An effective handoff helps ensure care transitions are safe and efficient, but achieving the ideal handoff can be challenging. Part 1 of this two-part series provided an overview of the role of handoffs in the perioperative setting (OR Manager, January 2020, 22-23, 25). This article offers best practices for successful…

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At Virginia Commonwealth University (VCU) Health System in Richmond, implementation of Enhanced Recovery After Surgery (ERAS) incorporates principles of Lean thinking, a management methodology that emphasizes “…maximize[ing] customer value while minimizing waste. Simply, lean means creating more value for customers with fewer resources,” according to the Lean Enterprise Institute.1 Several…

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Of the approximately 57 million surgical procedures performed annually in the US, it is estimated that hospital inpatient procedures (overnight admissions) account for less than 20% of cases. Many procedures once performed in hospital outpatient surgery departments (HOPDs) have moved to ambulatory surgery centers (ASCs) over the past 15 years,…

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Starting the first cases of the day on time is key for maintaining the OR schedule. A delay in first case on-time starts (FCOTS) can lead to less OR utilization, greater facility costs, and dissatisfaction among physicians, OR staff, and patients. It’s a problem in many surgical suites, but when…

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Editor's Note In this study, specialty certification was associated with greater professional identity in ICU nurses and higher perceptions of knowledge of and value in evidence-based practices, whereas education level was not. Of 268 respondents from six hospitals and 12 adult ICUs in an integrated health system, 71% had a…

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Editor's Note The World Health Organization (WHO) has designated 2020 as the International Year of the Nurse and the Midwife, in honor of the 200th birth anniversary of Florence Nightingale. WHO and its partners are leading a year-long effort to celebrate the work of nurses and midwives, highlight the challenging…

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Editor's Note For the 18th year in a row, US adults taking the Gallup Poll rated nurses highest among professionals for honesty and ethics. In the survey, 85% of respondents rated nurses’ honesty and ethical standards as “very high” or “high,” similar to 2018. The top five also included engineers…

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Editor's Note In this study from Washington University School of Medicine, St Louis, a first case on-time starts (FCOTS) improvement initiative was linked to a higher frequency of FCOTS, which was independently associated with last case on-time ends (LCOTE) and decreased OR overtime costs. Of 12,073 cases (6,095 pre- vs…

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Editor's Note Surgery patients overwhelmingly prefer pre-surgical safety checklists to be completed in front of them, contrary to what is thought by anesthesiologists, this Swiss study finds. In this trial, which included 110 anesthesiologists and 125 non-premedicated ear-nose-throat or maxillofacial surgery patients, the patients overwhelmingly agreed that anesthesiologists should use…

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Malignant hyperthermia (MH) is a rare but life-threatening surgical complication that seems to turn the effects of general anesthesia upside down. Instead of relaxing, muscles become rigid, releasing large amounts of acid and potassium into the blood. Instead of a normal slowing of breathing, respirations quicken, and end-tidal CO2 rises.…

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