The Journal of medical practice management : MPM
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Traditionally, the operating room (OR) in an academic medical center has faced numerous challenges to effective clinical productivity, including additional missions of teaching and research. Level 1 trauma poses more challenges related to the need for additional specialized personnel in anesthesia, surgery, and nursing. The present investigation explores lessons learned in efficiency, teamwork, and data evaluation at a level 1 academic teaching facility. ⋯ These results are remarkable in comparison to the greater-than 20% cancellation rate recorded in 2005 when the current OR leadership team first assessed OR efficiency. An increase in the number of cases completed per month likely can be attributed to a reduction in the number of case cancellations. Increased efficiency allows for more operations to be performed, leading to increased profitability and an increased ability of hospitals to continue caring for patients. We advocate the implementation of a comprehensive multidisciplinary strategy for sustained improvement in OR efficiency and utilization.
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Medicare's fee-for-service (FFS) payment model may contribute to unsustainable spending growth. Payers are turning to alternative payment methods. ⋯ The CMS's Center for Medicare and Medicaid Innovation developed four models of bundled payments and 48 discrete clinical condition episodes. Many surgical care procedures are included in the 48 different clinical condition episodes.
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Medication errors represent one of the most common causes of morbidity and mortality in hospitalized patients. Anesthesia has specific medication-related risks; providers must administer many potent intravenous medications quickly, often with minimal to no supervision. ⋯ Emphasis should be placed on implementing forcing functions when possible, utilizing technology, standardization, and education about the need for awareness in specific situations. More studies need to be done to define the epidemiology of medication errors in anesthesia, and more importantly, to assess interventions for preventing them.
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The operating room (OR) turnover is a critical period in patient care and OR management. Turnover time (TOT) is a traditional quantitative measure of OR efficiency but is lacking when used to describe the TOT process. ⋯ Interview data of OR staff can supplement quantitative efficiency measures and identify areas of opportunity in OR management and patient safety.
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Operative sterility is a critical factor with regard to infection in the postoperative period. In recent years, techniques and devices have been developed to reduce the potential for exposure to pathogens. ⋯ The SteriCup provides a designated sterile area to store suction catheters and removed endotracheal tubes and allows for their simple and safe disposal. Devices such as the SteriCup have the potential to improve operating room systems and minimize potential for operative infection.