Cataract surgeon gives pearls for safety, efficiency in a surgical center
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AMELIA ISLAND, Fla. — In his presentation at Cataract Surgery: Telling It Like It Is, Jason J. Jones, MD, discussed some tips he uses to ensure safety and improve efficiency in his ambulatory surgical center.
Efficiency starts in the preoperative area, which itself has helped Jones and his team improve efficiency. Rather than prep patients each in their individual room, the area is open, and they are all prepped in the same space. Since it was built in 1987, the surgical center is grandfathered and allowed by HIPAA.
To help move patients through the larger preoperative area, they are placed in a UFSK surgical chair that easily articulates into a bed. The chair is also powered, allowing a single staff member to move a patient anywhere in the open space.
To improve time efficiency, Jones and his staff do not use sticky pads to hook up surgical monitors. Instead, they use wrist clips that help them avoid struggling to place pads around thick body hair and then having to rip them off.
“That adds a lot to efficiency,” Jones said. “They’re hooked up once, and they’re not moved around a lot from one bed to another.”
A critical part of preoperative safety is ensuring the correct patient has the correct surgical site and correct IOL. At Jones’ practice, they reinforce patient identification by placing name tags on the patient’s chest and on their wrist. On the patient’s chest is a microscope sheet that clearly outlines important information, including the patient’s name and their referring doctor, as well as pertinent information about their surgery, like the correct eye and the type of lens being used. The staff also places a highly visible, circular orange sticker, allowing them to visually verify the correct surgical site.
“It’s bright enough that it will actually show through a paper drape,” Jones said.
Cabinets in the nurses’ station where the IOLs are stored have no doors, giving the staff better access with less noise and distraction.
“You don’t hear doors opening, closing and knocking around,” Jones said.
Jones also keeps a small workstation directly across from his two operating rooms that gives him a space to perform his IOL power calculations and keep a heads-up display of all the information he needs.
“It gives me all of the vitals of where I’m at for the day and what’s going on,” he said.
In the operating room, Jones keeps the same microscope sheet up with each patient to verify that each step of the surgery is correct. To help himself maneuver throughout the room more easily, he keeps his foot pedals on a rotating, spring-loaded device.
“You can literally kick it around to move it where you want it to go,” he said. “When my foot is not on it, it can roll on ball bearings and move around. When I put my foot down, it sinks into floor, it has a rubber stopper and it’s solid.”
Jones also said it is important to review every procedure, good or bad. He does this by capturing every surgery on video.
“I get to learn how I could do it better next time,” he said. “If I have anything that goes right, I look at it and judge it against my other videos.”
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Jones JJ. Safety & efficiency in my ASC. Presented at: Cataract Surgery: Telling It Like It Is. June 9-13, 2021. Amelia Island, Fla.
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