Study: Lean methods improve first case on-time starts
Editor's Note In this study, implementation of Lean interventions to redesign the workflow in the preoperative holding area of a large urban medical center was linked to significantly improved rates of elective first case on-time starts. Data from 23,891 surgical procedures performed over 415 days were examined−86 days before, 35…
Cesarean section ERAS pathway reduces recovery time, improves outcomes
Editor's Note A new enhanced recovery after surgery (ERAS) pathway has been developed and implemented at the University of Alabama at Birmingham to enhance recovery after cesarean delivery. Updated guidelines for the ERAS pathway include: Intake of water and clear sports drinks before surgery to keep mother hydrated. Walking after…
How do you handle social determinants?
Social and demographic factors play a huge role in any patient’s overall health and recovery from surgery. When treating patients who lack health insurance, family support, or language/literacy skills—among many other possible disadvantages—providing safe patient care can extend well beyond clinical aspects. OR managers and their staffs may take on…
Change PAT protocols to improve patient throughput
Preadmission testing (PAT) has been shown to reduce day-of-surgery delays and unnecessary testing that drive up the cost of healthcare. But it takes time and patience to put an effective PAT process in place. Sharon Ulep, MBB, CMCA, CPHQ, principal for healthcare strategy and consulting, Plante Moran, Southfield, Michigan, who…
PAT makeover enhances patient and provider satisfaction
Not all hospitals have a preadmission testing (PAT) process, and even when they do, communication breakdowns and inefficiencies can make the process ineffective. Recognizing that the PAT process at Yale New Haven Hospital, New Haven, Connecticut, needed a makeover was the first step in launching an improvement project that led…
Opioid prescriptions drop after orthopedic team changes protocol
Can hospital leaders and surgeons partner to reduce opioid use while maintaining high patient satisfaction scores? Leaders at OSS Orthopaedic Hospital in York, Pennsylvania, answer that question with a yes. Meghan McNelly, PharmD, MHA, FACHE, who was director of pharmacy at OSS when the opioid-reduction project started, says that from…
More cases start on time after nurses change workflow
Among the many variables that influence on-time starts of surgical cases are the arrival times of patients and staff, as well as the verifications and documentation required before patients are brought to the OR. Increasing on-time starts was a key initiative at Fox Chase Cancer Center. By exploring the influences…
Preop walking test helps predict postop cognitive dysfunction
Editor's Note A simple 6-minute walking test before cardiac surgery helped predict the risk for cognitive issues after surgery, in this study from Japan. A 6-minute walk distance (6MWD) test was performed preoperatively on 181 patients who had nonemergency cardiac surgery. After surgery, 51 patients had postoperative cognitive dysfunction (POCD).…
Patient optimization clinic creates a recipe for success
The government and insurance companies have imposed increasing penalties on healthcare facilities in recent years for readmissions. And with good reason: High readmission rates greatly increase costs and sometimes signal poor patient safety practices. In 2015, roughly 2 million patients were readmitted, costing Medicare $27 billion, according to the Centers…
Effect of dedicated OR teams on clinical outcomes in a colorectal ERAS program
Editor's Note Dedicated OR teams for a colorectal Enhanced Recovery after Surgery (ERAS) program at Johns Hopkins Hospital led to anesthesia providers becoming more central to the ERAS network, which increased process measure compliance and improved clinical outcomes in this study. Before the dedicated OR teams were instituted, surgeons were…
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