OR Nurse Reorganizes the Hospital Financial Engine

September 28th, 2011

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By , BSN, RN

Call her a consultant, call her a trouble shooter, or maybe use her term, re-organizer. Anita Wilson, RN, MS, LLC is all of those things and more. She is a perfect example of taking what you know best and turning to your best advantage. And even though her focus and passion is peri-operative services, her principles of management have a universality that can apply to any hospital unit.

Where did this all begin?

Kindergarten. Within a week of starting school for the very first time I was lining up the other kids and saying, "you go, now you go, now you." Years ago one of my sons told me, "You are so bossy!" I was 20 years old when I graduated from nursing school. I walked into surgery and never left. All those 35 years seem like they were yesterday. I'm an OR nurse!

How did you end up "reorganizing" hospital operating rooms?

I grew up Level-1 (the highest level of trauma hospitals) and knew I wanted to be the director. I went back to school and got the degrees, but they would never hire me for that top spot. I guess I was too outspoken, too direct. So, with a partner, we branched out on our own in 2000. Since then I have worked in everything from community hospitals to 1,000-bed county hospitals.

We do whatever the client needs. In hospitals, 68-72% of the revenue is generated by surgery. The OR is the financial engine of the facility. Also, 80% of supplies used in the hospital are used in the OR. Hospitals are finally getting savvy, they have access to more information, more data. They are learning you can't leave the cart unattended, and that's where I come in. The OR may lack leadership, or maybe the leaders don't know which directions they should be going. You need efficiency in the OR in order to make money. I make people millions of dollars.

Is there some kind of basic philosophy or methodology you use to make your client ORs more productive?

If you see me coming, you are having trouble. I am a change person. I take it as a given your nurses are providing good care pre-op, intra-op and post-op but you need help. Patients will always come. The surgeons are my number one clients. They don't have to operate in your facility, they want efficiency.

It comes down to what I call the Five S's:

  • Sort-Look at the OR like it's a desk you are cleaning up. First you sort: this is a pen, paperclips, paper, etc.
  • Setup-Then you arrange: pen to the right, paperclips in the cup, paper in the middle.
  • Shine-Clean it up. Get rid of the dust bunnies.
  • Standardize-Now, whenever I walk up to a desk, any desk, the pen is on the right and the paper in the middle and the paperclips are in the cup.

The fifth S takes as long to implement as the first four.

  • Sustain-If you don't sustain it, you simply move change-to-change. I'm going to open up that desk drawer and put my things in the same place every time.

Stay with those five S's—it won't steer you wrong.

Do you do all the work on your own?

Many of the problems we are given we work on ourselves and we subcontract to others. If we know SPD needs redesign we have two guys in Colorado Springs who are great. If they need scheduling redesign, we have Michelle in Florida who is amazing. We even have a proprietary scheduling program Michelle designed.

When talking to Wilson there is no doubt she loves what she does. She has followed her passion into yet another area of nursing that isn't the traditional bedside care role. "I've been in a lot of interesting cases, I've been a lot of interesting places and I've met a lot of interesting people," she says. "I love the roller coaster that is the operating room." And, she doesn't lack confidence. As she told one surgeon recently, "I can cure any problem behind the double doors."

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