Predictive modeling helps match resources with needs
Perioperative services is the key driver of a hospital’s performance. More than 68% of better performing hospitals’ revenue comes from perioperative services, and 60% of their margin is derived from the OR, according to Alecia Torrance, MBA, BS, RN, CNOR, senior vice president of clinical operations, Surgical Directions, Chicago. One…
Integrate systems to sustain gains from process change
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…
Take time to make time: Involve your team in closing schedule gaps
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…
Surgical resident work hours reform does not improve patient safety
Editor's Note Work-hour restrictions for surgical resident, revised nationally 4 years ago to protect patients against fatigue-related errors, have not had the desired effect of lowering postoperative complication rates, according to this new study. Researchers from the American College of Surgeons found no significant difference in surgical outcomes between 1…
Improving OR efficiency with constraint management
Editor's Note Simple changes in preadmission testing and OR scheduling, including appointing a senior nurse anesthetist to help direct OR use, resulted in improvements in OR efficiency and case volume in this study. Substantial improvement was seen in first case on-time starts (39% to 84%), as well as utilization of…
OR staff reap rewards of paperless patient tracking system
Clearing a patient for surgery is no easy feat, and a completely paper-based workflow can be very inefficient. Switching to a paperless tracking system has cut labor and costs in the preanesthesia screening services (PASS) department at Sinai Hospital, LifeBridge Health, Baltimore, and nurse leaders there hope to integrate the…
Redefining staff roles and responsibilities can help reduce turnover time
Turnover time is a major concern for OR leaders. We surveyed OR Manager readers last year to identify the business and efficiency issues they want to know more about. Reducing turnover times ranked second, just under cost control. Extended turnovers clearly affect labor costs, but they also have a strong…
No time to waste: A children's hospital Lean team streamlines its turnover process
Children’s Hospital of Los Angeles (CHLA) is renowned for patient care, but by early 2013 the increased complexity of new technology and other factors had eroded efficiency. Orthopedics had fallen to the bottom quartile compared to national benchmarks for turnover times, and executive leadership called for change. Within orthopedic surgery,…
Surgeon-nurse duo delivers excellent, efficient patient care
The number of nurse practitioners is expected to double by 2025, and the need for surgical first assistants is growing as residents’ work hours are reduced and surgeon assistants are eliminated to cut costs. This situation offers a great opportunity for advanced practice perioperative nurses. A double certification of nurse…
Boomer business: Lean strategy turns total joints into thriving enterprise
More than 7 million Americans are living with a prosthetic knee or hip, and there is a growing incidence of adults younger than 65 undergoing these procedures, researchers reported at the 2014 annual meeting of the American Academy of Orthopaedic Surgeons in March. Among those over 50 years of age,…
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