Perioperative managers and staffs are collecting data on a growing list of metrics on surgical quality—antibiotic prophylaxis, venous thromboembolism prevention, normothermia, and more. Now these and other metrics are coming into play as big companies like Walmart, Lowe’s, and Pepsico seek the best value for their insured employees, especially those…

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Do you know who your competitors for surgical volume are going to be? It may not be the hospital or surgery center down the street or even across town. Your competitor could be in the next state or even across the country, at least for some types of surgery. Big…

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One would think that reducing surgical complications would lower a hospital’s costs in addition to being the right thing to do. But the hospital’s bottom line can be seriously affected. The loss can be substantial unless new surgical volume is added to make up for the loss, a new analysis…

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A new study in the journal Health Affairs of total knee replacement (TKR) confirms that wide variations in care exist among hospitals based on factors such as geographic location. The High Value Healthcare Collaborative found significant variations in TKR among the 5 participating health care systems. Among these were length…

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Better data coupled with an at-risk salary model for anesthesiologists have helped one academic medical center to improve its performance for on-time starts and turnover time between cases. The hospital’s surgical volume was growing, and it had to make the most of its OR time. Yet a lot of the…

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First of 3 articles on applying Lean management to turnover time. Sinai Hospital of Baltimore faced a challenge. The block schedule was maxed out, even though new ORs had been added. There was a need to eke out every available minute. Despite efforts to improve turnover time, it had plateaued…

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Second of 3 articles on applying Lean management to turnover time.   Efforts to weed waste from turnover time quickly took root in one 10-OR department. Within about a month after OR staff and certified registered nurse anesthetists (CRNAs) embraced the new process, turnover time decreased from about 26 minutes…

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Third of 3 articles on applying Lean management to turnover time.   Creating a “visual workplace” is a principle in Lean management. Visual cues have been one solution for improving turnover time at Thomas Jefferson University Hospital in Philadelphia. In a visual workplace, the goal is to make waste, problems,…

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Lean management in a teaching hospital’s otolaryngology OR improved efficiency, morale, and finances in a study from the University of Michigan (U-M), Ann Arbor. After 18 months: • turnover time (from exit of one patient to arrival of the next) fell by nearly one-third to 29 minutes • turnaround time…

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Since the days of the first rudimentary radiographs, radiation safety has been a concern in the OR, but that concern has risen as the number of hybrid ORs and procedures with imaging has risen. “The level of image guidance in the OR, whether it’s radiographic or fluoroscopy, has become highly…

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