Bullying: From conflict to confrontation to civility in the OR--Part 1
Nurse bullying is a hot issue, even in the lay press—consider the 2015 Marie Claire article, “Mean Girls of the ER: The Alarming Nurse Culture of Bullying and Hazing.” Numbers vary, but the American Nurses Association reports that between 18% and 31% of nurses have experienced bullying at work. The…
Editorial
Efforts in 2017 to dismantle the Affordable Care Act (ACA) were largely unsuccessful, but a tax reform bill that includes a provision to abolish the ACA’s individual insurance mandate seems likely to pass. As a result, 13 million fewer Americans will be insured by 2027, and premiums will go up…
Peer initiative cultivates a better OR culture
The following “success story” describes the PEER initiative at Geisinger Medical Center, which has involved staff in making decisions to improve processes and communication. OR Manager periodically publishes success stories like this from nurse leaders or other healthcare providers who want to share their experience with our readers. Recent examples…
Where are you on the value-based care continuum?
Healthcare providers are straddling a variety of payment models while many regulatory changes remain in flux under the Trump Administration. Although the shift from fee-for-service to value-based payment began some years ago, not everyone is on board. Opinions about bundled payments also remain mixed, despite reports of improved outcomes and…
Robotics: Building a winning business case
Robotic-assisted surgery offers many potential advantages, including shorter operative time, less morbidity, and faster patient recovery. But rigorous comparisons with traditional surgical methods and cost-effectiveness analyses are still limited, and the price tag of the robot (in the neighborhood of $1 million) and annual maintenance contract (roughly $150,000) may give…
ASC quality reporting deadlines moved up in 2018
On November 1, 2017, the Centers for Medicare & Medicaid Services (CMS) released its final rule for the 2018 Medicare Hospital Outpatient Prospective Payment System/ASC Payment System and Quality Reporting Programs. In summary, several ambulatory surgery center (ASC) measures (ASC-1 to ASC-14) are unaffected, except that three measures (ASC-5, -6,…
Wearing long sleeves to prep decreases airborne contaminants
Editor's Note Wearing long sleeves with gloves while prepping a patient in the OR decreased large-particle and microbial shedding compared with prepping with bare arms, in this study. A mock patient skin prep was performed in 3 different ORs. A long-sleeved gown and gloves or bare arms were used to…
Joint Commission posts decision rule changes for 2018
Editor's Note The Joint Commission on December 12 posted its summary of changes to accreditation and certification decision rules for all programs for 2018. Changes include initial accreditation, reaccreditation, and certification. The decision rules are effective for surveys and reviews beginning January 1, 2018. Joint Commission requirement. Read More…
Perioperative myocardial injury common after noncardiac surgery
Editor's Note Perioperative myocardial injury (PMI) is a common complication after noncardiac surgery (occurring in 1 of 7 patients), and it is associated with substantial short- and long-term mortality (9% and 22%), this study finds. This analysis included 2,018 patients having 2,546 surgical procedures. PMI occurred after 397 of the…
ECRI Institute issues annual technology hazards list
Editor's Note ECRI Institute on December 12 issued its list of Top 10 Health Technology Hazards for 2018. The list, which is available for free (registration required), identifies sources of technology dangers or difficulties and details steps to minimize the occurrence of adverse events. Topping the list is ransomware and…