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The purpose of this paper is to explore the perceptions of operating room staff towards the use of the World Health Organization Surgical Safety Checklist in a tertiary hospital in Jordan.

This was a qualitative descriptive study. Semi-structured interviews were conducted with a purposeful sample of 21 healthcare staff employed in the operating room (nurses, residents, surgeons and anaesthesiologists). The interviews were conducted in the period from October to December 2021. Thematic analysis was used to analyse the data.

Three main themes emerged from data analysis namely compliance with the surgical safety checklist, the impact of surgical safety checklist, and barriers and facilitators to the use of the surgical safety checklist. The use of the checklist was seen as enabling staff to communicate effectively and thus to accomplish patient safety and positive outcomes. The perceived barriers to compliance included excessive workload, congestion and lack of training and awareness. Enhanced training and education were thought to improve the utilization of the surgical safety checklist, and help enhance awareness about its importance.

While steps to utilize the surgical safety checklist by the operation room personnel may seem simple, the quality of its administration is not necessarily robust. There are several challenges for consistent, complete and effective administration of the surgical safety checklist by the surgical team members. Healthcare managers must employ interventions to eliminate barriers to and offer facilitators of adherence to the application of the surgical safety checklist, therefore promoting quality healthcare and patient safety.

This study investigates the relationships between team dynamics and performance in healthcare operations. Specifically, it explores, through wearable sensors, how team coordination mechanisms can influence the likelihood of surgical glitches during routine surgery.

Breast surgeries of a large Italian university hospital were monitored using Sociometric Badges – wearable sensors developed at MIT Media Lab – for collecting objective and systematic measures of individual and group behaviors in real time. Data retrieved were used to analyze team coordination mechanisms, as it evolved in the real settings, and finally to test the research hypotheses.

Findings highlight that a relevant portion of glitches in routine surgery is caused by improper team coordination practices. In particular, results show that the likelihood of glitches decreases when practitioners adopt implicit coordination mechanisms rather than explicit ones. In addition, team cohesion appears to be positively related with the surgical performance.

For the first time, direct, objective and real time measurements of team behaviors have enabled an in-depth evaluation of the team coordination mechanisms in surgery and the impact on surgical glitches. From a methodological perspective, this research also represents an early attempt to investigate coordination behaviors in dynamic and complex operating environments using wearable sensor tools.

The purpose of this paper is to present the effect of the introduction of cross-functional team (CFT)-based organization, rather than, on planning and performance of OR teams.

In total, two surgical departments of the Radboud University Nijmegen Medical Center (RUNMC) in the Netherlands were selected to illustrate the effect on performance. Data were available for a total of seven consecutive years from 2005 until 2012 and consisted of 4,046 OR days for surgical Department A and 1,154 OR days for surgical Department B on which, respectively 8,419 and 5,295 surgical cases were performed. The performance indicator “raw utilization” of the two surgical Departments was presented as box-and-whisker plots per year (2005-2011). The relationship between raw utilization (y) and years (x) was analyzed with linear regression analysis, to observe if performance changed over time.

Based on the linear regression analysis, raw utilization of surgical Department A showed a statistically significant increase since 2006. The variation in raw utilization reduced from IQR 33 percent in 2005 to IQR 8 percent in 2011. Surgical Department B showed that raw utilization increased since 2005. The variation in raw utilization reduced from IQR 21 percent in 2005 to IQR 8 percent in 2011.

Hospitals need to improve their productivity and efficiency in response to higher societal demands and rapidly escalating costs. The RUNMC increased their OR performance significantly by introduction of CFT-based organization in the operative process and abandoning the so called functional silos.

The stepwise reduction of variation – a decrease of IQR during the years – indicates an organizational learning effect. This study demonstrates that introducing CFTs improve OR performance by working together as a team.

This paper aims to present a method for strategic planning and implementation processes in health care based on lean management.

Within the framework of the action research methodology, the authors present the ten steps of a kaizen project, which enable lean transformation over a period of time. The study is underpinned by a literature review of enablers and barriers and an implementation case in a tertiary care hospital.

