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…
New staffing structure builds on success of specialty team model
Less than a year after adopting a “college structure” model akin to that of specialty teams, the UF & Shands Academic Health Center in Gainesville, Florida, is close to achieving a goal of 100% on-time starts. “We track first-case start times, and a report goes out every morning, so we’ll…
Implementing a daily huddle protects patients, avoids delays
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…
'Second victim' rapid-response team helps fellow clinicians recover from trauma
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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