First in a series on OR performance. How can you make progress on on-time starts? Are you attracting the right cases to meet your volume and revenue projections? How can you manage block utilization more consistently? The first answer to these persistent questions is good OR governance and a strong…

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There's a tax on income, on gasoline, and on a new car you buy. They're even talking about a tax on soft drinks. But there's a hidden tax you may not be aware of—the tax on trust—that can undermine your effectiveness as a manager. Max Brown When trust is high…

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Holy Cross Hospital in Silver Spring, Maryland, was known locally as an excellent "baby" hospital at a time when the community population was aging. Deciding to broaden its scope to better serve the community, leaders at Holy Cross decided to expand the hospital's expertise in gerontology, opening its Seniors Emergency…

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Reprocessing of single-use devices is now mainstream, with an estimated 70% of US hospitals using single-use devices reprocessed by third-party companies, according to industry figures. In an opinion piece in the March 2010 Academic Medicine, authors from The Johns Hopkins University School of Medicine call reprocessing a "common sense strategy"…

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Over the 8 years from 2001 to 2009, the cost of a lumbar spinal fusion with implants rose from under $6,000 to over $14,000 per case, with a small decline of 2% between 2008 and 2009. This was the second year in a row that the implant cost per case…

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A pilot pneumonia prevention program significantly reduced postoperative pneumonia in a hospital postsurgical unit. "Postoperative pneumonia is a problem facilities face continually, but our research shows simple steps in prevention can have a substantial effect," says Sherry Wren, MD, FACS, chief of general surgery at the Veterans Affairs (VA) Palo…

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Two hospitals, both recognized nationally for their strong performance on patient outcome and financial measures, describe their approaches to OR governance. Leadership triad provides a strong base for safety Regions Hospital St Paul, Minnesota Level 1 trauma center with 17 ORs and an ambulatory surgery center As Regions Hospital moved…

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The anesthesiologist switches the patient from the ventilator to the cardiopulmonary bypass machine but forgets to resume ventilation after the patient is removed from bypass. The possible results? Longer surgery time, permanent brain damage, or even death. This isn't an uncommon error. A simple "smart system" would give a warning…

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Though morbidity and mortality differences based on age might be expected, the degree of difference is staggering. Perioperative morbidity in older patients can be as high as twice that of younger patients, and mortality can be 3 to 7 times higher, finds a study in the Archives of Surgery. Another…

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How to charge for OR supplies is a frequent question OR business managers ask. In this column, Keith Siddel, MBA, an expert on health care business operations, responds to questions about supply packs and billing for endovascular procedures. The questions were posed by members of OR Manager's OR Business Management…

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Privileging (HR.02.01.03) was the toughest standard to meet for Joint Commission-accredited ambulatory care centers in the first half of 2009, with 45% of facilities surveyed out of compliance. Accreditation expert John Rosing, MHA, FACHE, comments on the elements of performance (EPs) that caused the most compliance difficulty. Rosing is with…

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Staying on top of credentialing and privileging requirements in an ambulatory surgery center (ASC) is a daunting task. Credentialing applications need to be tracked; licensure, education, and other qualifications verified; databases checked for suspensions and any other adverse actions; and reappointments followed up. ASC leaders know accreditation surveyors expect all…

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