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January 2009 See the full issue

FAQs posted on 2009 Universal Protocol

The Joint Commission in November posted answers to frequently asked questions (FAQs) about the 2009 Universal Protocol for surgical site verification. The protocol, introduced in 2004, was revised after a summit in 2007. The changes are effective Jan 1, 2009. Managers will want to review the FAQs and discuss them…

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By: OR Manager
January 1, 2009
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Does your staff understand delegation?

An RN is circulating on a case when near the end, the surgeon hands the scrub technician a suture and tells her to close the wound. In another situation, the next case requires medications to be drawn up, and the surgical technologist (ST) offers to do this while the RN…

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By: OR Manager
January 1, 2009
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Meeting challenges for spine costs

Spinal surgery is a costly specialty that strains OR budgets. The wide variation in techniques and costly technology make it difficult to manage. Challenges go beyond rods and screws. An array of biologics, such as bone morphogenic protein (BMP) and demineralized bone matrix (DBM) can add thousands of dollars to…

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By: Pat Patterson
January 1, 2009
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Top strategies for juggling quality, cost of physician preference items

Managing the costs of procedures with implants continues to be a juggling act for OR directors and business managers. Total joint replacements, once profitable, have seen prices climb while Medicare reimbursement slides. Some spinal procedures still have a positive margin because the surgery is more often performed in younger patients…

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By: OR Manager
January 1, 2009
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Staff spearhead's an OR's green effort

Protecting the environment and running an efficient OR aren't mutually exclusive at Oregon Health & Science University (OHSU), Portland, thanks to the commitment of a surgeon, an OR nurse leader, and the OR nursing staff. Clearly labeled bins aid recycling. Trash for recycling is placed in green bags. "Just because…

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By: Cynthia Saver, RN, MS
January 1, 2009
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Nation's emergency care a ticking time bomb'

Economic woes and a failing health care system mean more people than ever are relying on emergency care. But emergency physicians give the country a C- for its support for emergency resources. "Emergency medical care is the most overlooked part of our health care system, and the one everyone depends…

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By: OR Manager
January 1, 2009
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What makes a behavior code effective?

ORs have been reviewing their codes of conduct and behavior policies in view of new requirements in the Joint Commission's Leadership Standards, which took effect Jan 1, 2009 (related article, p 17). The University of Wisconsin (UW) Hospital & Clinics in Madison has an 8-year track record for its policy.…

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By: Pat Patterson
January 1, 2009
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OR leaders bracing for more cost pressures with economic downturn

With no bailout in sight, health care needs to invent its own version of the hybrid car—become more efficient and cost-effective—to survive the economic downturn, one consultant quips. The times will challenge OR leaders to do even more to reduce costs and streamline operations. "We will all need to pitch…

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By: Pat Patterson
January 1, 2009
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Toward an effective code of conduct

Some facilities have had a code of conduct for years, and managers say it works well. At others, nurses still are too intimidated to remind physicians to wash their hands. In a lively discussion at the Managing Today's OR Suite conference in October 2008 in Washington, DC, it was clear…

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By: Pat Patterson
January 1, 2009
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CDC sterilization, disinfection guideline

A new evidence-based guideline from the Centers for Disease Control and Prevention (CDC) provides guidance on key issues such as endoscope repro-cessing, emerging pathogens, disinfection of surfaces, and susceptibility of antibiotic-resistant pathogens to disinfectants. The new Guideline for Disinfection and Sterilization in Healthcare Facilities, in the works for a number…

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By: Pat Patterson
January 1, 2009
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ASCs take steps to improve handoffs

Here comes the 10th patient of the day, out of the operating room and into the postanesthesia care unit (PACU). Quick: Does she have any allergies? What medications has she received? And is that her daughter in the waiting room? Even in the smaller setting of an ambulatory surgery center…

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By: Paula DeJohn
January 1, 2009
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Closing the loop on biopsy specimens

When a surgical procedure includes a biopsy, the tissue specimen goes to a laboratory for analysis, and the result comes back to the physician. That much is clear, wherever the surgery took place. What happens next, however, can be a mystery in the context of an ambulatory surgery center (ASC).…

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By: Paula DeJohn
January 1, 2009
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Moving your surgery center into an EMR

Health care is not shy about adopting new technology when it comes to the latest generation of computed tomography, linear accelerators for cancer treat-ment, or other scientific innovations. Yet in their business functions, facilities have been reluctant to invest in information technology such as electronic medical records (EMR) and purchasing…

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By: OR Manager
January 1, 2009
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AdvaMed adopts expanded code of ethics

The code of ethics that guides relations between medical device companies and health care professionals has had a major update. The trade group AdvaMed (Advanced Medical Technology Association) issued a comprehensive revision of its ethics code in December 2008. The revised code is effective July 1, 2009. The purpose, AdvaMed…

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By: OR Manager
January 1, 2009
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