As 2009 continues to unfold, the future of the nation's economic status remains unstable and uncertain. The government has spent billions of dollars to help stabilize the economy. States are struggling to meet budget deficits and are looking at measures to cut costs including cutbacks in Medicaid funding and other state health programs. Experts predict we can continue to expect increasing economic challenges in the coming months.
Healthcare feeling the pinch
Healthcare organizations are reacting to the effect of the economic climate and the initiative and challenges 2009 will bring. The Institute for Healthcare Improvement (IHI) ended its 2-year "5 Million Lives" campaign and has announced a new quality improvement goal that focuses on helping healthcare organizations "establish priorities, organize work, and optimize resources." The World Health Organization has proposed a surgical checklist to decrease patient events.1 In addition, the Department of Health and Human Services (HHS) and a new White House Office of Health Reform are reviewing new ways to cut costs and improve access to and quality of healthcare.
The American Hospital Association (AHA) published a report in November 2008 based on a survey that indicated hospitals are feeling the effects of the economy. The report showed that hospitals are reevaluating the need for renovation or new construction, implementation of new information technology, and delaying purchases of new technology and equipment.2
Right in our own field, perioperative leadership is being pressed to identify opportunities to improve operations and financial spending. Close examination of financial processes are necessary to maintain fiscal health. Managers of surgical suites will be assessing and managing instrument and supply costs, improving missed charges, and increasing operational efficiency. Retaining nurses is more important than ever not only to provide and maintain an effective team approach and optimal patient outcomes, but also because retention means less fiscal cost in hiring and orienting later.
We are the front line
In the midst of all this financial unrest is the perioperative nurse. We are at the front line. In the past, most of us left the finance worries to leadership and we focused on patient care. We can't afford this attitude literally or figuratively. In this climate, it's no longer adequate to focus only on the health of the patient; we must now also focus on the health of the organization. Managing costs will be the theme for perioperative nurses in the upcoming months.
As perioperative nurses, we assume the roles of leader, teacher, clinical expert, facilitator, communicator, and guardian. The role of fiscal manager in the OR is equally essential. Ensuring correct supplies, making sure instrumentation is in good repair, and ensuring accurate and complete charges are some ways in which we can impact the financial outcomes. This may be a daunting task but being accountable and responsible in leading the team toward this goal is a good place to start.
Elizabeth M. Thompson, RN, CNOR, MSN
Editor-in-Chief, Nursing Education Specialist, Mayo Clinic, Rochester, Minn. [email protected]
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