Obstructive sleep apnea is a major clinical and economic challenge in the postoperative period, affecting up to one-fourth of patients undergoing elective surgical procedures. The prevalence among orthopedic patients having joint arthroplasty may be especially high because obesity is a widespread comorbidity in this patient population. Obesity is 1 of…

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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…

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Shooting incidents are occurring throughout the US with increasing and alarming frequency. Among those in late 2013: the Washington, DC, Navy Yard on September 16—12 dead, 3 injured before the gunman took his own life; the Sparks, Nevada middle school on October 21—1 dead, 2 wounded before the student wielding…

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The South Carolina Hospital Association (SCHA) and the Joint Commission Center for Transforming Healthcare have teamed up to make the state’s healthcare highly reliable. In a joint project titled “South Carolina Safe Care Commitment,” 21 hospitals in South Carolina are learning about high reliability practices (chart, p 12). High reliability…

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Early indications are that the South Carolina Safe Care Commitment project, though still in its infancy, holds promise for increasing the reliability of healthcare in that state (cover story). Certainly the progress made thus far supports the framework put forth by the Joint Commission in 2013 to help all healthcare…

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When Mark Katlic, MD, MMM, FACS, descended into the basement of the hospital where he was a resident 30 years ago to satisfy his curiosity, he had no idea that what he found would set him on his career path. Dr Katlic had cared for a few surgical patients more…

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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…

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Innovations in surgical techniques, anesthesia, and equipment, along with the drive to decrease healthcare costs, are increasing the number of patients and procedures deemed suitable for outpatient surgery. Among the elective procedures now being performed at ambulatory surgery centers (ASCs) are total joint replacements. The buzz at recent conferences has…

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Each year, 2.5 million people in the US develop pressure ulcers, according to the Agency for Healthcare Research and Quality (AHRQ). Surgical patients are at especially high risk because of immobility during long procedures and anesthesia that blocks sensitivity to pain and pressure. The Centers for Medicare & Medicaid estimates…

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Environmental hygiene is an ongoing concern in all hospitals because of its role in patient safety and infection control. Standardized processes can greatly improve the efficacy of OR cleaning, but continuous monitoring is needed to ensure compliance with those steps. Inconsistent cleaning processes, staff turnover, new equipment, and unclear expectations…

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