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…
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…
OR debriefings put the safety checklist ‘on steroids’
See it, say it, fix it. That saying by a former FedEx pilot set the stage for a major quality improvement effort in surgical services at a South Carolina medical center. A key QI tool is debriefings performed at the end of every case. These quick exchanges help to bring…
Tying anesthesia salaries to on-time starts, turnovers
Better data coupled with an at-risk salary model for anesthesiologists have helped one academic medical center to improve its performance for on-time starts and turnover time between cases. The hospital’s surgical volume was growing, and it had to make the most of its OR time. Yet a lot of the…
A safer, faster way for postoperative x-rays
With patient safety as its primary goal, the University of Michigan Health System has created a new process using bar-coded sponges and electronic radiology orders to ensure no items are unintentionally left in a patient during surgery. Electronic orders provide for a standardized process that not only is safer but…
Lean: Tackling waste in the sterile supply area
When Providence Sacred Heart Medical Center and Children’s Hospital in Spokane, Washington, decided to tackle waste and inefficiencies in its 4,400 square-foot-case cart and sterile supply room, leaders set modest goals for improvement: increase case picking productivity by 4% and relocate enough items to create 6 carts of space for…
Surgery is front and center in new Medicare value-based purchasing
This year, the quality movement takes a big step with the start of Medicare’s value-based purchasing (VBP) program. Beginning October 1, 2012, part of your hospital’s Medicare payments will be based on your hospital’s performance on a set of quality measures, usually referred to as the core measures and HCAHPS…
Data for benchmarking your OR's performance
Hospitals are facing stiff economic winds. They are challenged by shrinking reimbursement from Medicare and Medicare, even as more patients will be covered by these publicly funded programs. Perioperative managers and directors are under pressure to make the most of their department’s resources. You’re being asked to measure every aspect…
Looking to front-line clinicians, staff for lasting improvements
A patient with a multidrug-resistant infection is coming to your OR. That patient will travel from her room—one of the most contaminated areas of the hospital—to surgery, which is perhaps the cleanest. How can her caregivers avoid cross-contamination that could transmit the infection to others? At 219-bed St Patrick Hospital…
Managing urgent cases with accountability
A4-level classification system with built-in accountability measures is used for managing urgent and emergent cases at Munson Medical Center in Traverse City, Michigan, a 390-bed referral center with 14 ORs. The policy was developed by a steering committee of surgeons, anesthesiologists, OR management, and the administration working with a consultant.…
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