The timeout protocol is an essential step before any invasive procedure to prevent wrong site, wrong procedure, and wrong person surgery. The pause also allows for the antibiotic to be given and charted, implants to be checked for accuracy, and equipment to be assessed for functionality. The timeout protocol is…

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The patient had come to the OR for joint replacement surgery. Though she had a complicated medical history, there was no reason to believe she would have serious problems. But during the surgery, things went wrong, and despite everyone's efforts, the patient died. It hit the team hard, including the…

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A unified effort by physician and nurse leaders to introduce preoperative briefings has helped boost perceptions of OR safety at a Colorado hospital. The briefings, held right before the incision, are an expanded timeout that allows the team to check critical information and establish an atmosphere of open communication. Preop…

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Postoperative patients are among the groups at highest risk for developing ventilator-associated pneumonia (VAP), one of the leading causes of morbidity and mortality in ICU patients. The Surgical Care Improvement Project (SCIP), a national quality partnership, is targeting VAP as one of 4 types of major surgical complications to prevent.…

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Removing the gallbladder through the vagina. Performing an appendectomy through the mouth. Doing an abdominal exploration through the rectum. It is a startling concept, but physicians are exploring new ways to perform surgery using the body's natural openings. Many questions remain, but researchers believe the approach holds promise of a…

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OR managers and their hospitals must create a culture where the staff is willing to come forward with information about errors so everyone can learn from mistakes. But the culture must also recognize the need for accountability and, in some cases, disciplinary action. That is a "just culture" that improves…

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Supply chain management doesn't normally conjure images of diamonds and clocks, but it did when Eugene Schneller, PhD, traced the trends in his keynote at the OR Business Management Conference held May 9 to 11 in Savannah, Georgia. Schneller, who is professor and director of health sector supply chain initiatives…

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A nurse goes to the refrigerator to get blood for an evening case, only to find it has already been taken back to the blood bank. A set is missing the same instrument for the second time this week. There have been problems with timely delivery of blood units for…

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At the FASA meeting in New Orleans in May, speakers from outside the health care field struck a common chord: ASCs have a great story to tell, one that combines cost-effective care with excellent outcomes. Speakers encouraged attendees to tell their story to politicians, legislatures, and the general public. One…

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Timing will be everything for ambulatory surgery centers (ASCs) getting ready for Medicare's new ASC payment system. The biggest payment overhaul in 20 years is slated to take effect Jan 1, 2008. But the final rule is not expected until this month or later, giving ASCs a short time to…

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