Shared Governance - Inpatient and Outpatient OR

[seeenoharekrispe]

Hello all!

This issue is regarding Unit Based Councils (UBCs) commonly employed in Magnet designated hospitals. If you have any experience with UBCs, your input would be greatly appreciated! In fact, ANY input would be appreciated, but if you have any experience in the matter, please say so in your reply!

TL : DR - Hospital wishes to implement unified Inpatient/Outpatient OR UBC (2 different units in one UBC). Have you seen it work? How did they work it out? (If not) How can I convince management it probably won't work?

Details

My organization is now seriously pursuing Magnet status and is starting to implement Shared Governance by forming UBCs in each unit. The Magnet team and the Perioperative Administration have decided that the Main (Inpatient) OR be combined with the Ambulatory (Outpatient) OR to form one collaborative council.

Personally - and I share the same sentiment as every other staff member who has given me input - I disagree with this combined Unit Based Council. Firstly, the name implies that each unit has its own distinct council, comprised of members of said unit. Although both units are Operating Rooms, there are many differences between the two units:

• Patient Acuity
  
  • Main OR = Inpatient and Outpatient; patients frequently come down from floors and ER to the OR
    
  • Ambulatory OR = Exclusively Outpatient; same-day surgery
    

  [*]Staff Hours, Composition, Workflow

  • Main OR = Clinical Techs available for turnover, patient moving help, running specimens, etc.; multiple shifts (morning, midshift, evening); on-call staff
    
  • Ambulatory OR = no Clinical Techs; one 8-hour shift; no call
    

  [*]Service Breakdown

  • Main OR = heavy in General, Ortho, Spine/Neuro
    
  • Ambulatory OR = mostly General, ENT, GYN
    

  [*]Equipment/Instruments

  • Each OR has its own set of equipment and instruments/trays that it has to manage
    

  [*]Logistics

  • The Ambulatory OR is physically separate from the rest of the hospital (where the Main OR is situated)
    

One of my main concerns is that, because of the differences between the units (and there probably are more), there will not be much common ground for discussion during the UBC meetings. If the members wish to make changes within their respective units, I think they must be working under the same premise, the same understanding of the same problem; otherwise, it would be a waste of time to sit in a meeting and listen to others tackle a problem about their Spine Service that might not even exist in your own unit (because you don't even do spine procedures in your OR)!

My question is this: if you have seen a similar unified UBC for two separate units work, how did they reconcile their differences? If it didn't work out, why not? What do you think would be the best route to convince management that this will probably not work?

If you've read this far, thanks!

Thanks in advance for your responses!

- seeenoharekrispe