Total joint cases on firm footing after OR team huddles
Effective use of a daily huddle and customized software for scheduling have had a dramatic impact on efficiency at NYU Langone Orthopedic Hospital in New York City. Cancellations on the day of surgery have dropped from a rate of about 10% prior to implementation of huddles to less than 1%,…
How many different procedures are right for your ASC?
When launching a new ambulatory surgery center (ASC), owners must consider a myriad of issues—financing, design, building construction or purchase, regulatory compliance, certification, staffing, and marketing. Underlying all of these considerations are which procedures the center will provide and whether the ASC will be single specialty, like gastrointestinal (GI) or…
Colorectal ERP improves outcomes, lowers costs despite use of expensive drugs
Editor's Note Implementation of an enhanced recovery pathway (ERP) for colorectal surgical patients substantially reduced length of stay, total hospital costs, and direct pharmacy costs without increasing complications or readmission rates in this study. The study, which included 160 colorectal patients before ERP was implemented and 146 patients after implementation,…
Meta-analysis supports ‘weekend effect’ for surgical patients
Editor's Note Postoperative mortality rises as the day of the week of elective surgery approaches the weekend and is higher after admission for urgent/emergent surgery on the weekend, this meta-analysis from the University of Calgary finds. The analysis included 10 studies that involved about 6.7 million patients having elective procedures…
PACU patient flow improves with CRNA assistance
Throughput inefficiencies are a growing problem in surgical services departments. Patients are held in the OR because there is no room in the postanesthesia care unit (PACU), and patients are held in the PACU because there are no beds available in the patient care unit or because outpatients having major…
Efficiency efforts improve staff satisfaction with turnover time
Cost mitigation has become a priority in the American healthcare industry, and addressing inefficiencies is a popular way to curb the high cost of medical care. Decreasing turnover time between cases may pave the way for additional cases to be scheduled, theoretically leading to increased revenue for the hospital. However,…
No consensus on what defines a high-performing system
Editor's Note In this study, researchers reviewed literature from a 10-year period and found no consensus on what defines a high-performing healthcare delivery system or healthcare organization. High performance was variably defined across different dimensions, including: quality (93% of articles) cost (67%) access (35%) equity (26%) patient experience (21%) patient…
Electronic scheduling system radically improves OR workflow
Between the expanding population and the increasing number of surgical procedures being performed, demand for surgical services is climbing. One study has predicted a 14% to 47% increase in surgical demand across all surgical fields by 2020. Given the high cost of operations, an efficient workflow is paramount, and there…
Reducing robotic OR turnover times with a pit stop model
Editor's Note Concepts from motor racing pit stops, including role definition, task allocation, task sequencing, and a visual cue for ease-of-use, created efficient and sustainable approaches for decreasing robotic OR turnover times in this study. Average turnover time was 99.2 minutes before introducing the pit stop model and 53.2 minutes…
Efforts to improve FCOTS may reduce overutilized OR time
Ccommon cost-saving strategies in the OR include increasing workflow efficiency, reducing turnover times, implementing standardized preoperative protocols, and improving surgical case scheduling and first case on-time starts (FCOTS). These interventions aim to decrease under- and overutilized time in the OR, but there is conflicting evidence about their economic value. Many…
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