Editor's Note In this study, the use of a preinduction checklist significantly improved information exchange, knowledge of critical information, and perception of safety in anesthesia teams. A total of 105 teams using the checklist were compared with 100 control teams. The outcome scores for the checklist group vs the controls…

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Editor's Note Development of an anesthesia enhanced recovery pathway (ERP) at Johns Hopkins Hospital, Baltimore, resulted in a 45% reduction in length of stay in colorectal surgery patients. In addition, patient satisfaction scores improved from the 37th percentile to the 97th percentile. The goals of the ERP were achieving superior…

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Editor's Note A trust-based accountability model that included senior hospital leadership and frontline providers provided an enabling structure to rapidly implement an integrated recovery pathway and quickly improve outcomes, value, and experience of colorectal surgical patients, in this study. The pathway included preoperative education, mechanical bowel preparation with oral antibiotics,…

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Editor's Note When anesthesiologists supervise anesthesia residents and nurse anesthetists, the amount of clinical work (total weekly hours) they perform does not positively correlate with the quality of the supervision they provide, this study finds. The results suggest that anesthesiology department managers should be monitoring (and perhaps reporting) the quality…

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Editor's Note When surgeons listen to their preferred music, they’re more efficient at closing incisions, and their technique improves, this study finds. Researchers asked 15 plastic surgery residents at the University of Texas to perform layered closures on pigs’ feet. Half the resident worked in a silent OR and half…

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Editor's Note Surgical teams at Northwesterm Memorial Hospital in Chicago are decreasing the rate of urinary tract infections by focusing on the use of catheters before and immediately after surgical procedures. A process improvement program reduced the number of UTIs associated with catheters placed in patients in the OR from…

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Many organizations have reaped the benefits of adopting Lean concepts, such as greater workflow efficiency, staff engagement, and cost savings. After initial improvements are made, however, it can be hard to sustain the process changes over time. That was the case at Nemours A. I. duPont Hospital for Children in…

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Providing ideal patient care is the fundamental purpose behind Adaptive Design, an innovative systems approach that engages frontline staff in problem solving and focuses on improving patient care as part of everyone’s daily work. “More access to better care at a continually lower cost is the promise of doing Adaptive…

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At least half the battle in making and sustaining process improvements is getting the entire team on board with a new workflow. One key to getting buy-in from staff is to clarify why changes are needed and what the consequences may be if the new processes aren’t followed. In a…

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Turnover time and first case on-time starts are a common problem in most ORs, so leaders are always seeking ideas for improvement. OR Manager recently spoke with two leaders who have had remarkable success in each of these areas.   The Dartmouth-Hitchcock experience When the average turnover time (TOT) at…

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