The circulating nurse was cleaning up after surgery in an ambulatory surgery center (ASC) when she noticed the internal chemical indicator (a Class 5 integrating indicator) had not reached its appropriate endpoint response, which is a pass. That meant an unprocessed instrument tray had been used on the patient. Her…
Duke University Hospital has had a Pre-Operative Screening Unit (POSU) in place for the past 16 years to optimize patients prior to surgery, but until recently, there were no hard data on surgical cancellation rates. Now, a retrospective analysis has revealed that fewer cancellations occur when patients are seen in…
A column on managing the OR revenue cycle. Audits of Medicare payments to hospitals are up dramatically. In all, 89% of hospitals reported activity by recovery audit contractors (RACs) in the third quarter of 2012, according to an American Hospital Association (AHA) survey. Here are tips on how your OR…
OR Business Performance is a series intended to help OR managers and directors improve the success of their business. Surgical supplies are a major cost category for hospital ORs. Depending on the specialty and the procedure, supplies may represent 50% or more of total costs per case. Unfortunately, new…
The number of elderly people in the US is on the rise, and so is the number of older patients having surgery. However, while advances in technology and techniques may make surgery more feasible for those age 65 and older, ensuring successful outcomes for this cohort is challenging. Specific guidelines…
Ambulatory surgery patients who become incapacitated should have their wishes for care honored, the Centers for Medicare and Medicaid Services (CMS) stresses in its new guidelines. Previously, the guidelines permitted an ambulatory surgery center (ASC), for reasons of conscience or policy, to refuse to honor advance directives calling for cessation…
A perennial concern associated with surgery is avoidance of infection. As science reveals new risks and remedies, protocols change and so do regulations. To monitor infection control at ambulatory surgery centers (ASCs), surveyors use a 15-page worksheet from the Centers for Medicare and Medicaid Services (CMS). The ASC Infection Control…
Just before 2:50 pm on April 15, 2 postanesthesia care nurses from Beth Israel Deaconess Medical Center (BIDMC) crossed the Boston Marathon finish line. Their elation at finishing the race soon turned to fear when they heard the first of 2 explosions. They began searching for friends and family who…