The Department of Veterans Affairs' Nsqip

Communication: Today I had the pleasure of being in both the pre-operative and post-operative units. Communication within the members of both the teams were very efficient. I noticed the nurses work much more independently and focus more on one on one patient care. However, the nurses in pre-op did communicate a great deal with members of the surgical team. The nurses would call and inform the surgical team when a patient was prepared to enter surgery. Also, the surgical team would contact the pre-op nurses regularly to give them an update on how procedures were going in the OR. For example, if a surgeon was ahead of schedule they would contact the pre-op nurses to inform them that they could begin preparing the next patient ahead of time. Or vice versa, in cases that the surgeon was behind schedule. On the other hand, in post-op the nurse was also very independent. She would wait for a phone call from the PACU nurse, to receive a quick SBAR report of the patient just a few minutes before the patient was transferred. Via the telephone, the PACU nurse would inform the post-op nurse of current vitals, along with the types of anesthetics the patient received and outcomes of the procedure. Mainly, the nurses communicated with the patient and their family. Along with performing full body assessments, the pre-op nurses spent most of their time asking patients detailed questions regarding their health history, current health status, and use of medications. In addition, the pre-op

* Personnel Issues: One of the key barriers to effective interaction for the pre-op nurses is that they are not getting any information from the registrar or the surgeon related to the patients unique circumstances. There is not a communication process in place for the pre-op nurse to actively communicate with the surgeon or his office regarding a patient’s care during their day of surgery. An additional factor in this situation was the pre-op nurse documented the mother’s contact information in her notepad, but not on the

B. Experiment with new ways of carrying out a function: Incorporate Time-Out into Electronic Medical Records (EMR).

Texas Health Harris Methodist–Cleburne is one of the top performers in the country on the surgical care process-of-care measures, often referred to as the "core" or Surgical Care Improvement Project (SCIP) measures. The measures, developed by the Hospital Quality Alliance and reported to the Centers for Medicare and Medicaid Services (CMS), relate to achievement of recommended treatment in four clinical areas: heart attack, heart failure, pneumonia, and surgical care. In addition to its high performance on surgical measures, Texas Health is performing in at least the top 15th percentile in these other areas. This case study focuses on Texas Health 's achievement in providing recommended treatment related to surgical care. The hospital has

With the increasing popularity of physician "scorecards" that are so easily located online, there has been some concern as to whether they represent an accurate picture of the physician to whom the report card belongs. While it is certainly important to know about the physician one is going to see, the scorecards may not be fair and balanced. More people complain when something goes wrong than praise when something goes right (Survey, 2011). Because that is the case, the scorecards often include ratings from people who were less than satisfied with the physician while not including anything from those who thought the physician was adequate or even above average. Certainly some people who were happy with the service provided will mention it, but the percentage is much lower than those who will go online to complain about a physician and "warn" other people not to use his or her services (Survey, 2011). This is well worth considering when looking at physician scorecards.

Medical errors are the third-leading cause of death in the U.S., yet many hospitals and healthcare networks in the United States currently lack non-punitive incentives to change and are failing to actively seek to improve the quality of their services. An example of this is surgical errors. The Joint Commission (2017) provides numerous resources, checklists, universal protocols, and sentinel event alerts related to surgical errors, yet these events cost nearly $20 billion annually in the U.S. (Luthra, 2015). At Texas Health Resources (THR) alone, the state’s largest healthcare delivery institution, 1,820 patients had one or more preventable surgical complications in 2010, quadrupling their median length

In the health care system, patients put their trust and confidence in the hands of qualified medical professionals to properly handle all of their needs. Patient safety is an area that will continue to be explored and evaluated for improvement. In any clinical setting, it is imperative that proper diagnosis followed by an effective treatment plan is executed in a manner consistent with reducing the chance of mistakes being made. In the perioperative clinical environment the patient usually cannot speak for themselves due to being sedated. Therefore it is critically important to have a process in place to lessen or eliminated the possibility of performing the wrong surgery on the patient. The National patient safety

