VA study shows fewer patient deaths after OR team training
ORs in facilities that adopted team training had a lower rate of deaths for surgical patients than facilities that had not yet had training, in a large new study from the Veterans Health Administration. The 74 VA facilities that had team training saw an 18% decrease in their annual surgical…
Team agreement competition boost record for on-time starts
Third in a series on OR performance. With health care reform looming and the financial picture for hospitals uncertain, perioperative leaders know senior executives will look to the OR as a major source of revenue. That's likely to increase pressure to improve OR performance. Starting cases on time in the…
Joint MD-RN team drives results for an orthopedic service line model
An orthopedic service line has seen its volume rise and complications and costs go down since its surgical services director and chief of orthopedic surgery took the helm. Together, they have found they can drive change. It's an example of new types of collaborative arrangements hospitals are exploring with physicians.…
Building bridges between SPD and OR
The financial state of hospitals is not encouraging. Some issues cited in the January OR Manager include: reduced Medicare reimbursements, increased patient volumes, and inability to obtain credit, with 50% of hospitals in the US already approaching insolvency. One suggestion for countering these economic pressures was to increase surgical volume…
Making the case for specialty teams
Teams have long been discussed by OR managers as a way to improve physician and staff satisfaction. It makes sense to have teams of the same staff working with surgeons in the same specialty consistently. But a variety of management issues arise. How do you balance the need for specialist…
What's needed to address bad behavior?
The Joint Commission's new Leader-ship Standards, effective Jan 1, 2009, call for a code of conduct and a process for addressing disruptive behavior. In a Sentinel Event Alert in July, the commission made its case for why bad behavior is a safety threat and outlined 11 recommendations for addressing it.…
What works for teamwork training
A case is getting ready to start. The radio is playing. The surgeon is helping position the patient. The anesthesiologist is giving the antibiotic. Someone is hooking up the suction. The circulating nurse is calling for the time-out to verify the surgical site, but no one is paying much attention.…
Getting the whole team on board to prevent retained foreign bodies
A case of an item left behind after surgery can be like a canary in a coal mine—a signal that an OR department has systems problems. Retained items often happen as a result of poor communication and faulty processes. Perhaps nurses aren't using a standardized counting procedure in all ORs.…
WHO launches global program for safe surgery, with checklist
Crew resource management in the OR takes another step forward with the World Health Organization's (WHO) launch of Safe Surgery Saves Lives, which puts a new checklist, the surgical safety checklist (SSC), at the center of patient safety. Preliminary results from 8 pilot sites worldwide indicate the checklist nearly doubled…
Military's team-training tools now available to ORs, others
A63-year-old patient is having cataract surgery. The surgeon calls for the lens, and the circulating nurse, just returning from lunch, presents what he thinks is the correct lens. Without checking, the surgeon asks the nurse to open the lens container. The lens he inserts turns out to be the one…
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