We are excited to announce Southeast Ane

We are excited to announce Southeast Anesthesiology Consultants and Southeast Pain Care, are joining American Anesthesiology. Our parent company is changing, but our physicians are not. Therefore, patients can continue to rely on their personal physician to provide the same great care they have always received. Read more here: http://bit.ly/alh60t

For Urgent and Emergent Cases, Which One Goes to the OR First? – Summary by Jerry Ippolito

When several patients needing urgent or emergent surgery require use of an OR at the same, who decides which case goes to the OR first? For true emergencies, the decision is generally straightforward, with the patient rushed into the first available room. In many instances, however, the decision is not as clear. Should the patient with an open fracture go first? Should it be the patient with an ectopic pregnancy or perhaps the patient with an intestinal obstruction? Does the most senior surgeon get the first available OR slot? Should the decision be made on the basis of first-come, first-served? Or maybe the most assertive surgeon gets his or her case in first? Often the decision falls to the anesthesiologist of the day in the OR. Bu no matter who makes the decision, the competition between surgeons and arguments with anesthesiologists causes frustration. At times patients end up waiting for surgery longer than is clinically. Ideally, the decision should be base on an objective measure that reflects the clinical needs of the patient and gives surgeons, anesthesiologists and OR staff a predictable and fair system for prioritizing cases. Using a classification system for urgent surgery (such as the main article) also is the first step toward improving the flow of patients through the organization. Because the OR is the hub of inpatient flow, streamlining flow through the OR will also improve flow through the organization.

The complete article can be found in the July 2010 issue of OR Manager or at www.ORmanager.com

Greening of the OR – Summary by Jerry Ippolito

The Greening of the OR, a national effort to reduce surgery’s big environment was launched in May 2010 by Practice Greenhealth.  The 2-year old nonprofit claiming 1,000 hospital members, sees the OR as a major target for making healthcare more sustainable.

“ORs are the largest waste generators in the hospital.  We are examining a range of interventions for reducing the environmental impact,” says Mary Lisi, Practice Greenhealth spokesperson.

Some areas Practice Green-health is targeting for greener OR practices include:

• Single-use device reprocessing. Reprocessing of devices designated by the original manufacturer as disposable can be reprocessed safely under food and Drug Administration-approved processes, yielding cost savings and reducing waste
• Reusable vs disposables. Practice Greenhealth says it’s time to reconsider whether reusables may be superior to disposable gowns, drapes, basins, and similar items, noting that reusable materials have improved, and cost-benefit analysis now points back in the direction of reusables
• OR supply packs. Often, preassembled supply kits have items that aren’t used and are thrown away.  Some organizations have set up regular processes to review their pack contents
• Waste anesthetic gas scavenging. New systems are being developed that go beyond current scavenging methods to collect exhaled anesthetic so it can be recycled, potentially preventing worker exposure and emissions
• Fluid waste management.  Fluid management systems that can be hooded directly to the sanitary sewer represent a green advantage over suction canisters that either require solidifiers for disposal as regulated medical wastes or manual emptying

The complete article can be found in the July 2010 issue of OR Manager or at www.ORmanager.com

Steps for Developing and Implementing New Block Scheduling Rules – Summary

1. Establish a multidisciplinary and collaborative task-force comprised on surgeons, anesthesiologists, OR management and hospital administration
2. Review the current policies for scheduling cases and managing the block schedule.  Determine what the new policies should be
3. Propose new policies and gain consensus of the Surgical Services Executive Committee (e.g. OR Committee).
4. Meet with a core group of surgeons and anesthesiologists who maintain a vested interest in supporting the “total business” not just “their business”.  Introduce the new policies and elicit ideas and comment
5. Revise the policies, as appropriate, based on the input of the “core” group and publish the final policies
6. Present the new policies to the entire surgical medical staff; invite comment; inform the group when the policies will go into effect.  At least three months lead time is required for the surgeons to adjust office schedules.
7. Present the new policies to surgeons office managers and perioperative staff
8. Continue meeting with surgeons’ offices over the following several months to assure complete and accurate understanding
9. Implement keeping in mind that at least three months is required between the announcement date and implementation date

The complete article on block scheduling can be found in the publication July 2010 issue of OR Manager or at www.ORmanager.com

Southeast Anesthesiology Consultants provides you with the ability to staff your anesthesiology program, and can assist you in improving overall perioperative service efficiencies. By contracting with SAC, you can capitalize on our medical expertise to provide you program development, management, staffing and consulting in the following areas:
• Anesthesiology
• Pain Management
• Quality Initiatives
• Perioperative Services

Learn more about our services at www.seanesthesiology.com

Anesthesiology Shortage – Rand Corporation Study Highlights

A recent study by the Rand Corporation found:

• The current supply of anesthesiologists would have to increase by 3.800 to meet US demand
• The current supply of CRNAs would have to increase by 1,282 to meet US demand
• 54% of states have a shortage of anesthesiologists
• 60 % of states have a shortage of CRNAs
• Overall, a national shortage of anesthesiologists is “highly likely”
• If past trends hold, a shortage of anesthesiologists and surplus of CRNAs Is projected by 2020

July 2010,  OR Manager, www.ORmanager.com.

