Planning for capital purchasing requires skill. If the process isn’t effective, the OR director will end up with unhappy surgeons and staff. But done effectively, capital purchasing can build relationships among surgeons and hospital and OR leaders. “Capital planning is a challenge in today’s economy,” says Dana Crompton, MHA, vice…

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Where would you expect a patient to look to learn about the quality of your hospital’s services? Maybe the Joint Commission, Hospital Compare, or HealthGrades? Think Facebook, Google Reviews, or YouTube—that’s where many are likely to turn first. Social media increasingly are the go-to source for consumer reviews of any…

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Use of bone morphogenic protein (BMP) has risen sharply in the past decade, adding costs without evidence of better outcomes, according to a study in the February 2012 issue of Spine. BMP use rose rapidly, from 5.5% of lumbar fusions in 2003 to nearly a third (28.1%) of procedures in…

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A 65-year-old man with heart disease schedules a knee arthroscopy with his orthopedic surgeon. Thirty miles away, a note pops up to notify the hospital’s presurgical clinic of the impending surgery. A nurse practitioner pulls up the patient’s electronic health record (EHR), where she reviews the patient’s history. Comparing the…

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Preop “nurse navigators” aided by an electronic tool are helping a Pennsylvania health system create a more standardized, user-friendly preoperative process for preparing patients for surgery. A cornerstone of the process is evidence-based guidelines for preop evaluation developed by a 50-person task force. “We wanted to optimize our approach so…

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Four years ago, Duke Health’s Preop Screening Unit was facing challenges. The unit had a full schedule, some appointments were double-booked, and some patients had long wait times. There was no system for separating healthy patients from complex ones. Meanwhile, surgery centers were asking the unit to provide screening for…

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Capnography—is it the standard of care for patients having moderate sedation? Should capnographic monitoring be added for procedures performed under moderate sedation in areas like the preop holding area, GI endoscopy unit, and cath lab? The issue is generating discussion following an update in the American Society of Anesthesiologists (ASA)…

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Perioperative nurses’ roles have expanded to the point where it is difficult for them to be experts in all areas, especially the reprocessing of complex medical devices. And with reimbursement pressures, OR clinicians need to focus on patient care and physician satisfaction. So I challenge each operating room to recognize…

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The impact of health care reform on ambulatory surgery centers (ASC)—like that on health care in general—is still uncertain. But plenty of other factors are at work that are likely to play a role in shaping the industry’s future. While the dramatic growth of the 1990s has largely abated, a…

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Cataract surgery, almost exclusively outpatient, can have a serious complication if instruments retain a chemical residue after cleaning. It is known as TASS, for toxic anterior segment syndrome. Ophthalmologists say it is rare, but there are no consistent data to indicate when, where, and how often TASS occurs. The Food…

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