Getting patients through the surgical process smoothly is a continual quest. In a 6-month project, 29 hospitals in Illinois, Indiana, Michigan, and Ohio, with coordination from the Indianapolis-based regional office of VHA Inc, worked on improving processes before, during, and after surgery. The group benchmarked on 11 indicators, showing small…

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The preference list is wrong! How often have you heard that from surgeons or the OR staff? It is a constant battle—assuring that the preference list is right, updated, and available for the case. A collaborative effort between surgeons and OR managers can make it better for everyone involved. The…

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Updated guidelines for the preoperative cardiac evaluation and care of patients having noncardiac surgery have been issued by the American College of Cardiology and American Heart Association. The revision is the first since 2002. The guidelines include an updated algorithm for perioperative management. One recommendation is that patients not stop…

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At 2 am on a cold morning last year, a group of OR leaders from Johns Hopkins stood in the FedEx logistics center in Memphis. They wanted to see what they could learn that could be applied to moving patients through the OR. Two of them also visited Wal-Mart's distribution…

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Four major implant manufacturers made a deal with federal prosecutors to avoid prosecution related to kickbacks to surgeons. In the deal, announced Sept 27 by the US Attorney's office in New Jersey, the companies, including Zimmer, DePuy Orthopaedics, Biomet, and Smith & Nephew, also agreed to pay a total of…

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In too many hospitals, do-not-resuscitate (DNR) orders are automatically suspended when the patient passes through the OR doors, violating the individual's right to make decisions and going against what every major association related to perioperative care recommends. "This practice is short sighted and ill advised," says Richard Cook, MD, associate…

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On-time starts for the first case of the day, which had been running at 38%, shot up to 94% within 1 year. Physicians started to participate in decisions about the block schedule. And when capital budget time came, the physicians sat around the table and decided among themselves on spending…

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Almost a year after moving to computerized preference cards, the OR nursing staff in a small community hospital still didn't want to give up the 5 × 7 cards they had relied on for years. They liked the convenience of jotting down changes and found the computerized cards were not…

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With the attention focused on best practices, evidence-based care, and similar measurements, it is no surprise that the endoscope care questions I'm asked most often revolve around my experiences with other hospitals, endoscopy centers, and office endoscopy practices. What is the average age of GI scopes at other facilities? Is…

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More spinal surgery is moving to ambulatory surgery centers (ASCs) as spine surgeons look for the same control, efficiency, cost-effectiveness, and patient satisfaction that the outpatient setting has offered other specialties. As spine surgery migrates, hospitals are seeking ways to partner with surgeons to keep from losing the revenue from…

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ACalifornia neurosurgeon has set up an advanced spine center other surgeons might envy. Robert S. Bray, Jr, MD, spent $12 million to renovate an empty office building in Marina del Rey, California, and stocked it with state-of-the-art technology, opening the DISC (Diagnostic and Interventional Spine Care) integrated surgical center in…

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