Key points and possible contingency issues are presented for each of the steps, and a successful lean tools intervention is illustrated by examples of improvement projects of the surgical process. Conclusions of the implementation establish a roadmap for improvement projects in hospital environments based on lean management, thus bridging the existing gap between the large number of theoretical projects (much of the projects described are not sustainable over time as the hospital sector is very particular) that have failed to be implemented, or been paused mid-term, and the self-sustaining projects developed by improvement teams in the hospital.

The study details knowledge gleaned from a three-year project entailing various stages: forming improvement teams; training health-care professionals in lean management; drawing up a process map to identify value stream mapping improvement opportunities; implanting projects and verifying the results obtained; and finally, laying the cornerstones, which would make the project self-sustaining and open to long-term continuous improvement.

The purpose of this paper is to investigate the attitudes of healthcare professionals in Greece toward safety practices in gynecological Operation Rooms (ORs).

An anonymous self-administered questionnaire was distributed to surgical personnel asking for opinions on safety practices during vaginal deliveries (VDs) and gynecological operations (e.g. sponge/suture counting, counting documentation, etc.). The study took place in Hippokration Hospital of Thessaloniki including 227 participants. The team assessed and statistically analyzed the questionnaires.

Attitude toward surgical counts and counting documentation, awareness of existence and/or implementation in their workplace of other surgical safety objectives (e.g. WHO safety control list) was assessed. In total, 85.2 percent considered that surgical counting after VDs is essential and 84.9 percent admitted doing so, while far less reported counting documentation as a common practice in their workplace and admitted doing so themselves (50.5/63.3 percent). Furthermore, while 86.5 percent considered a documented protocol as necessary, only 53.9 percent admitted its implementation in their workplace. Remarkably, 53.1 percent were unaware of the WHO safety control list for gynecological surgeries.

Most Greek healthcare professionals are well aware of the significance of surgical counting and counting documentation in gynecology ORs. However, specific tasks and assignments are unclear to them. Greek healthcare professionals consider surgical safety measures as important but there is a critical gap in knowledge when it comes to responsibilities and standardized processes during implementation. More effective implementation and increased personnel awareness of the surgical safety protocols and international guidelines are necessary for enhanced quality of surgical safety in Greece.

The authors determine how the scheduling and sequencing of surgeries by surgeons impacts the rate of post-surgical complications and patient length-of-stay in the hospital.

Leveraging a dataset of 29,169 surgeries performed by 111 surgeons from a large hospital network in Ontario, Canada, the authors perform a matched case-control regression analysis. The empirical findings are contextualized by interviews with surgeons from the authors’ dataset.

Surgical complications and longer hospital stays are more likely to occur in technically complex surgeries that follow a similarly complex surgery. The increased complication risk and length-of-hospital-stay is not mitigated by scheduling greater slack time between surgeries nor is it isolated to a few problematic surgery types, surgeons, surgical team configurations or temporal factors such as the timing of surgery within an operating day.

There are four major limitations: (1) the inability to access data that reveals the cognition behind the behavior of the task performer and then directly links this behavior to quality outcomes; (2) the authors’ definition of task complexity may be too simplistic; (3) the authors’ analysis is predicated on the fact that surgeons in the study are independent contractors with hospital privileges and are responsible for scheduling the patients they operate on rather than outsourcing this responsibility to a scheduler (i.e. either a software system or an administrative professional); (4) although the empirical strategy attempts to control for confounding factors and selection bias in the estimate of the treatment effects, the authors cannot rule out that an unobserved confounder may be driving the results.

The study demonstrates that the scheduling and sequencing of patients can affect service quality outcomes (i.e. post-surgical complications) and investigates the effect that two operational levers have on performance. In particular, the authors find that introducing additional slack time between surgeries does not reduce the odds of back-to-back complications. This result runs counter to the traditional operations management perspective, which suggests scheduling more slack time between tasks may prevent or mitigate issues as they arise. However, the authors do find evidence suggesting that the risk of back-to-back complications may be reduced when surgical pairings are less complex and when the method involved in performing consecutive surgeries varies. Thus, interspersing procedures of different complexity levels may help to prevent poor quality outcomes.

