The Mayo Clinic in Rochester, Minnesota, added bar-coded sponge technology in February 2009 as part of a comprehensive 4-year effort to improve prevention of retained foreign objects (RFOs). The Mayo Clinic in Rochester has 98 ORs, 3 obstetrical ORs, and 8 labor and delivery birthing rooms in 2 hospitals and…

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A patient needs major surgery to remove 5 laparotomy sponges left behind during a previous case. The investigation finds that during an exploratory laparotomy, the circulating nurse introduced a 5-pack of sponges into the sterile field but did not enter the count on the worksheet or white board. Relief staff…

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The OR business manager position has gained ground in the past 5 years. Well over one-third (37%) of ORs responding to the OR Manager Salary/Career survey have business managers, compared with 24% in 2004. For the second year, the survey included specific questions about the OR business manager. The OR…

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In late 2007 and early 2008, an Arizona hospital saw an alarming increase in surgical site infections (SSI) with methicillin-resistant Staphylococcus aureus (MRSA). For the first quarter in 2008, the infection rate for total hip replacements and revisions averaged 3.73%, well above the national average of 1.6%, with most involving…

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Six hospitals in Indiana and Alabama agreed to pay the government more than $8 million to settle allegations that they submitted false claims to Medicare, the US Department of Justice announced September 29, 2009. The settlements resolve allegations that from 2002 to 2008, the hospitals overbilled Medicare for kyphoplasty, a…

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A lot of effort has gone into preventing wrong surgery through the Joint Commission's Universal Protocol and other measures. Still, the data suggest the incidence hasn't changed very much. The Joint Commission estimates about 40 wrong surgery cases happen every week in this country. The numbers are projected from Minnesota…

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Understanding how Medicare pays for inpatient and outpatient surgery is critical to your hospital's revenue. Medicare stipulates that certain procedures will be paid only if performed on an inpatient basis. How can you avoid pitfalls of billing for these inpatient-only procedures? OR Manager asked Keith Siddel, MBA, an expert on…

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Three elective surgical procedures saw declines in early 2009 for a group of facilities participating in the OR Benchmarks Collaborative. Hernia repair and total hip and total knee replacement volumes were down in January through July compared with the same period the year before. Declines were: Hernia repair: minus 7%…

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A former surgical technician who apparently infected more than a dozen patients with hepatitis C by stealing fentanyl and placing used syringes back on anesthesia carts pleaded guilty September 25, 2009, to federal charges of tampering and theft, the Denver Post reported. Kristen Diane Parker, 26, faces sentencing in December…

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Is it time to stop performing colonoscopies and go full steam ahead with knee surgery? Maybe. According to the proposed Medicare Outpatient Prospective Payment System (OPPS) rule released July 1, 2009, colonoscopy reimbursement rates for ambulatory surgery centers (ASCs) will decline by 5.6% in 2010, compared with an increase of…

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First in a series on quality improvement for ambulatory surgery centers. Ambulatory surgery centers (ASC) have a new source for benchmarking data. The national ASC Quality Collaboration is now posting quarterly data on 6 quality and safety measures (sidebar). The measures, which are in the public domain, were developed by…

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