvements in the operating room. The hospital, recognized as a Magnet facility since 2002 by the American Nurses Credentialing Center, has established nursing councils, of which the hospital’s Perioperative Practice Council is the oldest and largest. The council has 30 members, 27 of them nurses and three of them surgical technicians, representing the main operating room, the ambulatory surgery department, central sterile processing, nursing education and several other areas of the hospital. At the heart of the shared governance concept is the goal of shared accountability and empowerment for nurses.

“It gives us a forum to address concerns that affect us,” explains Tashma Watson, RN, co-chair of the Perioperative Practice Council. “It gives us a form of empowerment so we can be involved,” she says. “It gives us a way to be involved with nurses from all areas of the perioperative setting, a chance for us all to work together to make changes that can benefit all of us.”

Hospital for Special Surgery is a freestanding nonprofit facility that performed 23,000 surgeries in 2008. The council structure, and the perioperative council in particular, grew out of a recognition that the hospital needed to improve its preparation for surgical cases as it underwent significant volume growth several years ago, says Ron Perez, RN, JD, CNOR, assistant vice president for perioperative services, who has served on the council since its inception and co-chaired it until recently.

Nurses Elizabeth Goetz and Tashma Watson confer outside the inpatient OR suite at Hospital for Special Surgery.
Elizabeth Goetz, RN, left, and Tashma Watson, RN, confer outside the inpatient OR suite of the Hospital for Special Surgery. HSS has 28 operating rooms on three floors of the hospital where more than 23,000 surgical procedures were performed last year.
Courtesy of Polina V. Yamshchikov | Hospital for Special Surgery

The council has evolved over the years, and Perez says turning over the chairmanship to staff nurses such as Watson on a rotating basis is the latest step in transferring leadership responsibility to the people most invested in the council’s recommendations: staff nurses.

Opening these lines of communication has improved relations among physicians, nurses, and managers, those involved say.

“It certainly increases the team spirit,” Perez says. “I think (surgeons) recognize our involvement in the process and that we are empowered to speak up and make recommendations.”

One of the perioperative council’s projects is crafting a surgical safety checklist based on one published by the World Health Organization but tailored to HSS’s needs. Council member Elizabeth Goetz, RN, BSN, CNOR, a clinical coordinator in the hospital’s main operating room, says the checklist project and others like it that affect both physicians and nurses help build rapport between medical and nursing staffs. Nurses who are in control of their work environments also are likely to be more satisfied with their jobs, she says.

Read the full article at nurse.com.

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