An electronic form surgeons’ offices use to place scheduling orders has streamlined the preoperative process and sharply reduced case cancellations for a Chicago-area hospital. Cancellations are down from about 12% to less than 1% of cases since the scheduling form was introduced in early 2012. The offices took to the…

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A Medicaid patient is admitted to the hospital for repair of an enterocutaneous fistula. He’s considered a high risk for readmission after surgery because he doesn’t have a working refrigerator or telephone. That means he won’t be able to keep fresh food on hand or call his physician if he…

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The time-out is called, but conversations are going on, and the staff is still assembling equipment. No one seems to be listening. Then during the case, the anesthesiologist has trouble hearing over the loud music and chatter. The circulating nurse needs confirmation on a specimen but can’t get the surgeon’s…

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Seven hospitals working with the Joint Commission and the American College of Surgeons (ACS) on a 2-year project to reduce colorectal surgical site infections (SSIs) have saved more than $3.7 million by avoiding an estimated 135 SSIs, the commission announced in November 2012. The commission is pilot testing the approach…

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Ten Elements of Safer Surgery. First in a series.   What’s the essential ingredient for an OR to run safely and effectively? Many would sum it up with one word—leadership, followed closely by collaboration. An OR led by a strong team from surgery, nursing, and anesthesia backed by the hospital’s…

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Why does our hospital have a higher rate of venous thromboembolism (VTE) than others in our state? How are others preventing surgical site infections (SSIs) after colorectal surgery? What’s behind our urinary tract infection (UTI) rate? Hospitals in Tennessee are openly discussing issues like these through the Tennessee Surgical Quality…

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How long can a flexible endoscope be stored before it needs to be reprocessed for use in a patient? Guidelines differ, raising questions about the appropriate storage or “hang time.” Evidence is limited. What’s the best course? How do accreditation surveyors assess this? Though infections from GI endoscopes are rare,…

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Starting October 1, 2012, the Centers for Medicare and Medicaid Services (CMS) began requiring quality reports on Medicare claim forms from ambulatory surgery centers (ASCs). From all indications, complications were few, and ASCs already are using the new statistics to gain insight into operational trends. Ultimately, the self-reports of patient…

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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…

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She recalls it as one of her worst days as an OR director. She was paged to the postanesthesia care unit. When she got there, the surgeon told her there had been a horrible mistake. He had performed a total knee replacement on the wrong side. The surgeon asked if…

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