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Lean principles to optimize instrument utilization for spine surgery in an academic medical center: an opportunity to standardize, cut costs, and build a culture of improvement

  • September 15, 2017
Lunardini D, Arington R, Canacari EG, Gamboa K, Wagner K, McGuire KJ. Published in September 2016 in Spine Abstract STUDY DESIGN: Case study OBJECTIVE.: To optimize the utilization of operating room instruments for orthopedic and neurosurgical spine cases in an urban level 1 academic medical center through application of Lean principles. SUMMARY OF BACKGROUND DATA: Process improvement systems such as Lean have been adapted to health care and offer an...

Disruptions love company: Investigating flow disruption clusters in robotic surgery

  • July 11, 2017
Originally Published By Samuel A. Curtis, January 2017 Assessment of the safety and efficiency of new technologies in the operating room (OR) is critical, as an increasing number of technologies are adopted every year. An effective metric in system performance in the OR is the measurement of flow disruptions (FDs), defined as any deviation from...

Application of Lean Methodology for Improved Quality and Efficiency in Operating Room Instrument Availability

  • April 20, 2017
Farrokhi FR, Gunther M, Williams B, Blackmore CC. Published in Sept-Oct 2015 in Journal for Healthcare Quality Abstract Advances in surgical instrumentation allow surgeons to treat patients with less morbidity and shorter recovery time. However, the increasing complexity also adds to surgical risk, and to operating room supply chain burden. To improve the quality and...

Costs associated with instrument sterilization in gynecologic surgery

  • April 20, 2017
Van Meter MM, Adam RA. Published in November 2016 in American Journal of Obstetrics & Gynecology Abstract BACKGROUND: With rising health care expenditures, hospitals must contain costs in ways that maintain high-quality patient care. A significant portion of perioperative costs are associated with materials and supplies; many reusable instruments on surgical trays go unused, which...

Surgical instrumentation: the true cost of instrument trays and a potential strategy for optimization

  • April 20, 2017
Mhlaba JM, Stockert EW, Coronel M, Langerman AJ. Published in 2015, Vol. 4, No. 6, in Journal of Hospital Administration Abstract Objective: Operating rooms (OR) generate a large portion of hospital revenue and waste. Consequently, improving efficiency and reducing waste is a high priority. Our objective was to quantify waste associated with opened but unused...

A pilot study to assess the adequacy of the Brigham 20 Kit for cesarean delivery

  • April 20, 2017
Greenberg JA, Wylie B, Robinson JN. Published in May 2012 in International Journal of Gynecology & Obstetrics Abstract OBJECTIVE: To determine whether a kit of only 20 instruments could be used to perform cesarean deliveries in a consistently safe manner for the purpose of providing better surgical instruments to healthcare providers in limited-resource environments. METHODS:...

A prospective study of patient safety in the operating room

  • April 20, 2017
Christian CK, Gustafson ML, Roth EM, Sheridan TB, Gandhi TK, Dwyer K, Zinner MJ, Dierks MM. Published February 2006 in Surgery Abstract BACKGROUND: To better understand the operating room as a system and to identify system features that influence patient safety, we performed an analysis of operating room patient care using a prospective observational technique....

Comparison of economic and environmental impacts between disposable and reusable instruments used for laparoscopic cholecystectomy

  • April 20, 2017
Adler S, Scherrer M, Rückauer KD, Daschner FD. Published February 2005 in Surgical Endoscopy And Other Interventional Techniques Abstract BACKGROUND: The economic and environmental effects were compared between disposable and reusable instruments used for laparoscopic cholecystectomy. Special consideration was given to the processing of reusable instruments in the Miele G 7736 CD MCU washer disinfector...

How hospitals could be rebuilt, better than before

  • April 14, 2017
The Economist, April 8, 2017 Technology could revolutionize the way they work. IN A nondescript part of Cleveland, in a room known as the bunker, a doctor, nurses and medical technicians gather to keep watch over 150 patients in special-care units and intensive-care beds. Their patients are scattered around the region, in clinics that have...

