Outpatient
OPERATING ROOM
Connection OR salaries inch higher,
Old blood r
TING ROOM
aises death risk in
along with responsibilities
trauma patients receiving
transfusions
by Julie E. Williamson
A victim of severe trauma who gets as little as a single
unit of blood that’s been stored for more than a month
is twice as likely to die as an equally injured patient
who gets transfused with fresher blood, a new study
A
lthough continued economic woes supply distribution and purchasing, and en-
have as many as half of all U.S. hos- doscopy, and nearly three-quarters (74 percent)
pitals operating in the red, some also manage outpatient surgery. Eight-four
could say that, perhaps surprisingly, the finan- percent oversee the sterile processing function
finds. R
OPERA
ed blood cells stored longer than 28 days sig-
cial and professional outlook is rather rosy for and a full 90 percent are responsible for the
nificantly increased trauma patients’ risk of developing
those in OR management positions. post-acute care unit.
fatal deep vein thrombosis or multi-organ failure for six
The 2009 Healthcare Purchasing News OR “All of those [cost centers or functions listed]
months after transfusion, a team of pediatric intensive-
Management Salary Survey, which garnered report to me, plus PreOp Admissions, the
care specialists in Connecticut reported in the journal
205 respondents across various management PreOp clinic, Anesthesia, PACU overflow
Critical Care in September.
titles, revealed that, on average, 63.9 percent unit, as well as [the] OR,” said Nancy Cotton,
The new study is the latest to raise concerns about rules
of respondents saw their annual base salaries RN, MSN, CNOR, director of surgical services
governing the use of about 29 million units of blood trans-
increase over their 2008 earnings – and those for John Muir Health, Walnut Creek, CA. “We
fused every year in the United States. The American Red
who did earned a respectable 3.5 percent in- are all taking on more administrative func-
Cross says donated blood has a “shelf life” of 42 days, after crease, on average. The 2009 median income tions within existing cost centers. Our facility
which it must be discarded if not used. across all OR management titles was $77,890, is quite sophisticated with many tools avail-
Two earlier studies — one looking at a general hospital representing a notable increase over last year’s able for financial analysis, program develop-
population requiring transfusion and a second at heart average of $65,614. And while the percentage ment, performance improvement initiatives
surgery patients — found that the use of longer-stored blood
of those who experienced a pay hike in 2009 and scorecard reports just to name a few.”
in transfusions resulted in poorer outcomes. Hospital pa-
fell short of the 84.5 percent who reported in- The “doing-more-with-less” mantra ap-
tients administered blood stored longer than four weeks
creases in 2008, one could still reason that a pears to be popular amongst OR managers,
were three times as likely to acquire an infection in the
majority salary increase bodes as well. “I definitely feel secure
hospital than those who got fresher blood. Heart patients
well for the profession and un-
Salary by Gender
in my job, but a big part of that is
infused with blood stored longer than two weeks were
derscores the value that facility because I’m wearing so many
64% more likely to die than those whose red blood cells
executives place on those in OR
Male, 26%
$75,926
different hats these days and
were more briefly in storage.
management positions.
Female, 72%
have a bigger share of responsi-
$78,350
The fiscal challenges faced by bilities,” said one nurse manager
Though hospitals typically use their longest-stored blood
the healthcare industry don’t who works for a Phoenix-based
first to avoid wasting the precious resource, the authors of
appear to be negatively impact- ambulatory surgery center. “We
the Critical Care study suggest that physicians might con-
ing OR management professionals’ percep- have a hiring freeze right now and there are
sider the “preferential use” of younger blood on the most
tions of job security, either. Nearly 94 per- empty positions that, in the past, would have
critically injured trauma patients. The result would likely
cent of respondents indicated that they feel been filled. But with the economy the way it
mean more blood reaches its expiration date before it can
either very secure or somewhat secure in is and more people not wanting to spend
be used. (Los Angeles Times)
their current positions (48.8 percent and 43.9 money on healthcare – especially for elective
percent, respectively) – percentages closely procedures – we’re not able to justify the hir-
New rules protect patients’
aligned with 2008 findings. Part of that per- ing.” Although her facility also has a freeze
genetic information
ceived security may be linked to increasing on all raises and bonuses, she said her 2009
Individuals’ genetic information will have greater protec-
responsibilities, which helps make OR man- annual base salary is still “substantially more”
tions through new regulations issued by the U.S. Depart- agement professionals even more indispens- than the $62,500 average for OR managers in
ments of Health and Human Services (HHS), Labor, and able to resource-constrained healthcare insti- surgery center settings that was indicated in
the Treasury. The interim final rule will help ensure that tutions. the 2009 salary survey.
genetic information is not used adversely in determining While surgery center employees often fol-
healthcare coverage and will encourage more individuals Doing more, sometimes with less
low a set Monday through Friday schedule
to participate in genetic testing, which can help better iden-
Indeed, the survey revealed that OR manag- and don’t typically work extended hours, some
tify and prevent certain illnesses.
ers and directors, whom represented 41.5 per- managers and their staff are pulling double-
Under the Genetic Information Nondiscrimination Act
cent of survey respondents, tackle their fair duty with sister facilities, and even becoming
of 2008 (GINA), group health plans and issuers in the group
share of day-to-day responsibilities. Sixty per- educated in other patient care areas to broaden
market cannot: increase premiums for the group based on
cent of respondents work in ORs with 30 or their professional reach.
the results of one enrollee’s genetic information; deny en-
more employees and with ten surgical suites. “We’re doing a lot of cross-training in dif-
rollment; impose pre-existing condition exclusions; or do
Surgical services directors commanded the ferent departments, including a pain manage-
other forms of underwriting based on genetic information.
highest median 2009 salaries at $94,107, a sig- ment area within our facility,” the surgery
nificant jump over the $83,289 average re- center OR manager explained. “If we’re slow,
In the individual health insurance market, GINA prohibits
ported in 2008. Their wide-ranging responsi- we can step in and do what’s needed [else-
issuers from using genetic information to deny coverage,
bilities certainly appear to justify their where]. That’s one way to improve job secu-
raise premiums, or impose pre-existing condition exclusions.
top-earner status. More than half manage an- rity and keep our per diem nurses and full-
Visit www.dol.gov/ebsa for more information.
esthesia services, pre-admission testing, OR time [staff] busier.”
14 November 2009 • HEALTHCARE PURCHASING NEWS www.hpnonline.com
0911-ORsalary.pmd 14 10/12/2009, 4:25 PM
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