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…
Targeted Solutions Tool helps banish communication barriers during surgery
Process and communication concerns led OR management at the University of Florida Health Shands Hospital, Gainesville, to implement a Surgical Safety Process using the Joint Commission Center for Transforming Healthcare’s Targeted Solutions Tool (TST) for Wrong Site Surgery. “When we reviewed our patient safety reports, what came to the surface…
'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,…
Fast action, team coordination critical when surgical fires occur
New information on surgical fires sheds light on risk factors, patterns of injury, and why OR teams need to plan for their occurrence. A May 2013 study led by Karen B. Domino, MD, MPH, is the first to assess closed malpractice cases of surgical fires. Dr Domino, professor of anesthesiology…
Surgical liaisons: The bridge between the OR and family members
Surgery is a stressful time not only for patients but also for their families. Using a surgical liaison to communicate the status of an operation to those in the waiting area has boosted the satisfaction of patients, families, and surgeons, say perioperative directors whose hospitals have these positions. The liaison…
Three-part strategy suggested to improve patient throughput
Efficient throughput—difficult to achieve, yet essential to long-term financial success—is a Holy Grail for OR nurse leaders, who spend much time and energy seeking it. Given all the demands of their role, how can leaders best use their time to gain the most benefit from throughput initiatives? One method is…
Focus shifts to device fragments, small miscellaneous items in RSIs
Though retained surgical items (RSIs) cases are rare, they do happen, and they take a heavy toll throughout the system in terms of steep fines, malpractice claims, and compromised patient safety. Estimates of RSIs range from 1 in 1,000 to 1 in 7,000 procedures. And a 2003 study by the…
'Just Culture' encourages error reporting, improves patient safety
During a procedure in the OR, a medication is retrieved from the automated supply station and introduced onto the sterile field. The sterile field is then, unknowingly and unintentionally, contaminated by an unsterile medication. This example could happen in any operating room setting. In this case, the circulating nurse spoke…
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