Sixth in a series on ten elements of safer surgery.   Could you and your team find 30 minutes a day to prepare for the next day’s surgical schedule? The effort can be worthwhile. A Chicago-area hospital has found that a half-hour daily huddle not only heads off delays and…

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One Friday evening at University of Missouri Health System (MUHS) in Columbia, Missouri, Tony*, an RN with more than 17 years of critical care nursing experience, had a patient die unexpectedly during a routine procedure requiring moderate sedation. That weekend he was emotionally distressed, reliving the event and second-guessing his…

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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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How will a surgical site infection (SSI) develop in the next patient who has colorectal surgery? What can we do to prevent it? These 2 questions helped a team at Johns Hopkins Hospital in Baltimore to identify 6 interventions that achieved a 33% reduction in SSIs after colon operations. The…

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In a simple quiz, medical students are asked to read a short paragraph about what sounds like a robbery. Then, as individuals, they answer 18 questions about the paragraph. After that, they gather in a group to answer the questions as a team. On their own, some answer as few…

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Less focus on checking off boxes, more focus on teamwork. That's the shift experts say is needed to make lasting change to keep patients safer in surgery. The new study from the Veterans Health Administration finds OR team training was associated with a reduction in patient mortality (related article). VA…

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ORs in facilities that adopted team training had a lower rate of deaths for surgical patients than facilities that had not yet had training, in a large new study from the Veterans Health Administration. The 74 VA facilities that had team training saw an 18% decrease in their annual surgical…

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Third in a series on OR performance. With health care reform looming and the financial picture for hospitals uncertain, perioperative leaders know senior executives will look to the OR as a major source of revenue. That's likely to increase pressure to improve OR performance. Starting cases on time in the…

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An orthopedic service line has seen its volume rise and complications and costs go down since its surgical services director and chief of orthopedic surgery took the helm. Together, they have found they can drive change. It's an example of new types of collaborative arrangements hospitals are exploring with physicians.…

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The financial state of hospitals is not encouraging. Some issues cited in the January OR Manager include: reduced Medicare reimbursements, increased patient volumes, and inability to obtain credit, with 50% of hospitals in the US already approaching insolvency. One suggestion for countering these economic pressures was to increase surgical volume…

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