Competency matrix modeled on ski trail difficulty validates staff skills at Vail center
Surgeon concerns about staff competency and high turnover of surgical technologists at Vail Valley Medical Center (VVMC), Vail, Colorado, prompted the development of a staffing skills competency matrix. VVMC is a community hospital with 4 rooms in its main OR, 4 rooms in its adjoining surgery center, and 4 rooms…
Tracking tool streamlines scheduling, enhances communication with surgeons' offices
Sacred Heart Medical Center RiverBend in Springfield, Oregon, began OR optimization efforts soon after moving to a new facility in August 2008. Because of the US economic downturn around that same time, the hospital launched several initiatives to make the most of available resources, including a Lean process to improve…
Improving instrument readiness cuts case delays, boosts surgeon satisfaction
Surgical case delays have been found to last an average of nearly 17 minutes. Not only do such delays make surgeons dissatisfied, they also reduce case volume and related revenues, and they may lead to additional time under anesthesia for patients. The root causes of instrument-based delays are seldom simple,…
Changes in nurses' pay structure solve staffing and scheduling problems
Many OR directors struggle with designing effective nurse compensation systems. The ideal system would achieve department goals while maintaining nurse satisfaction. Unfortunately, a compensation plan that links these 2 objectives is often elusive. In 2012, OR leadership at a small Pennsylvania hospital developed a compensation system that effectively aligns nursing…
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…
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