Team participation and planning produce quality handoffs
After a poor handoff from the OR to the postanesthesia care unit (PACU) was identified as the culprit behind a serious adverse event, Nancy Robinson, DNP, MSN, RN, LHRM, CCM, made it her mission to avoid a recurrence. “I’m passionate about safe patient hand-offs,” says Robinson. “I didn’t want this…
First case on-time starts soar after rapid process improvement training
In 2011, fewer than half of all first cases at Dartmouth Hitchcock Medical Center in Lebanon, New Hampshire, were starting on time. That meant subsequent cases were also delayed, with overtime costs exceeding $500,000 a year. “People were unhappy with that for a lot of different reasons. It was a…
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…
South Carolina models high reliability standards through pilot program
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…
Editorial
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…
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…
Collaboration and creative thinking hold down the number of OR holds
Putting a hold on the OR can lead to revenue losses no manager wants to see. At Lehigh Valley Health Network (LVHN) in Allentown, Pennsylvania, OR holds were averaging 1,100 minutes per month. Jodi Koch, BSN, RN, director of perioperative services, and Kathleen Duckworth, RN, CPAN, their colleagues got holds…
Using Lean strategies to improve operating room efficiency
Improvements in first case on-time starts and turnover time at Lancaster General Hospital in Lancaster, Pennsylvania, attest to the success of using Lean strategies. Within an 8-month period, first-case on-time starts (FCOTS) jumped from 35% to 72%, and the monthly average overall turnover time (TOT) for a 7-month period was…
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