'Destination surgery': Metrics drive patients to centers with better care
Perioperative managers and staffs are collecting data on a growing list of metrics on surgical quality—antibiotic prophylaxis, venous thromboembolism prevention, normothermia, and more. Now these and other metrics are coming into play as big companies like Walmart, Lowe’s, and Pepsico seek the best value for their insured employees, especially those…
Surgical 'never events' pegged at 4,000 a year
Surgeons in the US leave a surgical item such as a sponge or a towel in a patient 39 times a week, perform a wrong procedure 20 times a week, and operate on the wrong body site 20 times a week, a new study estimates. The analysis is thought to…
An electronic path for streamlining scheduling
An electronic form surgeons’ offices use to place scheduling orders has streamlined the preoperative process and sharply reduced case cancellations for a Chicago-area hospital. Cancellations are down from about 12% to less than 1% of cases since the scheduling form was introduced in early 2012. The offices took to the…
A plan for avoiding readmissions after surgery
A Medicaid patient is admitted to the hospital for repair of an enterocutaneous fistula. He’s considered a high risk for readmission after surgery because he doesn’t have a working refrigerator or telephone. That means he won’t be able to keep fresh food on hand or call his physician if he…
Adopting a 'no interruption zone' for patient safety
The time-out is called, but conversations are going on, and the staff is still assembling equipment. No one seems to be listening. Then during the case, the anesthesiologist has trouble hearing over the loud music and chatter. The circulating nurse needs confirmation on a specimen but can’t get the surgeon’s…
Joint project targets prevention for colorectal surgical infections
Seven hospitals working with the Joint Commission and the American College of Surgeons (ACS) on a 2-year project to reduce colorectal surgical site infections (SSIs) have saved more than $3.7 million by avoiding an estimated 135 SSIs, the commission announced in November 2012. The commission is pilot testing the approach…
Solid OR governance is the foundation for safety
Ten Elements of Safer Surgery. First in a series. What’s the essential ingredient for an OR to run safely and effectively? Many would sum it up with one word—leadership, followed closely by collaboration. An OR led by a strong team from surgery, nursing, and anesthesia backed by the hospital’s…
Hospitals share data to prevent colorectal SSIs
Why does our hospital have a higher rate of venous thromboembolism (VTE) than others in our state? How are others preventing surgical site infections (SSIs) after colorectal surgery? What’s behind our urinary tract infection (UTI) rate? Hospitals in Tennessee are openly discussing issues like these through the Tennessee Surgical Quality…
Scope storage: Don't get hung up on a number
How long can a flexible endoscope be stored before it needs to be reprocessed for use in a patient? Guidelines differ, raising questions about the appropriate storage or “hang time.” Evidence is limited. What’s the best course? How do accreditation surveyors assess this? Though infections from GI endoscopes are rare,…
Quality reporting for ASCs is off to a good start
Starting October 1, 2012, the Centers for Medicare and Medicaid Services (CMS) began requiring quality reports on Medicare claim forms from ambulatory surgery centers (ASCs). From all indications, complications were few, and ASCs already are using the new statistics to gain insight into operational trends. Ultimately, the self-reports of patient…
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