We step inside many ASCs and hospitals in our daily course of business. It just dawned on me last month that something is missing – something that I haven’t noticed in the past. I finally figured it out. It was not what I was missing, but rather what I couldn’t see. Clear space!

We have somehow, somewhere, lost sight of - sight! The clutter! The sheer hoarding of – stuff! Everywhere in our hospitals and ASCs just look around and, like those 3-D pictures that have a picture within that if you focus hard enough comes to light, you will see what I’m talking about.

You should be able to look down your sterile corridor and see the other end – unobstructed! Rare! Rare is the facility where you can do that without seeing a linen cart, suture cart, piece of equipment, stretcher, X-ray rack, or other obstacles taking up space and blurring your vision. Our patients see this, and it is disarming to them who consider hospitals and surgery facilities to be like they see on TV – neat and spotless!

This bloat is not limited to the operating area, but metastasize to the waiting room (embarrassing in most centers) to the exposed front desk and the patient registration areas – all fully in view of our patients and their more focused family members.

Would you go to a doctor if their waiting room had a dead plant sitting in it?

If you are in the position to look at your budget – really look at it, you can see bloat there as well. Spending money on completely unnecessary items or services no longer needed simply because you have always done it is bloat. Does no one have the time to drill deeper into what you are actually wasting money on? In most cases – no.

Preference cards are, for the most part, antiquated and need to be updated after the first 6 months the surgeon does that procedure. If not, then it is because no one is looking at them or checking with the surgeon.

Look at your supply rooms, janitor closets, locker rooms, waiting room, and lounge and tell yourself they look neat, organized, and professional. Most just can’t do it.

Patient charts should be purged according to your policy and procedure. Many never do.

Now – in defense of all of this, I agree with you when you say “There is not enough storage area in this facility!” You are completely right. For the most part, surgery centers allocate more space to income areas such as the number of operating rooms versus storage space. Regulations dictate how much space per operating room you need to have – but that is the minimum and rarely does anyone have more because of the cost but the minimum just isn’t enough! Everyone wants to cram another operating room into the smallest space available and not allocate enough for storage. So you got to play the hand you were dealt and make do.

Everyone is busy. Everyone is short staffed (or has convinced themselves they are) and no one has the time to deal with it. Solution! Pick a staff member to “Police the Area” – (military term to check it out and clean it up). That person is responsible for a period of time to roam the halls and identify what needs to go and what needs to stay. (Rotate them because eventually they will also lose sight of what is clutter and what is not). Then you decide where it goes! (Remember we have “Just in Time” inventory available to us with most vendors.) If nothing else, get some prefab cabinets that put stuff in there instead of in the corridors and patient areas.

You can also rent outside storage bins adjacent to your facility and put the larger items there – many surgery centers to that very successfully. Make sure you inventory what is stored where for easy access.

Bottom line – if you haven’t touched it in a year – you don’t need it. If you can see it – hide it. If you cannot remember why you have it - then store it or lose it.

If you need further tips, watch the TV show “Hoarders” on A&E.

Earnhart & Associates is a consulting firm specializing in all aspects of outpatient surgery development and management. Earnhart & Associates can be reached at their mailing address at 5114 Balcones Woods Drive, Suite 307-203, Austin, TX 78759.