OR Business Performance is a series intended to help OR managers and directors improve the success of their business.   How do you improve an OR’s financial performance? Last month’s column focused on two key strategies: using data to identify improvement opportunities and rallying support for organizational change. These strategies…

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OR teams are accustomed to using checklists to keep patients safe during surgery. Could extending presurgical checklists to the physician’s office or clinic produce even better results? The new Strong for Surgery initiative in Washington State is introducing checklists into offices and clinics to help address issues like nutrition, glycemic…

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Before any elective surgery, patients are expected to arrange for an escort who will take responsibility for them at discharge—someone who will drive them home and possibly care for them as they recover from the effects of anesthesia. Despite a strict policy that patients must have a “responsible adult escort,”…

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On-call requirements in perioperative services can be a barrier to recruiting younger RNs and in retaining older nurses. Covering the daily surgical schedule with fatigued staff who have worked during the night can be a safety issue or a staffing issue if the call team is too tired to work…

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Fourth in a series on ten elements of safer surgery.   It’s axiomatic that sterile processing is critical to safe and effective surgical care. The sterile processing department (SPD) is like an “engine room” for the OR, where the staff produce the sterile instruments and other equipment needed for surgical…

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Last month, we wrote about the long history of unnecessary preoperative testing for healthy patients. This month, we’re happy to report that some leading medical societies are publicly calling for physicians and patients to rethink certain kinds of testing. The recommendations are part of the Choosing Wisely campaign, an effort…

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Marty Makary, MD, MPH, now a prominent cancer surgeon at Johns Hopkins, says he once took a year off from medical school because the culture didn’t feel right to him—“it wasn’t telling patients the truth.” He had witnessed wide variations in quality and the medical community’s lack of response. He…

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Checklists are a common safety strategy in the OR. Why not have a checklist for the sterile processing department (SPD)? A “cockpit checklist” has helped reduce defects in instrument sets at Virginia Mason Medical Center in Seattle, Washington, by serving as the final quality assurance audit before a set enters…

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