The Journal of medical practice management : MPM
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All physicians have mentors, role models, and even historical figures in medicine to whom they turn for advice on everything from treating their patients to running their practices. To be sure, many physicians have learned valuable lessons from Osler, Halstead, Fleming, Pasteur, and a long list of former professors, supervisors, and practice partners. In this article, however, we suggest that modern physicians can turn to a most unlikely source of wisdom and knowledge. ⋯ It may be hard to believe, but modern physicians can learn much about the care of patients and the business of running their practices from the very same books they are reading with their children and grandchildren. The idea that well-trained and sophisticated physicians can learn from Dr. Seuss is not as far-fetched as it may seem initially.
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Medication errors represent one of the most common causes of morbidity and mortality in hospitalized patients. Anesthesia has specific medication-related risks; providers must administer many potent intravenous medications quickly, often with minimal to no supervision. ⋯ Emphasis should be placed on implementing forcing functions when possible, utilizing technology, standardization, and education about the need for awareness in specific situations. More studies need to be done to define the epidemiology of medication errors in anesthesia, and more importantly, to assess interventions for preventing them.
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Operative sterility is a critical factor with regard to infection in the postoperative period. In recent years, techniques and devices have been developed to reduce the potential for exposure to pathogens. ⋯ The SteriCup provides a designated sterile area to store suction catheters and removed endotracheal tubes and allows for their simple and safe disposal. Devices such as the SteriCup have the potential to improve operating room systems and minimize potential for operative infection.
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The operating room (OR) turnover is a critical period in patient care and OR management. Turnover time (TOT) is a traditional quantitative measure of OR efficiency but is lacking when used to describe the TOT process. ⋯ Interview data of OR staff can supplement quantitative efficiency measures and identify areas of opportunity in OR management and patient safety.
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When an unexpected perioperative crisis arises, simulation studies have suggested that the use of an emergency manual (EM) may offset the large cognitive load involved in crisis management, facilitating the efficient performance of key steps in treatment. However, little is known about how well EMs will translate into actual practice and what is required to use them optimally. ⋯ In the interim, cautious use of these cognitive aids is recommended, especially when the diagnosis is not straightforward, falls "in between" sections of the EM, or falls outside of the EM itself. Further research should focus on the efficacy of EMs as measured by the percentage of critical steps correctly performed by their users in scenarios that do not closely mirror one of the listed EM scenarios from the beginning or as the situation evolves.