First in a series on OR design and construction. Faced with dated structures, an aging baby boomer generation, and demands for new technology, hospitals are in the midst of a building boom. A 2006 report from The Center for Health Design (CHD) estimated that the US will spend $200 billion…

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OR managers who document their use of the "Five W's of Employee Counseling" will never lose a wrongful-termination suit, a veteran manager says. Heather Carelock, RN, MPA, CNOR, who has had 35 years of experience in managing ORs and surgical services, says she's learned the importance of a documentable, consistent…

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Creating a more seamless system for OR inventory and charging often has been hampered by information systems that don't talk to each other, or don't talk easily. Humans in the OR and materials management may not talk much either. Gradually, these barriers are coming down, and hospitals are taking a…

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Rhode Island Hospital's leadership team, in collaboration with independent consultants and expert physicians, is working to address processes that led to 3 wrong-site procedures in 2007. The hospital, located in Providence, was reprimanded and fined $50,000 by the state health department after the third incident, which occurred Nov 23. Two…

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The report card for OR information systems is out. Users gave their systems scores that were a little higher in 2007 than in 2005. Leading the pack was USA, with Meditech in second place and McKesson Horizon in third. The average overall score was 77.4 out of 100. Perioperative system…

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State health officials in Nassau County, New York, notified 628 patients in November 2007 that they should be tested for hepatitis and HIV. The testing was advised because they were treated by an anesthesiologist who used single syringes to draw from multiple-dose vials in a pain clinic and orthopedist's office,…

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A data-driven project dramatically improved on-time starts in our operating rooms at St Boniface General Hospital, a 507-bed academic tertiary care facility in Winnipeg, Manitoba, Canada. The previous year's performance had averaged 75%. The goal was set to achieve a 90% rate. Reasons for delays The operating room management, along…

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ECRI Institute and Boston Scientific in November settled their lawsuits over price transparency for cardiac devices. The terms were not disclosed. ECRI Institute sued Guidant Corporation in 2006 over the right to publish pricing for cardiac devices as part of its benchmarking service. Guidant countersued, saying ECRI had interfered with…

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New surveyor guidelines spell out what Medicare expects from hospital infection control programs to help fight current threats like multidrug-resistant organisms, disease outbreaks like flu or SARS, and bioterrorism. The hospital conditions of participation for infection control have not changed. The revised guidelines from the Centers for Medicare and Medicaid…

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The award-winning new 8-story E.W. and Mary Firstenburg Tower at Southwest Washington Medical Center in Vancouver, Washington, includes a dedicated Heart and Vascular Center with 6 interventional rooms and 2 ORs. The hospital is one of the first in the country to offer an integrated center with interventional radiology, cardiovascular,…

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With a swipe of a barcode, a perioperative nurse documents supply use in the patient's record, helps create an accurate patient bill, and starts the process to reorder the product. Kaleida Health, a 5-hospital network serving western New York State, has pulled off what many organizations strive for, an integrated…

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The coming year may prove to be one of the most important in the life of your ambulatory surgery center (ASC). You will begin to see the effects of Medicare's revised ASC payment system and will want to monitor closely exactly how the new rule financially affects your ASC. Use…

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Reduce the likelihood of patient harm associated with the use of anticoagulation therapy. That is a Joint Commission 2008 National Patient Safety Goal requirement, to be fully implemented by January 2009. The 1-year phase-in includes defined milestones during 2008. Anticoagulants are a safety risk for surgical patients. Many patients are…

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