If you receive a recall letter from a tissue supplier, how quickly could you identify which patients received that tissue? If one of your surgeons reports an infection in a patient who received a tissue graft, how will you follow up? Tracking of tissue is a patient safety issue—consider the…

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Three organizations describe steps they've taken to improve their preoperative processes. Close ties with MD offices Piedmont Hospital Atlanta500 beds, 21 inpatient and 8 outpatient ORs24,000 cases per year A close relationship with physicians' offices keeps the preop process on track at this urban facility. The relationships were forged 15…

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What role does a preoperative clinic play in addressing medical problems that could cause delays or cancellations if patients aren't assessed until the day of surgery? In a new study, researchers conducted a 3-month retrospective review of records of more than 5,000 patients seen in the preop clinic at Brigham…

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Amissing consent form. A patient who arrives on the morning of surgery needing a cardiac work-up. A history and physical absent from the chart. A lab result that isn't available. Difficulty coordinating the preanesthesia evaluation. Preop process articles Page 10: What works to smooth preop process? Page 14: Role of…

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Parallel processing—performing some tasks in tandem—is one strategy that helped an Ohio hospital reduce nonoperative time by 37%, from nearly 65 minutes to 42 minutes. Turnover time was reduced by 38%, from about 43 minutes to 26 minutes. The project team analyzed patient flow from the surgeon's office through discharge…

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What should our surgical infection rate be? The conventional way to answer is to benchmark your hospital's rates with data from the Centers for Disease Control and Prevention (CDC). But the new answer is likely to be-zero. It's been thought that a certain number of hospital-acquired infections are to be…

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Patients having hip replacement surgery can in rare cases develop bone cement implantation syndrome (BCIS). In 5 out of 6 reports of the syndrome received by the Pennsylvania Patient Safety Authority the patient died from cardiac arrest associated with the implantation of the new prosthesis. Though use of cement for…

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During a preoperative screening, a nurse learns that a patient scheduled for a hernia operation in your ambulatory surgery center (ASC) has several comorbidities, including cardiac disease and chronic obstructive pulmonary disease. The history and physical are sketchy. In another case, a patient seems confused about the procedure she is…

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Ambulatory surgery centers (ASCs) employ a variety of bonus and profit-sharing strategies to retain and reward staff. Many centers award bonuses based on a percentage of net profits. Some ASCs require the center to hit financial targets for a profit-sharing payout. Others give bonuses if employees meet a percentage of…

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Asimultaneous quintuple kidney transplant took place at Baltimore's Johns Hopkins Hospital on Nov 14, 2006. The historic event was made possible by a kidney swap involving 4 transplant candidates who each had a relative willing to donate a kidney and a fifth candidate who matched a donor who had offered…

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