The authors empirically connect choices made in scheduling work that varies in task complexity and to patient-centric health outcomes. The results have implications for achieving high-quality outcomes in settings where professionals deliver a variety of technically complex services.

The purpose of this study is to describe and analyse the quality of a professional surgical service process, and to reveal the main elements that constitute excellence in the experience of the surgical service of a private hospital. First, a theoretical framework for the surgical service process is created. Second, empirical research is conducted through a mail survey of surgical patients in a private hospital. A total of 240 questionnaires were delivered and the response rate was 83 per cent. Third, the underlying quality dimensions in the surgical service process are constructed using factor analysis. Finally, the main elements of excellence in a surgical service experience are revealed by utilising discriminant analysis. Empirical results indicate that, in private surgical services, the surgical procedure itself is the single most important element, but that it must be supplemented by quality dimensions in both output and process throughout the whole surgical service process.

Since 1990, the National Confidential Enquiry into Perioperative Deaths (NCEPOD) has published a total of 14 reports. These are intended to assist clinical staff in applying the lessons learned from the analysis of post‐operative deaths to help prevent future incidents. However, anecdotal evidence suggests that the dissemination of this information does not always take place. Access to these reports should be encouraged and perhaps considered more formally during surgical training. Their use is also advocated in the multidisciplinary setting and as part of clinical audit. Unacceptable standards of medical record keeping are frequently highlighted in the NCEPOD reports. All health‐care professionals have a responsibility to raise these standards such that clinical documentation conforms with a basic acceptable standard that does not compromise patient care. Risk managers should also make use of the NCEPOD reports in meeting the requirements of Clinical Negligence Scheme for Trusts (CNST) standards.

The purpose of this research is to (1) analyse the effect of customised on-demand 3DP on surgical flow time, its variability and clinical outcomes (2) provide a framework for hospitals to decide whether to invest in 3DP or to outsource.

The research design included interviews, workshops and field visits. Design science approach was used to analyse the impact of the 3D printing (3DP) interventions on specific outcomes and to develop frameworks for hospitals to invest in 3DP, which were validated through further interviews with stakeholders.

Evidence from this research shows that deploying customised on-demand 3DP can reduce surgical flow time and its variability while improving clinical outcomes. Such outcomes are obtained due to rapid development of the anatomical model and surgical guides along with precise cutting during surgery.

We outline multiple opportunities for research on supply chain design and performance assessment for surgical 3DP. Further empirical research is needed to validate the results.

The decision to implement 3DP in hospitals or to engage service providers will require careful analysis of complexity, demand, lead-time criticality and a hospital's own objectives. Hospitals can follow different paths in adopting 3DP for surgeries depending on their context.

The operations and supply chain management community has researched on-demand distributed manufacturing for multiple industries. To the best of our knowledge, this is the first paper on customised on-demand 3DP for surgeries.

The first aim of this paper is to bring empirical evidence from an atypical organizational setting to the debate surrounding the currency of business process re‐engineering, which some commentators have dismissed as a damaging “fad”. The second aim is to suggest how the process orientation advocated by re‐engineering can facilitate a creative visualization of organizational process and a participative approach to redesign. The paper is based on the experience of an acute teaching hospital seeking to reduce patient delays affecting the work of the operating theatres department. The project began towards the end of 1994, was overseen by a hospital steering committee, was conducted by a small internal project team (with researcher as member), and was based initially on a process mapping exercise. The elective surgical in‐patient process (one of the hospital’s “core processes”), from referral to discharge, was mapped using the knowledge of project team members, interview and survey data from 39 respondents, informal discussions with over 50 other hospital staff, and from a photo‐documentation and photo‐elicitation procedure. Interviews, survey questionnaires, informal discussion and the photo‐elicitation sessions were also used to develop a wide series of recommendations from staff with respect to redesigning the patient process and reducing theatre delays.