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Suze

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    Suze
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    Paul,
    Several good points and suggestions have been offered in response to your data gathering activities.
    I am going to offer a different perspective with the hopes it will assist you in understanding the culture and context into which you find yourself.  This will establish priorities, and set the stage for action plans.
    Before any data gathering can be done with assurance in your case, consider and get clear the following:
    1)  Why was your position created?  It sounds like it is a revenue decision that is driving the creation of your position.  Hospitals are in trouble right now, given the economic conditions and the erosion of their investment dollars.  In order to create more revenue in the OR (the primary revenue driver in a hospital), more cases need to be performed.  In order to perform more cases, there has to be time in the schedule to accomodate those cases.  So is your #1 priority to find where/when this time exists, or whether it exists at all?  In other words, capacity?
    2)  Do you have access to the consultant reports?  There is a very good chance they have done time studies in your hospital.  Check to see if they documented times with overlapping cases, and room changes.  If this has been done in the past, why are you being asked to do it again?  It could be the consultant’s report isn’t well understood, or isn’t deemed valid by the OR staff.  Be sure to find out what is going on with past consultant reports, and how you can analyze their recommendations now.  Chances are they recommended at some point a PI person be hired to implement their findings (?)
    3) Getting back to #1), there may be an inherent conflict in this new position that needs further clarification.  What is the primary description of your job?  Were you hired to a) boost revenue (a business position in which clinical data is obtained), b) facilitate process improvement for the purpose of enhancing standards of care, or c) generate quality enhancements for the purpose of improving patient care?  Depending upon the answer, the staff in the OR will respond differently – and it is your responsibility to effectively manage these responses.  Do they know why you are there?  What is their perception of that?  Do you know why you are there?  These are the answers you need, because this is the first time someone has occupied this position.  There are naturally alot of unknowns, and before you go much further, get all this straightened out.  With your boss, write a very short business plan for what it is you are being asked to do in the next year.  This helps identify in writing what your boss wants of you, so that if you meet resistance along the way, you can go back to a document that was mutually created.  A new position like this is a target for alot of criticism, and a whole lot of history behind it.
    4)  Absolutely agree that you need a team.  This is not a good place to be on your own – harsh culture, big egos, and some very strong opinions on just about everything but the kitchen sink.   Before you move one more inch forward, work with your boss to assemble that team and get this into your written yearly plan.  I think a poster here may have provided some good info on assembling a team.
    5) Remember how vulnerable you are right now.  While you may feel confident, and competent, others are looking at you very carefully.  You are the first in a new position.  They don’t trust you yet.  Like all things involving nurses, you should consider spending a lot of time developing good relationships as you work toward your job-related goals.  As one poster mentioned, it is essential that you involve personnel in the decisions.  This comes with time and dedication.
    Good luck, Paul!
     
     

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