A surgeon blasts dangerous care, calls for ’transparency revolution’
Does your OR have a Hodad, a Raptor, or a Shrek? These are handles for dangerous surgeons that Martin Makary, MD, MPH, describes in his scathing new book, Unaccountable. Dr Makary, a surgeon and patient safety leader at Johns Hopkins, advocates a “transparency revolution” to make data public and motivate…
Lateral violence: Tools managers can use to help shift the culture
An orientee comes to you in tears saying a couple of tenured nurses have snapped at her or huffed impatiently when she asked a question. Several other staff have met with you individually about conflict and hurtful comments they say are happening on one of the specialty teams. You already…
Curbing OR traffic: Finding ways to minimize the flow of personnel
A traffic cop? Stop signs? Flashing lights? Is there a way to curb the number of people passing in and out of ORs during cases? The number during a lengthy major surgery can reach a dozen or more, with door openings every minute or two. Door openings affect the OR’s…
Tracking data, changing behavior
Top 3 delay reasons Aug 2010 Sept 2010 Oct 2010 1. Surgeon - H&P not completed Surgeon - H&P not completed Surgeon - Procedure consent not completed 2. Tie: All other reasons tied Patient/family - Questions/apprehension Tie: Anesthesia - assessment not completed; surgeon - late/unavailable 3. Tie: All other reasons…
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.…
A 'civility and respect' policy for surgery
When an orthopedic surgeon threw a pair of scissors in the OR last summer at North Shore Medical Center's Salem Hospital, a policy was in place to address the incident. Introducing a "civility and respect" policy was one of the first things Marc Rubin, MD, did when becoming chief of…
Process for addressing disruptive behavior must be in place by Jan 1
A surgeon blows up at the staff because an instrument is missing from a set. A new nurse is in tears after a senior RN snaps at her for asking how to set up a piece of equipment. A resident won't respond when a nurse asks about a medication order.…
A positive direction for employee behavior
In a busy OR, one employee who's consistently late or always wants to take off early can wreak havoc on scheduling and performance. Seemingly small conduct problems are frustrating for managers: Is it worth starting the recruitment and orientation process over again just to replace a person whose small infractions…
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