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August 2007 See the full issue

No single step prevents wrong surgery

No single step, whether the time out before the incision or surgical site marking, is adequate to prevent wrong surgery. Rather, site verification needs to be a package of activities that involves the team—the nurse, patient, surgeon, and anesthesia provider—as well as an accurate OR schedule and consent and a…

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By: OR Manager
August 1, 2007
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Universal Protocol won't change for now

The Joint Commission isn't making immediate changes in the Universal Protocol for surgical site verification. But revisions could be coming. One issue being discussed is who should mark the surgical site. Joint Commission officials discussed the protocol in a June 21 audioconference as a follow-up to a wrong-site surgery summit…

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By: OR Manager
August 1, 2007
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New major study on surgical outcomes

The American College of Surgeons (ACS) reported in June on a 3-year surgical outcomes study involving nearly 185,000 patients in 142 centers. Results from the ACS National Surgical Quality Improvement Program (NSQIP) are reported in 20 articles in the June Journal of the American College of Surgeons. One article describes…

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By: OR Manager
August 1, 2007
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Planning for the worst: OR director shares lessons from the Gulf Coast

How would your OR manage if the hospital was on emergency power for 3 days, there was no running water, and supplies were dwindling? You didn't know when help would arrive. Still, sick and injured patients kept arriving, and families were flocking to your doors. After Hurricane Katrina in 2005,…

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By: OR Manager
August 1, 2007
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OR analyst: A support for periop leaders

Perioperative directors have seen their jobs expand, with growing demands for financial analysis, operational efficiency, and quality monitoring. To help provide support, HCA Inc, one of the nation's largest health care providers, developed the role of OR analyst. It's estimated more than 50% of HCA's 173 hospitals now have such…

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By: Source: HCA Inc.
August 1, 2007
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Toward a more wired OR supply chain

Instrument tracking Currently use an instrument tracking system Yes 36% No 64% Electronic purchasing Percentage of transactions performed through electronic data interchange (EDI) Surgical supplies None 14% 1%-25% 18% 16%-50% 20% 51%-75% 28% >75% 21% Physician preference items None 34% 1%-25% 34% 16%-50% 14% 51%-75% 11% >75% 7% Source: Hositals…

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By: OR Manager
August 1, 2007
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Joint Commission's 2008 safety goals

The Joint Commission has made 2 major changes to the National Patient Safety Goals for 2008, requiring organizations to: take steps to reduce harm from anticoagulant therapy. develop a method to enable caregivers to request help when a patient's condition seems to be worsening. The new requirements will be phased…

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By: OR Manager
August 1, 2007
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Is it time to add instrument tracking?

ORs probably have as much money tied up in their instrument inventory as in surgical supplies, from $1 million to $5 million. Yet automation for instrument tracking is much less common than other materials management technologies. (See related article.) The need for keeping track of your instrument dollars is "similar…

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By: OR Manager
August 1, 2007
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The Carrot Principle: A low-cost, high-return employee motivator

"When you recognize people for what they do well, they actually do better." Max Brown will speak on The Carrot Principle at a luncheon on Friday, Oct 5, at the Managing Today's OR Suite Conference Oct 3 to 5 in San Diego. He is with the Carrot Culture Group, a…

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By: Kate McGraw
August 1, 2007
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A health system's experiment with 90-day warranty for CABG

When you buy a car, you can get a 5-year warranty. A refrigerator and washer and dryer come with a 1-year guarantee. But if a patient has heart bypass surgery and develops a sternal wound infection, not only is there no guarantee, but the patient's insurer will probably be charged…

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By: OR Manager
August 1, 2007
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Preventing TASS: Advice from experts

Four letters that strike fear into the heart of any administrator of an ambulatory surgery center (ASC) are T-A-S-S, or toxic anterior segment syndrome. This complication of cataract surgery has been around for years, but news of an outbreak in 2006 brought it to the forefront. A new report of…

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By: Cynthia Saver, RN, MS
August 1, 2007
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An ASC's relentless focus on savings

No cost is too small to escape the eyes of managers at Evansville Surgery Center in Evansville, Indiana, which shaved about $100,000 from its supply budget in the past year as part of an overall $417,000 reduction in variable costs. Evansville has 2 multispecialty surgery centers that perform about 9,900…

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By: OR Manager
August 1, 2007
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