Editor's Note In this study, survival rates for geriatric patients were significantly improved when emergency general surgery procedures were performed at hospitals with higher operative volumes. Of 41,860 surgical procedures evaluated at 200 hospitals, mortality decreased as hospital emergency operative volume increased. For every standardized increase in volume, reduction in…

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Contaminated surgical instruments made ECRI Institute’s 2019 annual top 10 list of health technology hazards, coming in at number five: “Mishandling flexible endoscopes after disinfection can lead to patient infections.” Number two on the list in 2018 was “Endoscope reprocessing failures continue to expose patients to infection risk.” It’s not…

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Editor's Note This study from a large academic medical center finds that the practice of overlapping surgery does not expose patients to increased risk of negative outcomes. Data on operative procedures from January 1, 2014 to December 31, 2015 at the University of Alabama at Birmingham, were used to compare…

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Flipping rooms, or running two ORs back to back, is common in many perioperative services departments. Certain rules of thumb can help ensure efficiency and good outcomes, but sometimes those rules either don’t exist or are unclear. Does your facility have guidelines for overlapping surgery, and do your surgical teams…

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Perioperative leaders, including those in the sterile processing department (SPD), need to know when to make sweeping—not just incremental—changes to improve workflow and optimize the talents of their staff. Sometimes gains in productivity and staff satisfaction depend not only on identifying process improvements but also on placing staff in areas…

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A common strategy for managing OR utilization is block scheduling: Assigning surgical time to individual surgeons or surgeon groups based on their volume. But what sounds like a simple process is often complicated by the potential for dissatisfaction and reduced utilization. Yet done effectively, block scheduling can significantly boost the…

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Inefficiencies in surgical case scheduling can lead to large revenue losses. When leaders at Providence Sacred Heart Medical Center (SHMC) in Spokane, Washington, realized poor room utilization was the cause of more than $1 million in annual overtime costs, they knew that better planning was needed. “For every 60 minutes…

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Many healthcare organizations have adopted Lean processes to save money, improve workflow, and reduce waste. But it’s not just process change that drives success. It’s the individuals—especially those on the front lines—who work together to identify problems and solutions. It’s also ongoing efforts to sustain changes once they have been…

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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…

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Anyone who has been involved in an OR design and construction project knows it is a labor-intensive, time-consuming effort—and usually far from seamless. There’s almost always something no one thinks of until it is too late, and the staff must learn to live with the flaws. But a multidisciplinary team…

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