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Daily Tiered Huddles help prioritize and resolve OR problems

When you have a problem, are you empowered to solve it? What happens when staff encounter an obstacle? Cleveland Clinic’s Tiered Huddle process empowers all caregivers to see problems and tackle issues on their own or escalate them for assistance. The tiered huddles have energized teams to work across the…

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By: Judith M. Mathias, MA, RN
November 18, 2019
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Establishing quality standards for ERAS care elements

At Virginia Commonwealth University System (VCU Health) in Richmond, we are using quality standards to establish operational definitions for elements of Enhanced Recovery After Surgery (ERAS). This article describes what those standards are and how they are implemented. Previous articles in this series appeared in the October 2019 and November…

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By: OR Manager
November 18, 2019
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Editorial

Our series on Enhanced Recovery After Surgery (ERAS), which began last month with an overview of its history and perioperative pathway, continues in this issue with examples of improved outcomes and the roles played by perioperative team members (see p 18). ERAS, known to speed recovery and increase patient satisfaction,…

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By: Elizabeth Wood
October 21, 2019
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The role of the OR in ERAS pathway implementation

The US has been on a journey for the last several years to reduce the cost of healthcare. In 2017, the percent of gross domestic product attributed to healthcare goods and services was at 17.9%. This is expected to reach as much as 19.4% by the year 2027.1 Factors contributing…

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By: OR Manager
October 21, 2019
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Proactive steps paramount for greater surgical stapler safety

Internal surgical staplers made headline news in 2019. Reports discussed the little-known US Food and Drug Administration database housing tens of thousands of stapler-related problem reports and covered the agency’s recent proposal to reclassify staplers as Class II devices, instead of the more lightly regulated Class I. ECRI Institute named…

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By: OR Manager
October 21, 2019
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Enhanced Recovery After Surgery: The new standard for perioperative care

Enhanced Recovery After Surgery (ERAS®) is a comprehensive, multifaceted, and multidisciplinary approach to the care of the surgical patient. ERAS bundles evidence-based elements to facilitate a faster recovery with fewer complications.1 Spanning the continuum of perioperative care, ERAS elements include: • patient engagement and education • preoperative optimization of nutrition…

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By: OR Manager
September 23, 2019
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Seminar eases nurses' discomfort with sudden patient declines

A patient’s condition can change in the blink of an eye. Are you prepared to respond? And what happens if the patient dies? This is the focus of an annual seminar at Houston Methodist Hospital that was developed to increase the comfort level of perioperative nurses caring for a patient…

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By: Judith M. Mathias, MA, RN
September 23, 2019
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Inspections reveal need to overhaul bronchoscope reprocessing methods

Extensive research by Cori L. Ofstead, MSPH, and her colleagues at Ofstead & Associates (St Paul, Minnesota) has raised concerns about insufficient reprocessing of gastrointestinal endoscopes and ureteroscopes—even when recommended practices are followed—and their new study makes a compelling case for more stringent reprocessing of bronchoscopes as well. In their…

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By: Judith M. Mathias, MA, RN
August 23, 2019
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Team training empowers OR staff to improve patient safety

Poor communication has been the root cause of many sentinel events over the years, and there has been growing recognition of how the work environment and culture influence patient outcomes. In a 2018 Sentinel Event Alert, the Joint Commission stressed the need to develop a “reporting culture”—to make it safe…

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By: Elizabeth Wood
August 23, 2019
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Legal and ethical questions temper excitement about AI--Part 2

As part of a special series on artificial intelligence (AI), OR Manager is taking a deep dive into the many facets of this new technology and its impact on patient care. In this issue we continue our examination of the challenges related to AI, which began in last month’s issue…

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By: Cynthia Saver, MS, RN
July 24, 2019
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