Subject(s)
Operating Rooms/organization & administration , Appointments and Schedules , Budgets , Efficiency, Organizational , Health Planning , Humans , Interprofessional Relations , Leadership , Operating Room Information Systems , Operating Rooms/economics , Organizational Policy , Personnel Administration, Hospital , Personnel Staffing and Scheduling , Physician Executives , WorkforceABSTRACT
Hospitals have to purchase new technology, update equipment, and replenish supplies continually to meet the needs of patients and the medical and nursing staff in a sound financial way. Thus, inventories must be maintained accurately and adequately with proper controls. Awareness of the cost of capital and operational supplies is essential to meeting budget allocations. With or without centralized buying, the MM department has the expertise to assist every department in purchasing to meet its needs and in setting and resetting inventory levels for its supplies. Explanations and formulas for handling capital equipment and regular supplies and some formats have been presented to facilitate the process. Because OR items are both expensive and numerous and OR storage space the most costly space in the hospital, physicians and nurse managers must understand the financial processes and inventory management and educate their staffs in these matters.
Subject(s)
Financial Management, Hospital/organization & administration , Materials Management, Hospital/organization & administration , Operating Rooms/organization & administration , Budgets/organization & administration , Capital Financing/economics , Capital Financing/organization & administration , Cost Control , Equipment and Supplies, Hospital/economics , Financial Management, Hospital/economics , Humans , Inventories, Hospital/economics , Inventories, Hospital/organization & administration , Materials Management, Hospital/economics , Medical Staff, Hospital/economics , Medical Staff, Hospital/organization & administration , Nursing Staff, Hospital/economics , Nursing Staff, Hospital/organization & administration , Operating Rooms/economics , Physician Executives , Purchasing, Hospital/economics , Purchasing, Hospital/organization & administration , WorkforceABSTRACT
As physicians in the OR suite, anesthesiologists' interests extend beyond the technical issues of rendering anesthesia care, and a number of topics germane to problems in the OR and anesthesia department have been covered. More and more anesthesiology practices are locating outside the "safety" zone of the hospital; thus, it becomes encumbent on the physicians working in those environments to be aware of the regulations, safety standards, and hazards in order to provide a safe environment for their patients and to run a well-managed OR suite.
Subject(s)
Anesthesiology/organization & administration , Operating Rooms/organization & administration , Anesthesia Department, Hospital/legislation & jurisprudence , Anesthesia Department, Hospital/organization & administration , Anesthesia Department, Hospital/standards , Anesthesia Department, Hospital/statistics & numerical data , Anesthesiology/legislation & jurisprudence , Anesthesiology/standards , Anesthesiology/statistics & numerical data , Biomedical Engineering/instrumentation , Credentialing , Drug and Narcotic Control/legislation & jurisprudence , Equipment Safety , Equipment and Supplies, Hospital , Humans , Infection Control , Informed Consent , Maintenance and Engineering, Hospital , Medical Staff Privileges , Operating Rooms/legislation & jurisprudence , Operating Rooms/standards , Operating Rooms/statistics & numerical data , Risk Management , Safety , Surgicenters/legislation & jurisprudence , Surgicenters/organization & administration , Surgicenters/standards , Surgicenters/statistics & numerical dataABSTRACT
The objectives of quality improvement in the OR include improved perioperative care of the patient and OR efficiency, decreased hospital length of stay, and decreased costs. We submit that multidisciplinary outcome measurement is a prerequisite for coordinated outcomes management to achieve quality patient care in an effective, efficient, and financially responsible way, and we provide a guide to do so. The data obtained by such cross-discipline study can identify the need for patient, family, and/or staff education, improved interaction and collaboration across disciplines, revision of clinical paths, and improved hospital systems as well as benchmarking the performance of the OR against local or national standards.
Subject(s)
Operating Rooms/standards , Outcome Assessment, Health Care , Benchmarking , Critical Pathways , Efficiency, Organizational , Financial Management, Hospital , Hospital Costs , Humans , Inservice Training , Interprofessional Relations , Length of Stay , Operating Rooms/economics , Operating Rooms/organization & administration , Patient Education as Topic , Personnel, Hospital/education , Quality Assurance, Health CareABSTRACT
The effect of 20 mL of intraarticular bupivacaine (0.25%, with or without 1:200,000 epinephrine), morphine (0.03%, with or without 1:200,000 epinephrine), or normal saline on postoperative analgesia after arthroscopic knee surgery was studied in a randomized, prospective, double-blind trial in ASA I-III outpatients receiving general anesthesia (n = 112) or regional anesthesia (n = 27 [spinal (n = 25) or epidural (n = 2)]). The visual analogue pain scores in the postanesthesia care unit and 3, 6, 12, and 24 h after surgery, time to first analgesic use, and total 24-h analgesic requirements were recorded. In those who received general anesthesia, the visual analogue scores were significantly lower in the bupivacaine group compared with both the morphine- and placebo-treated patients (P less than 0.05). The time to first analgesic use was longer in both the bupivacaine and morphine groups when compared with the control group (P less than 0.05). No significant differences were detected in total 24-h analgesic requirements among the groups. Patients who had received regional anesthesia had lower visual analogue scores compared with patients who had received general anesthesia irrespective of the intraarticular treatment (P less than 0.05). Our results indicate that intraarticular injection of bupivacaine after arthroscopic knee surgery provides prolonged analgesia but that there is no significant prolonged analgesia provided by intraarticular morphine.
Subject(s)
Analgesia/methods , Bupivacaine , Knee Joint/surgery , Morphine , Adult , Arthroscopy , Bupivacaine/administration & dosage , Double-Blind Method , Female , Humans , Injections, Intra-Articular , Male , Morphine/administration & dosage , Pain Measurement/drug effects , Prospective StudiesSubject(s)
Carbon Dioxide/metabolism , Knee/surgery , Respiration , Tourniquets , Adult , Anesthesia, General , Blood Pressure , Enflurane , Female , Fentanyl , Heart Rate , Humans , Intraoperative Period , Male , Middle Aged , ReperfusionABSTRACT
This article reports the case of a man who developed a pure motor paraplegia following epidural anesthesia with a pattern of slow recovery over subsequent months. Reviewing the available literature on post-epidural paraplegia we noted a number of potential etiologies and analyzed their role in its causation. On the basis of this analysis we have identified five distinct clinical groups and a constellation of factors which can lead to an increased risk of post-epidural paraplegia in susceptible surgical patients.