Improving efficiency in the operating room

  • March 29, 2017
Surgeons need to document the timing of all steps in the operating room to become more efficient. Ocular Surgery News U.S. Edition, March 25, 2017 Uday Devgan, MD New ophthalmology residents sometimes mistakenly think that performing a surgery quickly is the key to doing more cases in a day. On the contrary, rushing a surgical...

Surgeon–patient communication during awake procedures

  • March 26, 2017
Claire S. Smith, M.F.A., Kristina Guyton, M.D., Joseph J. Pariser, M.D., Mark Siegler, M.D., Nancy Schindler, M.D. M.H.P.E., Alexander Langerman, M.D. S.M., F.A.C.S. DOI:http://dx.doi.org/10.1016/j.amjsurg.2016.06.017 Highlights •Surgeons make use of diverse strategies for communication during awake procedures. •The awake patient’s presence impacts surgeons’ communication with staff and trainees. •Surgeons describe challenges in balancing teaching and maintaining...

Going Under the Knife, with Eyes and Ears Wide Open

  • March 26, 2017
The article explores the issues surrounding performing surgical procedures with patients awake and alert to, and in some cases able to see, what is happening. Alex Langerman, Explorer’s Co-founder, is the Senior author of a study titled, Surgeon-patient communication during awake procedures, along with Dr. Mark Siegler, Director of the University of Chicago’s MacLean Center...

To Your Health – How Do You Make the OR Lean?

  • March 15, 2017
Originally Published by Chicago Booth Magazine – Winter, 2017 Written By Debbie Carlson The Challenge: While over the years digital tools have been introduced to streamline presurgery and postsurgery processes, the operating room itself is still largely managed on paper. During surgery, workflow and efficiency often take a backseat to traditional methods and the processes...

Four Areas of Savings are Underutilized or Overlooked by Hospitals

  • February 18, 2017
We were excited to read the Advisory Board’s recent research note that Hospitals may underestimate or overlook four areas of cost savings, including (as noted by Jenna Koppel): Unfavorable contract terms. Supplies and purchased services are a growing portion of total hospital costs, and can account for a big portion of avoidable costs. Outdated care protocols....

The Case for Build-to-Order Instrument Sets

  • February 15, 2017
We were excited to see an article recently in Outpatient Surgery Magazine heralding the benefits of build-to-order instrument sets. At Explorer, we see the value of reducing instruments per tray and tray sets play out daily. As the article aptly points out, there’s enormous value to be captured here including: Increased ease of assembly and...

Operating Room Inefficiencies and Costs – A White Paper Summarizing ExplORer’s Findings

  • February 7, 2017
By Dr. Alex Langerman and CEO Jennifer Fried. Hospital and healthcare systems are under increasing pressure to reduce costs due to declining reimbursement, new payment systems such as accountable care organizations, and the increase in high- copayment insurance plans resulting in comparison shopping by patients. Bundling of payments by Medicare and private insurers as well...

Efficiency Improvement in the Operating Room – A Synopsis of Published Efforts

  • January 27, 2017
Abigail J. Fong, MBA,a,b Meghan Smith, MBA,a,c and Alexander Langerman, MD, SMa,c,* a University of Chicago Operative Performance Research Institute, Chicago, Illinois b Pritzker School of Medicine, University of Chicago, Chicago, Illinois c Department of Surgery, Section of OtolaryngologydHead and Neck Surgery, University of Chicago, Chicago, Illinois Hospitals and health systems must focus on improving...

Wastage of Medical Supplies and Drugs in the Operating Room

  • October 10, 2016
PUBLISHED October 21, 2009 by Medscape Anyone visiting an operating room would be impressed by the staggering amount of garbage produced even after a simple 90-minute surgery. In fact, a routine operation in a hospital often produces more waste than a family of 4 might produce in an entire week. One reason operating rooms generate...

Assessing the magnitude and costs of intraoperative inefficiencies attributable to surgical instrument trays.

  • October 10, 2016
Published October, 2014 Efficiency in the operating room has become a topic of great interest. This study aimed to quantify the percent use of instruments among common instrument trays across 4 busy surgical services: Otolaryngology, Plastic Surgery, Bariatric Surgery, and Neurosurgery. We further aimed to calculate the costs associated with tray and instrument sterilization, as...
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