Fifth in a series on ten elements of safer surgery.   This marks the fifth year since the worldwide roll-out of the World Health Organization (WHO) Surgical Safety Checklist. In some hospitals, the checklist has taken root and become a way of life. In others, acceptance is slower. For others,…

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Strict requirements needed to comply with a recall for the Neptune brand of roving suction devices are raising questions and concern for ORs whose facilities continue to use the devices. The recall of the Neptune Waste Management System from Stryker, used to collect and dispose of fluid waste, was initiated…

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Before any elective surgery, patients are expected to arrange for an escort who will take responsibility for them at discharge—someone who will drive them home and possibly care for them as they recover from the effects of anesthesia. Despite a strict policy that patients must have a “responsible adult escort,”…

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Fourth in a series on ten elements of safer surgery.   It’s axiomatic that sterile processing is critical to safe and effective surgical care. The sterile processing department (SPD) is like an “engine room” for the OR, where the staff produce the sterile instruments and other equipment needed for surgical…

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Last month, we wrote about the long history of unnecessary preoperative testing for healthy patients. This month, we’re happy to report that some leading medical societies are publicly calling for physicians and patients to rethink certain kinds of testing. The recommendations are part of the Choosing Wisely campaign, an effort…

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Marty Makary, MD, MPH, now a prominent cancer surgeon at Johns Hopkins, says he once took a year off from medical school because the culture didn’t feel right to him—“it wasn’t telling patients the truth.” He had witnessed wide variations in quality and the medical community’s lack of response. He…

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Checklists are a common safety strategy in the OR. Why not have a checklist for the sterile processing department (SPD)? A “cockpit checklist” has helped reduce defects in instrument sets at Virginia Mason Medical Center in Seattle, Washington, by serving as the final quality assurance audit before a set enters…

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Lean management and automation have come together to create a sterile processing department (SPD) that can efficiently process the 700 to 1,000 instrument sets a day needed to support a caseload that is primarily orthopedic. The SPD at New England Baptist Hospital in Boston is one of the few in…

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Team members simply introducing themselves to one another at the start of a case made a difference in the rate of infectious events in a pilot study. The rate was 1.9% when the introductions were documented and 21.1% when they were not. (The infectious event rate included surgical site infections,…

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Shortening the time it takes for an outpatient procedure may increase volume, OR utilization, and hence revenue—but that is not the point, say the nation’s top performers in a recent survey of procedure times. Rather, the purpose is to enhance patient safety and satisfaction. For example, less time in the…

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