When several patients needing urgent or emergent surgery arrive at a hospital simultaneously, who decides which case goes to the OR first? For true emergencies, the decision is generally straightforward, with the patient rushed into the first available room. But in many other situations, the decision is not as clear:…

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As an aging population, a recovering economy, and health care reform bring more patients into the operating room, will there be enough surgeons to care for them? A shortage of 124,000 to 159,000 MDs is projected within 15 years—and about a third of the shortage will be in surgery, according…

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David Goodman, MD, MS The rate of hip replacements in Boulder, Colorado, is more than 5 times higher than in Bryan, Texas, which has the lowest rate. Rates for knee replacements also vary widely, with Manhattan's rate only about one-fourth that of Lincoln, Nebraska. Many other types of surgery have…

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A4-level classification system with built-in accountability measures is used for managing urgent and emergent cases at Munson Medical Center in Traverse City, Michigan, a 390-bed referral center with 14 ORs. The policy was developed by a steering committee of surgeons, anesthesiologists, OR management, and the administration working with a consultant.…

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The Greening of the OR, a national effort to reduce surgery's big environmental footprint, was launched in May 2010 by Practice Greenhealth. The 2-year-old nonprofit, claiming 1,000 hospital members, sees the OR as a major target for making health care more sustainable. "ORs are the largest waste generators in the…

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Attendees at the 2010 OR Business Management Conference in San Francisco May 12 to 14 got a snapshot of challenges facing ORs, ranging from the OR of the future to the effects of new health care law. Networking supplemented the presentations and gave attendees the opportunity to exchange ideas and…

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Second in a series on OR performance. Performing more cases with the same OR capacity and personnel—and having more satisfied surgeons, anesthesia providers, and staff. That may sound like utopia, but there is a way to make it happen. The answer is a well-run block scheduling program. The need to…

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Here's a variation on a traditional interview question: How do you envision your ambulatory surgery center (ASC) in 3 years? In 5 years? Those who reply, "I don't know because I'm too busy analyzing last week's utilization," are not unusual. Unlike hospitals, health systems, and the average small business, ASCs…

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There's a new abbreviation you will be hearing as part of health care reform—ACOs, or accountable care organizations. An ACO could be entering your ambulatory surgery center's local market. Encouraged under the health care reform bill signed in March 2010, ACOs are a strategy for curbing the rapid growth in…

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Is there a shortage of anesthesia providers now? Does the nation face a shortage in the future? The answer for the current labor supply is: It depends on your area and whether your facility is urban or rural. The anesthesia labor supply and practice patterns vary dramatically, a new indepth…

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