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Outpatient Connection


Surgical teams can reduce expensive postoperative complications with checklist Researchers at the University of Connecticut Health Center, Farmington, and Saint Francis Hospital and Medical Center, Hartford, have confirmed two simple cost-effective methods to reduce expensive postopera- tive complications—communications team training and a surgical checklist. Investigators found that when surgical teams completed communications training and a surgical procedure checklist before, during, and after high-risk operations, patients experienced fewer adverse events such as infections and blood clots. The study is published in the December issue of the


Journal of the American College of Surgeons. Surgical teams come together for one common goal—to treat patients using surgical procedures—but occasionally unforeseen circumstances can occur during the process. Sometimes surgical equipment isn’t on hand, or the patient requires more blood than expected, which delays the procedure and requires dispensing more anesthesia while a team member hurries to get needed supplies. Also, surgical team members may have inconsistent


information about priorities for the procedure, explained Lindsay Bliss, MD, lead study author and general surgery resident at the University of Connecticut. As many as five to 20 clinicians can be involved in a single operation, depending on its length and complexity. For the University of Connecticut study, Dr. Bliss’ col- leagues compared three groups of surgical procedures to determine whether communications training coupled with a standardized checklist could bring surgical teams into agreement and reduce patients’ complications. The communications training included three sessions on top- ics such as differences between introverts and extroverts, effective dialogue among all operating room personnel, and how to use a surgical checklist. Dr. Bliss’ team used the one-page Association for


Perioperative Registered Nurses Comprehensive Surgical Checklist developed in April 2010. It includes protocols mandated by the World Health Organization, The Joint Commission, and the Centers for Medicare and Medic- aid Services, and has been endorsed by the American College of Surgeons and other surgical organizations. In one group, 246 procedures involved surgical teams who had undergone communications training, while the other group included 73 procedures involving surgi- cal teams who had not only gone through the same communications training but also used the checklist. Study results showed that the communications training coupled with the checklist curbed complications within 30 days of the procedures. When surgical teams had no communications training and did not use checklist, more than 23 percent of the procedures resulted in complica- tions within 30 days. About 16 percent of procedures by surgical teams who only participated in communications training led to complications within 30 days, and only 8.2 percent of the procedures had a 30-day complication when the surgical teams used both the communications training and the checklist. Even small steps like making sure everyone on the team introduced themselves before the procedure helped reduce complications.


OPERATING ROOM


Advanced operations fuel surgical suite innovations


by Jeannie Akridge


and equipping surgical suites. Life-saving and life-enhancing procedures that routinely occur within these rooms rely upon the lat- est in surgical technology and diagnostic equipment — a capital investment with the potential to generate a lion’s share of a facil- ity’s revenue.


H Imaging equipment is increasingly being


used to the benefit of patient outcomes and must be readily available to be used within the procedure, many times serving as an intraoperative guide for surgeons. An in- novative prototype at the University of Cali- fornia San Diego’s Jacobs Medical Center’s Hospital for Advanced Surgery features an intra-operative MRI that can be moved on a track to an adjoining room for diagnostic use when not being used in surgery. There’s no doubt ORs are getting smarter. Integrated and hybrid suites promise increas- ing efficiencies in an area that embodies the maxim “time is money”. Healthcare Purchasing News spoke with representa- tives from leading surgical suite equipment providers to learn more about the latest in- novations and motivations in OR design and equipment procurement.


HPN: Describe current trends in surgical suites and how they drive equipment pur- chases and room design. There are three key trends influencing equip- ment decisions and surgical theater design: Growing use of imaging technologies; workflow monitoring to drive efficiencies; and green initiatives to improve the environ- mental footprint and reduce the cost of care.


ospitals have too much at stake in their operating rooms to neglect due diligence when it comes to designing


Imaging provides a means to visualize anatomy and assess physiologic parameters in a variety of organ systems, which can facilitate less invasive therapies. Imaging devices can be divided into two categories; portable (ultrasound, c-arms, surgical mi- croscopes and endoscopes) and fixed (e.g.; c-arm, MRI, and CT). Portable equipment is shared throughout the surgical suite, while fixed equipment is dedicated to a particular room. Decisions about which types of imag- ing will be employed will have an impact on room designs. Efficiency is a hot topic in today’s operating suites. Hospitals are seeking ways to tighten up turnover times and improve their overall productivity in anticipation of additional economic challenges. Workflow solutions such as the RealView Visual Workflow Management Software allow critical hu- man, equipment, and workflow status to be visible, in real-time, which helps drive on-time procedure starts, faster room turn- over, improved surgical productivity and higher patient and physician satisfaction. Workflow technologies can automatically alert a surgeon that it is time to enter the OR based on confirmation that the room is clean, the patient is in the room, and all of the necessary surgical instruments are in place. At the same time, it can post status information for waiting families and others in the perioperative loop.


Skytron Hybrid Suite 16 January 2013 • HEALTHCARE PURCHASING NEWS • www.hpnonline.com


Green initiatives focus on reducing waste and the associated cost of waste, and on lower- ing the consumption of utility-based resources such as water and electricity. Operating rooms are one of the larger hospital waste producers and energy consumers. Through thoughtful purchase decisions that include such items as LED surgical lighting or a portable CT scanner, hospitals can reduce an- nual energy consumption. In addition, thoughtful room design and modifications focused on temperature and humidity control, hospitals can further reduce energy consumption. Robert Popilock, Senior Market Development Manager, Surgical Solutions, STERIS Corporation


See OPERATING ROOM on page 18


OPERATING ROOM


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