In a simple quiz, medical students are asked to read a short paragraph about what sounds like a robbery. Then, as individuals, they answer 18 questions about the paragraph. After that, they gather in a group to answer the questions as a team. On their own, some answer as few…

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Less focus on checking off boxes, more focus on teamwork. That's the shift experts say is needed to make lasting change to keep patients safer in surgery. The new study from the Veterans Health Administration finds OR team training was associated with a reduction in patient mortality (related article). VA…

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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…

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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…

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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.…

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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…

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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…

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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.…

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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.…

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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.…

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