LIGHTEN YOUR LOAD Heavy lies the head of the facility manager who tries to do it all herself.

sharing the hats
Delegating Those
Non-Patient Care Tasks

We have all heard it before: The key to effective management is delegation. But, if you're like me, sometimes it's hard to let go. What if the ball gets dropped? The problem is that either we can't get it all done well, or, worse, we trust it's getting done and it's not. If we take a team approach to all those jobs and documents we need to maintain, where each team member has clearly assigned roles, documents her activities and reports at monthly scheduled facility meetings, delegation may just work. Here are some "hats" you may want to put on key staff members.

• Safety officer. A cautious, rule-following staff member will shine wearing this hat. She can do facility walk-throughs, complete a safety checklist, keep your OSHA injury logs updated, maintain your Exposure Control Plan and test your eye wash station. Let her coordinate with your hazardous waste company. She can even shop for a "safer sharps" product for annual evaluation and make sure your spill kit is maintained.
• Emergency preparation nurse. You probably already know who wears this hat. She's already checking the crash cart supplies and equipment. Formalize her responsibilities to include reviews of emergency policies and forms, emergency training, coordinating drills, MH- and lipid-rescue response, and BLS and ACLS certification tracking.
• Infection control nurse. We know we need to provide formal training to the person wearing this hat, but consider expanding the duties to include maintenance of all of your facility health records, infection control tracking and hand hygiene surveillance. Consider including surveillance ?of your prep and scrub processes, too.
• QAPI/risk manager. This person should be great at documentation. She facilitates the training of staff for risk and quality processes, maintains incident reports, performs any needed follow-up and recommends trends for studies. She can also prepare the reports and collect your benchmarking data.
• Medical records custodian/HIPAA compliance officer. Makes sense to combine the 2 under one hat, since both jobs require privacy and security of records. She can also facilitate records requests, records storage and related policy maintenance.
• Patient liaison. Who wears your best patient advocate hat? Have her maintain your advance directive process, keep up with patient rights requirements and manage any formal grievances. She can help with patients who don't speak English and collect your patient satisfaction survey data.

Passing out all these hats will still require facilitation and support. Some hats may need to be yours, but you can still put them on at designated times so that those duties don't get missed. Ensure staff success by providing reporting tools. Maintain binders for each "hat" and keep them updated. Collaborate about findings and set goals. Track your activities and summarize them effectively to the governing board, then report the board's response and decision at your next team meeting. Hopefully, you may even end up with a few more good hair days.

— Leslie Mattson, RN, BSHM