SCOREing patient safety with a proactive approach
Avoiding preventable harm in the OR is the goal of any surgical services department, and meeting that goal requires excellent communication and collaboration among staff members. At Cedars-Sinai Medical Center in Los Angeles, the Safe Care in the OR Everytime (SCORE) project has raised awareness about safety and engaged front-line…
Shared governance teaches staff to take ownership of decision making
Certain words and phrases are used frequently in nursing—sometimes so frequently that their true meaning is lost. For some, the term “shared governance” is one of those. What is shared governance? “A dynamic staff-leader partnership that promotes collaboration, shared decision making, and accountability for improving quality of care, safety, and…
Editorial
Every perioperative services staff member, at every level, contributes to the success or failure of the department. Exceptional leaders understand this, and they are most successful when they discourage intimidation and invite everyone to take ownership of their roles. Teamwork in the OR is the next frontier in quality perioperative…
Communication, collaboration, commitment are cornerstones of high reliability healthcare
Providing dependably excellent care for all patients all of the time is the essence of high reliability healthcare, as defined by the Joint Commission in its 2013 report. Two large health systems—Kaiser Permanente and Cincinnati Children’s Hospital—are on the path to becoming highly reliable organizations. In recent years, improved processes…
No time to waste: A children's hospital Lean team streamlines its turnover process
Children’s Hospital of Los Angeles (CHLA) is renowned for patient care, but by early 2013 the increased complexity of new technology and other factors had eroded efficiency. Orthopedics had fallen to the bottom quartile compared to national benchmarks for turnover times, and executive leadership called for change. Within orthopedic surgery,…
Perceptive leadership fosters collaboration among hybrid OR staff
The expanded volume of interventional cardiology in recent years has played a major role in the growing prevalence of hybrid ORs. As a result, many perioperative services leaders have had to develop systems for managing hybrid ORs along with traditional ORs. “Management of hybrid ORs is really a collision of…
Multiple OR multidisciplinary team huddles promote ownership of process improvements
Huddles are hot. Experts cite them as effective patient safety tools, and many hospitals have implemented them on nursing units at the start of the shift. The perioperative services team at Vanderbilt University Medical Center in Nashville, Tennessee, broadened the huddle concept to include several disciplines and a structured format,…
Team participation and planning produce quality handoffs
After a poor handoff from the OR to the postanesthesia care unit (PACU) was identified as the culprit behind a serious adverse event, Nancy Robinson, DNP, MSN, RN, LHRM, CCM, made it her mission to avoid a recurrence. “I’m passionate about safe patient hand-offs,” says Robinson. “I didn’t want this…
Surgical team familiarity reduces operative time, improves performance
Surgical team familiarity contributes to reductions in operative time, and performance improves as team experience accumulates, a new study finds. Previous studies of teamwork and its influence on surgical outcomes have been limited by the challenge of objectively quantifying teamwork. Survey-based methodologies are subject to responder bias, and the tools…
Trauma center's mortality rate drops dramatically with use of new protocols
Trauma events occur every 5 minutes in the United States, and 30% of trauma patients die within 120 minutes of the event because of major organ injuries that lead to heavy blood loss. Better outcomes are achieved when care is initiated within 60 minutes, a time frame commonly referred to…
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