solution. They took every instrument in the barebones set, triplicated
them, peel-packed them and placed them in a Craftsman tool drawer in
the OR (see "Dr. Sinha's Barebones Instrument Set" on page 44).
4. Surgical efficiency
In his quest to achieve greater efficiency in the OR, Dr. Sinha took his
"cut out the clutter" theory to the actual total joint procedure itself. He
found that in performing total knee replacements, 95% of procedures
were identical from patient to patient, yet each scrub tech and nurse
was expected to work with different surgeons whose methods didn't
always align. This could create confusion and lengthen surgical time,
thus making each total knee costlier.
Dr. Sinha wanted to replicate those 95% similar procedures to the
point where he and his staff were working like a well-oiled machine.
He wrote down every step in the performance of a total knee replace-
ment. That's 274 individual actions between surgeon and assistants,
from sawing a patella to suctioning smoke.
"We got to the point where I could do an entire operation without saying a
word," says Dr. Sinha. "The techs knew what the next step was going to be."
5. Try e-dictation
Dr. Berend's surgery center invested in a program that transcribes sur-
gical notes instantly. "Instead of dictating, all the information is cap-
tured live in the OR for an e-op note," he said. "It also enables us to do
implant tracking and it communicates with the patient in follow-up to
get our satisfaction scores and outcome scores for the surgery center."
Joint Implant Surgeons calculated that it saved $1,000 per month in
record-keeping expenses. And the response rate on follow-up surveys
was higher than ever. It's more efficient, more accurate and it saves
money. That's the Triple Crown of good business.
OSM
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