The expanded volume of interventional cardiology in recent years has played a major role in the growing prevalence of hybrid ORs. As a result, many perioperative services leaders have had to develop systems for managing hybrid ORs along with traditional ORs. “Management of hybrid ORs is really a collision of…

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Huddles are hot. Experts cite them as effective patient safety tools, and many hospitals have implemented them on nursing units at the start of the shift. The perioperative services team at Vanderbilt University Medical Center in Nashville, Tennessee, broadened the huddle concept to include several disciplines and a structured format,…

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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…

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Surgical team familiarity contributes to reductions in operative time, and performance improves as team experience accumulates, a new study finds. Previous studies of teamwork and its influence on surgical outcomes have been limited by the challenge of objectively quantifying teamwork. Survey-based methodologies are subject to responder bias, and the tools…

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Trauma events occur every 5 minutes in the United States, and 30% of trauma patients die within 120 minutes of the event because of major organ injuries that lead to heavy blood loss. Better outcomes are achieved when care is initiated within 60 minutes, a time frame commonly referred to…

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Less than a year after adopting a “college structure” model akin to that of specialty teams, the UF & Shands Academic Health Center in Gainesville, Florida, is close to achieving a goal of 100% on-time starts. “We track first-case start times, and a report goes out every morning, so we’ll…

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Sixth in a series on ten elements of safer surgery.   Could you and your team find 30 minutes a day to prepare for the next day’s surgical schedule? The effort can be worthwhile. A Chicago-area hospital has found that a half-hour daily huddle not only heads off delays and…

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One Friday evening at University of Missouri Health System (MUHS) in Columbia, Missouri, Tony*, an RN with more than 17 years of critical care nursing experience, had a patient die unexpectedly during a routine procedure requiring moderate sedation. That weekend he was emotionally distressed, reliving the event and second-guessing his…

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Team members simply introducing themselves to one another at the start of a case made a difference in the rate of infectious events in a pilot study. The rate was 1.9% when the introductions were documented and 21.1% when they were not. (The infectious event rate included surgical site infections,…

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How will a surgical site infection (SSI) develop in the next patient who has colorectal surgery? What can we do to prevent it? These 2 questions helped a team at Johns Hopkins Hospital in Baltimore to identify 6 interventions that achieved a 33% reduction in SSIs after colon operations. The…

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