scholarly journals Period Prevalence of Ketamine-Propofol Admixture “Ketofol” in the Operating Room among Anesthesia Providers at an Academic Medical Center

2015 ◽  
Vol 21 ◽  
pp. 1737-1744 ◽  
Author(s):  
Nathan J. Smischney
Keyword(s):  
Operating Room ◽  
Medical Center ◽  
Academic Medical Center ◽  
Period Prevalence ◽  
Anesthesia Providers ◽  
Academic Medical

First-case tardiness reduction in a tertiary academic medical center operating room: A lean six sigma perspective

2016 ◽  
Vol 5 ◽  
pp. 7-12 ◽  
Author(s):  
Pedro Ramos ◽  
Eloisa Bonfá ◽  
Patrícia Goulart ◽  
Marion Medeiros ◽  
Nélson Cruz ◽  
...  
Keyword(s):  
Operating Room ◽  
Six Sigma ◽  
Medical Center ◽  
Academic Medical Center ◽  
Lean Six Sigma ◽  
First Case ◽  
Academic Medical

scholarly journals Returns to Operating Room After Neurosurgical Procedures in a Tertiary Care Academic Medical Center: Implications for Health Care Policy and Quality Improvement

Neurosurgery ◽  
2018 ◽  
Vol 84 (6) ◽  
pp. E392-E401
Author(s):  
Panagiotis Kerezoudis ◽  
Amy E Glasgow ◽  
Mohammed Ali Alvi ◽  
Robert J Spinner ◽  
Fredric B Meyer ◽  
...  
Keyword(s):  
Health Care ◽  
Quality Improvement ◽  
Operating Room ◽  
Health Care Policy ◽  
Medical Center ◽  
Academic Medical Center ◽  
Tertiary Care ◽  
Neurosurgical Procedures ◽  
Care Policy ◽  
Academic Medical

Assessing the Workplace Culture and Learning Climate in the Inpatient Operating Room Suite at an Academic Medical Center

2019 ◽  
Vol 76 (3) ◽  
pp. 644-651
Author(s):  
Pedro Tanaka ◽  
Natalya Hasan ◽  
Anita Tseng ◽  
Chinh Tran ◽  
Alex Macario ◽  
...  
Keyword(s):  
Operating Room ◽  
Medical Center ◽  
Academic Medical Center ◽  
Workplace Culture ◽  
Learning Climate ◽  
Academic Medical

scholarly journals An Ophthalmology Resident-Led Quality Improvement Initiative to Decrease the Incidence of Perioperative Corneal Injury

2019 ◽  
Vol 11 (02) ◽  
pp. e49-e53
Author(s):  
Amanda L. Ely ◽  
Mark Goerlitz-Jessen ◽  
Ingrid U. Scott ◽  
Erik Lehman ◽  
Tabassum Ali ◽  
...  
Keyword(s):  
Risk Factors ◽  
Quality Improvement ◽  
Chart Review ◽  
Medical Center ◽  
Academic Medical Center ◽  
Retrospective Chart Review ◽  
Corneal Injury ◽  
Surgical Case ◽  
Anesthesia Providers ◽  
Academic Medical

Abstract Objective This article evaluates the effectiveness of an ophthalmology resident-led quality improvement (QI) initiative to decrease the incidence of perioperative corneal injury at an academic medical center Design Retrospective chart review. Methods A retrospective chart review was conducted of all surgical cases performed 6 months prior to, and 6 months after, implementation of an ophthalmology resident-led QI initiative at an academic medical center. The QI initiative (which focused on perioperative corneal injury awareness, understanding of risk factors, and presentation of an algorithm designed to prevent perioperative corneal injury) consisted of a lecture and distribution of educational materials to anesthesia providers. Data collected through the chart review included type of surgical case, presence of diabetes mellitus or thyroid disease, patient age and gender, patient positioning (supine, prone, or lateral), level of anesthesia provider training, length of surgical case, surgical service, type of anesthesia, and type (if any) of perioperative eye injury. The rates of perioperative corneal injury pre- versus post-initiative were compared. Results The rates of perioperative corneal injury pre- and post-initiative were 3.7 and 1.9 per 1,000, respectively (p = 0.012). Significant risk factors for perioperative corneal injury include longer duration of surgery (odds ratio [OR] 90–180 vs. < 90 minutes = 4.18, 95% confidence interval [CI] 1.43–12.18; OR > 180 vs. < 90 minutes = 8.56, 95% CI 3.01–24.32; OR > 180 vs. 90–180 = 2.05, 95% CI 1.17–3.58), patient position lateral > prone > supine (OR prone vs. lateral = 0.25, 95% CI 0.09–0.67; OR supine vs. lateral = 0.13, 95% CI 0.07–0.23), nonhead and neck surgeries (OR = 0.32, 95% CI 0.11–0.87), and surgery performed under the general surgery service (OR general surgery service vs. other subspecialty services = 6.50, 95% CI 2.39–24.76). Conclusions An ophthalmology resident-led QI initiative consisting of educating anesthesia providers was associated with a significant decrease in the rate of perioperative corneal injury.

