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Conference Connections Issues
A Simple Way to Reduce Infection Risks
April 08, 2010 Never Tolerate Bullying in the OR
April 22, 2010 Do Your Homework Before Applying for Accreditation
May 06, 2010 Trim Payroll Expenses the Smart Way
May 20, 2010 Communicate Changes in Care — Verbally and in Writing
June 03, 2010 It's All Connected: Finding Balance, Not Juggling, is Key to Happiness and Success
June 17, 2010 The Laughter Keeps Us Sane: Columnist Paula Watkins Tells It Like It Is
July 01, 2010 An Efficient OR is a Safe OR: Dr. Vinod Malhotra Shows the Way
August 03, 2010 |
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August 3, 2010
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An Efficient OR is a Safe OR: Dr. Vinod Malhotra Shows the Way
See Dr. Malhotra at OR Excellence
Can Patient Safety and OR Efficiency Co-Exist?
Thursday, Oct. 28
8:00 a.m. to 9:15 a.m.
Contrary to conventional wisdom, safety measures don't have to slow OR efficiency, and efficiency doesn't have to threaten surgical safety. In fact, they're 2 sides of the same coin, says Vinod Malhotra, MD. "Patient safety plus efficiency, together they contribute to the overall quality of care."
That's a formula Dr. Malhotra has honed in the more than 30 years he's spent as a practicing anesthesiologist at New York-Presbyterian Hospital. Boasting 23 inpatient ORs, 17 ambulatory ORs and another 18 rooms where interventional procedures are performed, the New York City teaching hospital seeks efficiency not as a luxury, but as a key to survival. Dr. Malhotra has served as its clinical director of operating rooms since 1995, and overseeing a facility that hosts 30,000 OR cases and 28,000 out-of-OR interventions annually has taught him a thing or 2 about what it takes to strike a balance between safety and efficiency, which he shares through lectures nationwide.
First, he explains, you must understand efficiency as more than just going faster. "Efficiency is not rushing things and making decisions in haste," he says. "Rather, it's a careful, planned response to events as they unfold during the day."
For example, consider the pre-op time out. When the concept was introduced at New York-Presbyterian, "initially it was seen as more busywork by some of our colleagues," admits Dr. Malhotra, who also serves as a professor of clinical anesthesiology at Weill Cornell Medical College in New York. But through collaboration with surgeons, anesthesia providers and nursing staff, administrators were able to draft a time out protocol that not only reduced the risk of errors, but also enhanced efficiency by ensuring that the surgical team had all the supplies, equipment and information they needed for a smooth case.
Another effort that plays roles in both efficiency and safety is standardization. A few years ago, Dr. Malhotra found that the hospital used as many as 8 different mixtures of local anesthetics in several different strengths to cover physicians' preferences. This wide range of options created both efficiency and safety concerns, as it was more difficult for staff to locate the right combination and easier for them to accidentally pick up the wrong mixture or strength.
"Standardization [of anesthesia drugs] makes it easier to stock, easier to find, safer for the patient and more efficient because you don't have to look for all different types of combinations," says Dr. Malhotra, who eventually whittled the hospital's choices down to 2 drug mixtures.
In implementing such strategies, he says, it's important to understand not only the processes that contribute to safety and efficiency in the OR, but also the people who must carry out those processes on a day-to-day basis. "Some of the changes require a cultural change or a behavioral change, and they might not be met with full enthusiasm up front," he says. The best way to overcome that hurdle? "Engage individuals in conversations and discussions about the changes you're making. Make them a part of the decision-making process - that goes a long way."
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| | Breeze Up to Yachting in Ft. Lauderdale: World's Largest Boat Show Coincides With OR Excellence
Ft. Lauderdale is known as the "Yachting Capital of the World," but there will be more yachts around than usual when OR Excellence is in town, and bigger ones, too. The Ft. Lauderdale International Boat Show will be taking place in 4 marinas along the Intracoastal Waterway and at the Broward County Convention Center from Oct. 28 through Nov. 1, providing a unique opportunity for ORX attendees.
Last year about 100,000 people checked out yachts more than 200 feet in length, enjoyed cocktails and took in concerts on barges while learning about the latest boats and gear for fishing, diving and recreational sailing. Dozens of seminars on marine topics and fishing clinics are given during the boat show. The big draw, of course, is the luxury yachts open to the public. If you go, make sure you wear easily removable shoes, as you'll have to take them off to board most of the boats.
The huge yachts on display, and for sale, will include Cakewalk, a 281-foot classic design that features luscious wooden brightwork evoking the golden age of yachting. (It's also the largest yacht built in the United States since the 1930s.) The largest and fastest aluminum sailing yacht in world, the 201-foot Felicita West, will also be docked on the waterway. For those interested in smaller, more affordable boats, hundreds of runabouts, cabin cruisers, jet boats and fishing boats will be on display as well.
The Ft. Lauderdale International Boat Show takes place takes place at the Bahia Mar Yachting Center, Hall of Fame Marina, Las Olas Municipal Marina, Hilton Fort Lauderdale Marina and Broward County Convention Center. Hours and ticketing information are available on its website, and an OR Excellence discount will be available.
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| | Questions from the 2009 ORX Tournament of Champions
15. Which of the following should NOT be used to extinguish an OR fire?
a. water
b. fire blanket
c. saline
d. carbon dioxide fire extinguisher
Correct answer: b
16. During monopolar electrosurgery, dispersive electrodes should be placed on patients:
a. in pre-op
b. in the OR, before patients are positioned
c. in the OR, after patients are positioned
Correct answer: c
Don't miss the 2010 OR Excellence Tournament of Champions
Thursday, Oct. 28
10:15 a.m. - 11:15 a.m.
Your knowledge of surgical facility management issues will be put to the test when you team up with your peers for a fun, interactive game-show-like competition hosted by John D. Kelly, MD, an orthopedic surgeon and stand-up comic from the University of Pennsylvania. Education, pride and some great prizes will be on the line. |
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