Vanderbilt adds new twist to M&M tradition with focus on improvement
The morbidity and mortality (M&M) conference is a traditional forum that provides clinicians with an opportunity to discuss errors and adverse events. Most are discipline specific. When a mortality or significant morbidity occurs in the OR, however, it is rarely owned by a single discipline. Multiple disciplines take care of…
Executive walk rounds open gates to communication with staff
“Each year, diagnostic errors result in the deaths of an estimated 44,000 to 80,000 patients, and many thousands die because of teamwork and communication errors affecting their care or because they do not receive necessary evidence-based interventions,” according to an article published online last year in JAMA. No one would…
Multiple OR multidisciplinary team huddles promote ownership of process improvements
Huddles are hot. Experts cite them as effective patient safety tools, and many hospitals have implemented them on nursing units at the start of the shift. The perioperative services team at Vanderbilt University Medical Center in Nashville, Tennessee, broadened the huddle concept to include several disciplines and a structured format,…
Rounding tool off to a good start in improving patient satisfaction
A mobile, web-based rounding tool is allowing the perioperative leadership team at Vail Valley Medical Center (VVMC) in Vail, Colorado, to collect, analyze, and report on information gathered from surgeons, staff, and patients to improve quality of care and move toward high reliability. Software designed by MyRounding Solutions in Littleton,…
Tracking tool streamlines scheduling, enhances communication with surgeons' offices
Sacred Heart Medical Center RiverBend in Springfield, Oregon, began OR optimization efforts soon after moving to a new facility in August 2008. Because of the US economic downturn around that same time, the hospital launched several initiatives to make the most of available resources, including a Lean process to improve…
Team participation and planning produce quality handoffs
After a poor handoff from the OR to the postanesthesia care unit (PACU) was identified as the culprit behind a serious adverse event, Nancy Robinson, DNP, MSN, RN, LHRM, CCM, made it her mission to avoid a recurrence. “I’m passionate about safe patient hand-offs,” says Robinson. “I didn’t want this…
Preparing for disaster: Boston hospitals know the drill but keep practicing
In the days after the Boston Marathon bombing on April 15, 2013, many praised the way the city’s hospitals responded to the attack. But clinicians in those hospitals aren’t resting on their laurels. They have examined what worked well (and not so well) after the event and continue to plan…
Lack of surgical checklist compliance suggests need to improve implementation
Surgical checklist compliance among 4 Canadian hospitals was around 60% in a large, retrospective study of acute care operations performed in 2010 and 2011. Although Alberta Health Services in Calgary, Alberta, Canada, had mandated checklist use starting in 2009, limitations such as instructional misuse, lack of perceived benefit, and lack…
Potential process improvements captured through web-based survey
How to identify the most common problems that occur in the OR and then find ways to prevent them is a trick most OR leaders would love to learn. A solution that shows some promise is a web-based debriefing questionnaire, judging by the experience of a multidisciplinary safety team at…
Surgical team familiarity reduces operative time, improves performance
Surgical team familiarity contributes to reductions in operative time, and performance improves as team experience accumulates, a new study finds. Previous studies of teamwork and its influence on surgical outcomes have been limited by the challenge of objectively quantifying teamwork. Survey-based methodologies are subject to responder bias, and the tools…
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