A Successful Organized Effort to Improve Operating Room First-Case Starts in a Tertiary Academic Medical Center

2020 ◽  
pp. 000313482095143
Author(s):  
Melissa M. J. Chua ◽  
Keith Lewis ◽  
Yi-An Huang ◽  
Mary Fingliss ◽  
Alik Farber
Keyword(s):  
Operating Room ◽  
Medical Center ◽  
Academic Medical Center ◽  
Or Efficiency ◽  
Patient Dissatisfaction ◽  
Real Time Measurement ◽  
First Case ◽  
Academic Medical ◽  
Improve Operating Room ◽  
Operational Plan

Background Operating room (OR) inefficiency drives up cost, decreases revenue, and leads to surgeon, staff, and patient dissatisfaction. Given a low mean first-case start rate in our tertiary academic medical center, we developed a process to improve first-case start rates in an effort to increase OR efficiency. Methods A working group of the OR Executive Committee was constituted to develop and implement a multistep operational plan. This plan was predicated on a sensible staggered start framework, coordination of stakeholder responsibilities, a visual preoperative Stop/Go checklist tool, real-time measurement, and feedback. Results Within 11 days of implementation, 95% of first-start OR cases were tracked to start on time. Throughout the observation period (May 2015-July 2016), the goal of a daily mean 80% on-time start rate was either met or exceeded. Conclusions Implementation of an organized collaborative effort led to dramatic improvements in first OR case on-time rates. Such improvement in OR utilization may lead to an increase in staff and patient satisfaction and cost reduction.

Successful strategies for the reduction of operating room turnover times in a tertiary care academic medical center

2014 ◽  
Vol 187 (2) ◽  
pp. 403-411 ◽  
Author(s):  
Bhavani S. Kodali ◽  
Dennie Kim ◽  
Ronald Bleday ◽  
Hugh Flanagan ◽  
Richard D. Urman
Keyword(s):  
Operating Room ◽  
Medical Center ◽  
Academic Medical Center ◽  
Tertiary Care ◽  
Academic Medical

Curtailing Unnecessary Waste Among Operating Room Personnel: Evaluating the Cost Awareness of Commonly Used Surgical Items

2021 ◽  
pp. 000313482199507
Author(s):  
Adee J. Heiman ◽  
Lauren Camargo ◽  
Deepa Bhat ◽  
Vilok Desai ◽  
Ashit Patel ◽  
...  
Keyword(s):  
Global Education ◽  
Medical Center ◽  
Academic Medical Center ◽  
Operating Room Personnel ◽  
Knowledge Deficit ◽  
Anesthesia Providers ◽  
Academic Medical ◽  
Ancillary Staff ◽  
The Cost ◽  
Cost Awareness

Background Operating rooms (ORs) generate 70% of hospital waste, leading to increased costs for the hospital, patient, and the environment. The lack of cost awareness among physicians has been well documented; however, there is little information on anesthesiologists or ancillary OR staff. This study aimed to evaluate the cost awareness of commonly used items at an academic medical center among OR personnel. Methods Anonymous surveys were distributed to OR personnel (nurses, surgical technicians (STs), nurse anesthetists, anesthesiologists, surgeons, and residents), asking for the estimated costs of ten commonly used items. These costs were then compared against actual costs to evaluate the accuracy of participants’ estimates. Responders were clustered by job, highest level of education, and years of experience for comparison. Results 167 surveys were collected, and overall only 16.4% of estimates were accurate within 50% of actual price. No significant differences in accuracy between groups were identified overall ( P = .2), but both surgical and anesthesia attendings had significantly higher rates of correct responses than their respective residents. No difference was seen in accuracy when all attendings (surgeons and anesthesiologists) were compared with either nurses or STs. Linear regression demonstrated no correlation between number of years at current position or years at institution and number of correct responses ( R2 = .0025 and R2 = .005, respectively). Discussion Addressing the knowledge deficit around item costs via global education of all OR personnel (surgeons, anesthesia providers, and ancillary staff) could be a viable pathway to reduce waste, and thus cost, for our healthcare system.

scholarly journals Effects of Intraoperative Reading on Vigilance and Workload during Anesthesia Care in an Academic Medical Center

2009 ◽  
Vol 110 (2) ◽  
pp. 275-283 ◽  
Author(s):  
Jason M. Slagle ◽  
Matthew B. Weinger
Keyword(s):  
Medical Records ◽  
Medical Center ◽  
Academic Medical Center ◽  
Direct Patient Care ◽  
General Anesthetic ◽  
Task Distribution ◽  
Anesthesia Providers ◽  
Academic Medical ◽  
Random Intervals ◽  
Manual Tasks

Background During routine cases, anesthesia providers may divert their attention away from direct patient care to read clinical (e.g., medical records) and/or nonclinical materials. The authors sought to ascertain the incidence of intraoperative reading and measure its effects on clinicians' workload and vigilance. Methods In 172 selected general anesthetic cases in an academic medical center, a trained observer categorized the anesthesia provider's activities into 37 possible tasks. Vigilance was assessed by the response time to a randomly illuminated alarm light. Observer- and subject-reported workload were scored at random intervals. Data from Reading and Non-Reading Periods of the same cases were compared to each other and to matched cases that contained no observed reading. The cases were matched before data analysis on the basis of case complexity and anesthesia type. Results Reading was observed in 35% of cases. In these 60 cases, providers read during 25 +/- 3% of maintenance but not during induction or emergence. While Non-Reading Cases (n = 112) and Non-Reading Periods of Reading Cases did not differ in workload, vigilance, or task distribution, they both had significantly higher workload than Reading Periods. Vigilance was not different among the three groups. When reading, clinicians spent less time performing manual tasks, conversing with others, and recordkeeping. Conclusions Anesthesia providers, even when being observed, read during a significant percentage of the maintenance period in many cases. However, reading occurred when workload was low and did not appear to affect a measure of vigilance.

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