Shooting incidents are occurring throughout the US with increasing and alarming frequency. Among those in late 2013: the Washington, DC, Navy Yard on September 16—12 dead, 3 injured before the gunman took his own life; the Sparks, Nevada middle school on October 21—1 dead, 2 wounded before the student wielding…

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The South Carolina Hospital Association (SCHA) and the Joint Commission Center for Transforming Healthcare have teamed up to make the state’s healthcare highly reliable. In a joint project titled “South Carolina Safe Care Commitment,” 21 hospitals in South Carolina are learning about high reliability practices (chart, p 12). High reliability…

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Early indications are that the South Carolina Safe Care Commitment project, though still in its infancy, holds promise for increasing the reliability of healthcare in that state (cover story). Certainly the progress made thus far supports the framework put forth by the Joint Commission in 2013 to help all healthcare…

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Surgical team familiarity contributes to reductions in operative time, and performance improves as team experience accumulates, a new study finds. Previous studies of teamwork and its influence on surgical outcomes have been limited by the challenge of objectively quantifying teamwork. Survey-based methodologies are subject to responder bias, and the tools…

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When Mark Katlic, MD, MMM, FACS, descended into the basement of the hospital where he was a resident 30 years ago to satisfy his curiosity, he had no idea that what he found would set him on his career path. Dr Katlic had cared for a few surgical patients more…

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Process and communication concerns led OR management at the University of Florida Health Shands Hospital, Gainesville, to implement a Surgical Safety Process using the Joint Commission Center for Transforming Healthcare’s Targeted Solutions Tool (TST) for Wrong Site Surgery. “When we reviewed our patient safety reports, what came to the surface…

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Putting a hold on the OR can lead to revenue losses no manager wants to see. At Lehigh Valley Health Network (LVHN) in Allentown, Pennsylvania, OR holds were averaging 1,100 minutes per month. Jodi Koch, BSN, RN, director of perioperative services, and Kathleen Duckworth, RN, CPAN, their colleagues got holds…

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Improvements in first case on-time starts and turnover time at Lancaster General Hospital in Lancaster, Pennsylvania, attest to the success of using Lean strategies. Within an 8-month period, first-case on-time starts (FCOTS) jumped from 35% to 72%, and the monthly average overall turnover time (TOT) for a 7-month period was…

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Maintaining a strong relationship with the hospital CEO has always been important for an OR leader. In the coming year, good relations with the executive suite will be critical. Hospital executives are under greater pressure now than at any time in the last 30 years. Changes in the healthcare market…

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The OR environment plays host to a perfect storm of high stakes, time constraints, and egos. As a surgical services director, you’ve likely seen your share of disruptive behavior, and your hospital probably has a zero tolerance policy for transgressions like throwing a surgical instrument across the room during surgery,…

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Innovations in surgical techniques, anesthesia, and equipment, along with the drive to decrease healthcare costs, are increasing the number of patients and procedures deemed suitable for outpatient surgery. Among the elective procedures now being performed at ambulatory surgery centers (ASCs) are total joint replacements. The buzz at recent conferences has…

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Nearly a month past the statutory November 1, 2013 deadline, the Centers for Medicare & Medicaid Services (CMS) released its final 2014 hospital outpatient and ambulatory surgical center (ASC) payment rule, CMS-1601-FC. CMS published the rule in the December 10, 2013 Federal Register. The deadline for comments is January 27,…

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