Zegers et al. (2011) conducted an applied, cross-sectional, quantitative study measuring the cause and the degree of prevention over surgical adverse events (AEs). Retrospective data was collected from random sampling of 7926 patient records within 21 different Dutch hospitals and reviewed for AEs by 2 expert panels then further analyzed with SPSS 14.0 statistical software program. Study findings of surgical AEs accounted for 3.6% of overall hospital admissions and represented 65% of all AEs. Causation of 65% of the

Though confusions are more likely to happen in emergency operations, the Joint Commission on Accreditation of Health Care Organizations (JCAHO) reported that 58% of surgical confusion occurred in ambulatory patients and 29% involved inpatients. Wrong site confusions occurred in 76% of cases, wrong patient in

Summary: The Bosk reading Error, Rank, and Responsibility is about the professionalization of surgical residence in the United States.

Surgery complications and adverse events resulting from procedures done on the wrong site or patient are a significant patient safety concern. The World Health Organization initiated a surgical checklist to be used as a basis for all surgical procedures within the hospital in 2008. The checklist is intended to reduce the number of deaths resulting from surgical procedures across the world (The World Health Organization, 2008a). This initiative was intended to harness clinical will in addressing vital safety issues like poor communication, surgical infection, and inadequate anesthetic safety practices. These safety issues had proven to be deadly, preventable, and common in all countries. The checklist was developed in consultation with nurses, surgeons, patient safety experts, patients, and anesthesiologists around the world. The WHO checklist is not a component of official policy or regulatory device, but it is intended to be used as a tool for clinicians who want to improve their operations safety and reduce unnecessary surgical complications and deaths (Reynolds & Stevenson, 2009). The checklist developed by the WHO is not comprehensive. WHO encourages modifications and additions in order for it to fit the local practice. The surgical checklist will assist any organization to formulate a surgical policy, which will ensure that the surgical team is certain of the procedures, site, and patient before the surgery begins. Making use of

Despite the difference and no matter what phase of surgery the patient is in, the quality and continuum of care is extremely crucial. Kang (2015) states that, “Ineffective handoffs are known to contribute to gaps in nursing care of patients safety.” “The connection between ineffective communication and errors in the OR has been long recognized (Kang 2015).” Between prep carried out by perioperative nurses and safety/comfort tasks carried out by intraoperative nurses, goals of each surgery facility are the same. As long as each nurse is carrying out the duties specific to their particular facility, the patients continuum of care should not be a problem and safety of the patient will be maintained. Kang’s article explains the role of the intraoperative nurse and what downfalls can potentially lead to problems during surgery. Inpatient and single day surgeries may have slight differences in the role of each nurse, but it is what works best for that particular facility to run the smoothest for the procedures that are being

Operating the theatre is very costly so it is vital to manage the surgeon’s list efficiently; moreover, it should ensure safety and quality in care (Rymaruk, & Buch 2015). The surgeon's list comprises of the cases that has to be performed through the day. It is the foundation of the proper functioning of the operating room (Gore 2016). This essay will discuss the issues relating to the list management which includes the scheduling of the list, skill mix and staffing, resource management and challenges. Poor management, from any previously mentioned issues, leads to delays that impact the patient’s health, and increase the workload for staff (Higgins et al. 2011). It can also contribute to the increase in hospital budget with operational theatre

Understanding of the dangers of surgery is essential for both patients and specialists in the decision making process(Bilimoria et al., 2013). For this dialog to happen, the surgeon must know about patient- and operation-specific risk factors, national benchmarks, also, individual and additionally institutional result information. (Lyle et al., 2016). In addition, clinicians and patients additionally require data with respect to surgical dangers in order to make decisions on the kind of surgery or whether surgery ought to be performed at all(Bilimoria et al., 2013). However these facts have historically been informed by physicians experience increased by limited descriptive data, patients and physicians needs more detailed, accurate risk information(Cohen

The response rate of the camp has improved. From 15% earlier, 83% of the people now are taking surgery when advised to do so.