The Impact of Operating Room Distractions on Stress, Workload, and Teamwork
Our Take Distractions in the OR are associated with higher mental workload and stress and poorer teamwork among OR personnel, a study finds. The most prevalent distractions were those from external staff, followed by case-irrelevant conversations. Case-irrelevant conversations initiated by surgeons were associated with lower teamwork in surgeons and anesthesiologists. Equipment-related…
Don't let depression derail your staff's morale and motivation
Depression affects 9% of adults in the US and 18% of hospital-employed nurses, including those who work in perioperative settings. Nurses with depression not only suffer themselves, but their illness can impact their productivity and quality of care as well as their coworkers’ work lives. Nurse managers need to be…
'Territorial games' aim to help curb disruptive behavior in the OR
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,…
A surgeon blasts dangerous care, calls for ’transparency revolution’
Does your OR have a Hodad, a Raptor, or a Shrek? These are handles for dangerous surgeons that Martin Makary, MD, MPH, describes in his scathing new book, Unaccountable. Dr Makary, a surgeon and patient safety leader at Johns Hopkins, advocates a “transparency revolution” to make data public and motivate…
Lateral violence: Tools managers can use to help shift the culture
An orientee comes to you in tears saying a couple of tenured nurses have snapped at her or huffed impatiently when she asked a question. Several other staff have met with you individually about conflict and hurtful comments they say are happening on one of the specialty teams. You already…
Curbing OR traffic: Finding ways to minimize the flow of personnel
A traffic cop? Stop signs? Flashing lights? Is there a way to curb the number of people passing in and out of ORs during cases? The number during a lengthy major surgery can reach a dozen or more, with door openings every minute or two. Door openings affect the OR’s…
Tracking data, changing behavior
Top 3 delay reasons Aug 2010 Sept 2010 Oct 2010 1. Surgeon - H&P not completed Surgeon - H&P not completed Surgeon - Procedure consent not completed 2. Tie: All other reasons tied Patient/family - Questions/apprehension Tie: Anesthesia - assessment not completed; surgeon - late/unavailable 3. Tie: All other reasons…
What makes a behavior code effective?
ORs have been reviewing their codes of conduct and behavior policies in view of new requirements in the Joint Commission's Leadership Standards, which took effect Jan 1, 2009 (related article, p 17). The University of Wisconsin (UW) Hospital & Clinics in Madison has an 8-year track record for its policy.…
A 'civility and respect' policy for surgery
When an orthopedic surgeon threw a pair of scissors in the OR last summer at North Shore Medical Center's Salem Hospital, a policy was in place to address the incident. Introducing a "civility and respect" policy was one of the first things Marc Rubin, MD, did when becoming chief of…
Process for addressing disruptive behavior must be in place by Jan 1
A surgeon blows up at the staff because an instrument is missing from a set. A new nurse is in tears after a senior RN snaps at her for asking how to set up a piece of equipment. A resident won't respond when a nurse asks about a medication order.…
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