RT @amednews: Physician smartphone popul

RT @amednews: Physician smartphone popularity shifts health IT focus to mobile use http://bit.ly/cznPIy

What support surfaces are ORs using? – Summary by Jerry Ippolito

What support surfaces are ORs using? – Original Article Printed in OR Manager April 2010

Results of an informal survey of 51 Minnesota hospitals indicate:

What criteria does your hospital use to determine if a patient is at high risk for pressure ulcer development in the OR?

• Braden assessment  38%
• Length of procedure  26 %
• No criteria  23%
• Patient characteristics  15  %
• Braden assessment plus other criteria  13%
• Not applicable as lengthy procedures are not performed  5%

Support surfaces used in OR for patients not at risk for pressure ulcer development

• Standard OR mattress  61%
• Mattress with pressure redistribution properties beyond standard surface  39%

For patients deemed at high risk for pressure ulcer development

• Standard OR mattress  44%
• Mattress with pressure redistribution properties beyond standard surface

Surgical site infection rate data – Summary by Jerry Ippolito

Surgical site infection rate data – Original Article Appeared in OR Manager

The Centers for Disease Control and Prevention (CDC) collects and reports SSI data through the National Healthcare Safety Network (NHSN).  Facilities volunteer to participate and submit infection data in a standardized manner.

The latest report for 2006-2008is posted at www.cdc.gov/nhsn/index.html with the SSI rates reported in Table 22 by procedure code

If you want to compare your facility’s SSI rates and ratios with those of NHSN, the CDC indicates that you must collect your data according to the method described by NHSN

NHSN uses a risk index that assigns surgical patients to categories based on 3 major risk factors:

1. Duration of procedure
2. Wound class: Contaminated (Class 3) or dirty/infected (Class 4)
3. ASA classification of 3, 4 or 5, referring to the American Society of Anesthesiologists physical status

Learn how SAC helps prevent surgical site infection by monitoring antibiotic protocols through our proprietary QA measurement tool called – Quantum Clinical Navigation System. www.seanesthesiology.com

Southeast Anesthesiology Consultants provides you with the ability to staff your anesthesiology program, and can assist you in improving overall perioperative service efficiencies. By contracting with SAC, you can capitalize on our medical expertise to provide you program development, management, staffing and consulting in the following areas:
• Anesthesiology
• Pain Management
• Quality Initiatives
• Perioperative Services

Learn more about our services at www.seanesthesiology.com

Sepsis, pneumonia after surgery takes heavy toll in lives and costs – Summary by Jerry Ippolito

Sepsis, pneumonia after surgery takes heavy toll in lives and costs

Two common hospital acquired conditions, sepsis and pneumonia killed 48,000 patients and cost $8.1 billion in 2006 alone, according to a large national study.

In a separate analysis of outcomes associated with surgery, the researchers found that nearly 20% of patients who developed a sepsis after surgery died as a result.  Patients with sepsis stayed in the hospital 22 days longer at an extra cost of $33,000 per person.

Patients who developed postoperative pneumonia were in the hospital for an extra 14 days at a cost of $46,000.  In 11% of cases, patients died from pneumonia.

According to Ramanan Laxminarayan, PhD, one of the study’s authors, “In many cases, these conditions could have been avoided with better infection control in hospitals.  The nation urgently needs a comprehensive approach to reduce the risk posed by these deadly infections”.

The researchers analyzed 69 million discharges from hospitals in 40 states.

For the complete article: Eber MR, Laxminarayan R, Perencevich E N, et. al Archives of Internal Medicine 2010; 170(4):347-353

Southeast Anesthesiology Consultants provides you with the ability to staff your anesthesiology program, and can assist you in improving overall perioperative service efficiencies. By contracting with SAC, you can capitalize on our medical expertise to provide you program development, management, staffing and consulting in the following areas:
• Anesthesiology
• Pain Management
• Quality Initiatives
• Perioperative Services

Learn more about our services at www.seanesthesiology.com

New training kit for malignant hyperthermia – Summary by Jerry Ippolito

New training kit for malignant hyperthermia – As seen in OR Manager April 2010

The Malignant Hyperthermia Association of the United States has introduced a new training kit to help OR staff better prepare for MH emergencies.

The kit includes a 22 minute video of t mock drill and cards that detail how to prepare for a drill and specific responsibilities of participants.  The kit also includes case scenarios, frequently asked questions, and a demonstration on mixing dantrolene.

www.medical.mhaus.org/index.cfm/fuseaction/content.display/pagepk/mockdrillkit.cfm

Southeast Anesthesiology Consultants provides you with the ability to staff your anesthesiology program, and can assist you in improving overall perioperative service efficiencies. By contracting with SAC, you can capitalize on our medical expertise to provide you program development, management, staffing and consulting in the following areas:
• Anesthesiology
• Pain Management
• Quality Initiatives
• Perioperative Services

Learn more about our services at www.seanesthesiology.com