Surgery
Develop standard work for successful ERAS implementation
At Virginia Commonwealth University (VCU) Health System in Richmond, implementation of Enhanced Recovery After Surgery (ERAS) incorporates principles of Lean thinking, a management methodology that emphasizes “…maximize[ing] customer value while minimizing waste. Simply, lean means creating more value for customers with fewer resources,” according to the Lean Enterprise Institute.1 Several…
Can your hospital survive the growing dominance of ASCs?
Of the approximately 57 million surgical procedures performed annually in the US, it is estimated that hospital inpatient procedures (overnight admissions) account for less than 20% of cases. Many procedures once performed in hospital outpatient surgery departments (HOPDs) have moved to ambulatory surgery centers (ASCs) over the past 15 years,…
FCOTS increase through smarter scheduling and surgeon accountability
Starting the first cases of the day on time is key for maintaining the OR schedule. A delay in first case on-time starts (FCOTS) can lead to less OR utilization, greater facility costs, and dissatisfaction among physicians, OR staff, and patients. It’s a problem in many surgical suites, but when…
FDA: Class I recall of Medfusion 4000 Syringe Pumps
Editor's Note The Food & Drug Administration (FDA) on December 19, 2019, identified the recall by Smiths Medical ASD, Inc of its Medfusion 4000 Syringe Pumps as Class I, the most serious. The recall was initiated because of malfunctioning low-battery alarms, which may lead to an interruption of therapy. The…
Laser-based imaging system, AI algorithm accurately identify brain tumors
Editor's Note Researchers at NYU Langone Health combined advanced optical imaging with an artificial intelligence (AI) algorithm to produce accurate, real-time intraoperative diagnosis of brain tumors in this study. Compared with the accuracy of pathologists’ interpretation of conventional histologic images, the results for both methods were comparable. The AI-based diagnosis…
Bacterial contamination of surgical scrubs worn outside the OR
Editor's Note In this study from Israel, researchers found that surgical scrubs worn outside the OR were contaminated with a low bacterial load and only a small number of pathogenic bacteria. For the study, specimens were collected at the entrance to the OR from surgical scrubs worn by 133 surgeons.…
First-year analysis of OR Black Box study
Editor's Note In this first-year analysis of a data capture system called the OR Black Box, frequent intraoperative errors, events, variation in surgeons’ technical skills, and a high amount of environmental distractions were identified. In 132 patients having elective laparoscopic general surgery: auditory distractions occurred a median of 138 times…
Can punctuality decrease OR costs?
Editor's Note In this study from Washington University School of Medicine, St Louis, a first case on-time starts (FCOTS) improvement initiative was linked to a higher frequency of FCOTS, which was independently associated with last case on-time ends (LCOTE) and decreased OR overtime costs. Of 12,073 cases (6,095 pre- vs…
Patients prefer checklists to be completed in front of them
Editor's Note Surgery patients overwhelmingly prefer pre-surgical safety checklists to be completed in front of them, contrary to what is thought by anesthesiologists, this Swiss study finds. In this trial, which included 110 anesthesiologists and 125 non-premedicated ear-nose-throat or maxillofacial surgery patients, the patients overwhelmingly agreed that anesthesiologists should use…
Development of surgery-specific second victim peer support program
Editor's Note In this study, researchers at the Massachusetts General Hospital, designed, implemented, and assessed the effect of the first surgery-specific peer support program in the US. The program uses five steps: creation of a conceptual framework choice of peer supporters training of peer supporters multifaceted identification of major adverse…
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