Safety [This article from the January 2020 issue of OR Manager summarizes information presented at the 2019 OR Manager Conference. The presenter offered tips to help attendees comply with Joint Commission standards and achieve a successful Joint Commission survey. Readers are asked to note the following points of clarification: The presentation…
Malignant hyperthermia (MH) is a rare but life-threatening surgical complication that seems to turn the effects of general anesthesia upside down. Instead of relaxing, muscles become rigid, releasing large amounts of acid and potassium into the blood. Instead of a normal slowing of breathing, respirations quicken, and end-tidal CO2 rises.…
Projections for healthcare industry trends in 2020 started to proliferate near the end of 2019 as attention turned to the new year. Reflecting on the Institute of Medicine’s (IOM) landmark 1999 report, “To Err Is Human: Building a Safer Health System,” some healthcare leaders said the report has raised awareness…
A care transition poses a danger point for patients—failing to “hand off” needed information from one clinician to another can lead to significant morbidity and mortality. The Joint Commission was so concerned about handoffs that in 2017 it issued a sentinel event alert on the topic. “Handoffs are a safety…
In 2017, the Joint Commission issued a Sentinel Alert Event on the problem of inadequate handoff communication, focusing attention on this vital aspect of care. (See related story, p 22.) Clinicians and leaders agree that handoffs are important, but implementing them effectively can be challenging, particularly in the fast-paced perioperative…
Enhanced Recovery After Surgery The implementation of Enhanced Recovery After Surgery (ERAS) is based on the concept of organizing care around the patient, addressing medical condition needs to optimize readiness for surgery and reducing the likelihood of postoperative complications. Efficacy is measured by how well we perform according to these…
Keeping up with Medicare’s regulatory and reporting requirements for ambulatory surgery centers (ASCs) can be as difficult as ensuring physicians arrive to start their cases on time. “Regulations can change frequently,” says Gina Throneberry, MBA, RN, CASC, CNOR, director of education and clinical affairs for the Ambulatory Surgery Center Association…
When you have a problem, are you empowered to solve it? What happens when staff encounter an obstacle? Cleveland Clinic’s Tiered Huddle process empowers all caregivers to see problems and tackle issues on their own or escalate them for assistance. The tiered huddles have energized teams to work across the…
At Virginia Commonwealth University System (VCU Health) in Richmond, we are using quality standards to establish operational definitions for elements of Enhanced Recovery After Surgery (ERAS). This article describes what those standards are and how they are implemented. Previous articles in this series appeared in the October 2019 and November…
Our series on Enhanced Recovery After Surgery (ERAS), which began last month with an overview of its history and perioperative pathway, continues in this issue with examples of improved outcomes and the roles played by perioperative team members (see p 18). ERAS, known to speed recovery and increase patient satisfaction,…
