Lean management and automation have come together to create a sterile processing department (SPD) that can efficiently process the 700 to 1,000 instrument sets a day needed to support a caseload that is primarily orthopedic. The SPD at New England Baptist Hospital in Boston is one of the few in…

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Team members simply introducing themselves to one another at the start of a case made a difference in the rate of infectious events in a pilot study. The rate was 1.9% when the introductions were documented and 21.1% when they were not. (The infectious event rate included surgical site infections,…

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Shortening the time it takes for an outpatient procedure may increase volume, OR utilization, and hence revenue—but that is not the point, say the nation’s top performers in a recent survey of procedure times. Rather, the purpose is to enhance patient safety and satisfaction. For example, less time in the…

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All ORs have protocols for cleaning between cases and at the end of the day’s schedule. But constant vigilance is needed to make sure cleaning is thorough and carried out consistently. Though an OR may look clean, studies have shown there’s room for improvement. For example, only 25% of OR…

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This month’s article on preop testing research had a familiar ring (page 20). Researchers at the University of Texas Medical Branch (UTMB) in Galveston have found much more testing is being done than seems to be needed. They’re documenting the patterns. Seems not much has changed. These new studies join…

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Surgical checklists have gained traction in recent years as studies have shown that they improve patient safety. Using surgical crisis checklists might be the next logical step, judging by a recent simulation study. OR staff missed just 6% of life-saving steps when using crisis checklists, but when staff relied on…

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Ten elements of safer surgery. The third in a series, this article focuses on presurgical evaluation.   Making sure patients have the appropriate preoperative preparation, including testing, is necessary not only for patients’ safe care but also for a smooth process on the day of surgery. Advocate Health Care, a…

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What preoperative tests does your facility require for a healthy 40-year-old having a knee arthroscopy? What about a healthy 82-year-old having an elective procedure? Do these patients need testing at all? A good deal of testing is performed without clinical indications, studies have found. Researchers at the University of Texas…

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I have heard the following statement from OR personnel: “We use rigid sterilization containers and run a 270-275ºF (132-135ºC) prevacuum steam sterilization process in our OR. So we no longer use IUSS.” Is that an IUSS cycle? IUSS, or immediate-use steam sterilization, was formerly known as flash sterilization. This article…

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Since the early days of aviation, pilots have used checklists before, during, and after each flight. Cooks follow recipes. Builders don’t build without team meetings and signoffs at every step. Health care professionals, however, only recently began to adopt checklists. Often, the excuse has been that medicine is an art,…

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