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the people who put them there.
Only then are patients allowed into the OR, where one last robust
physician-led time out is carried out before the first cut is made.
"Fortunately, we never had a big mistake before we started this,"
says Ms. Fairchild. "There's nothing more devastating than a wrong
site or wrong procedure. But one of the big benchmarks for errors is
near-misses, and we've definitely had a reduction in those."
Along with empowering employees, promoting communication and
implementing fail-safe procedures, the Crane Center has also taken
several other steps to guard the safety of both patients and staff,
including:
• Switching to laryngeal wands that don't require the use of a laser.
"When you're lasering off lesions, the risk of fire is sky-high," says Ms.
Fairchild. "With the new wands, the risk of fire is minimal and they're
much safer for patients' airways. They cost a little more, but we think
they're worth it."
• Installing smoke evacuators in every OR. "Our staff members
weren't used to using them all the time, but we did some research and
showed them that when things are vaporized, a big concern is the
stuff that's in the smoke, not just the smoke itself."
• Using ALARA (as low as reasonably achievable) as the standard
for radiation exposure. "It's 30% of what the government allows," says
Ms. Fairchild. "We also have ceiling-mounted lead shielding that pro-
tects the whole body, and we provide portable shields, in addition to
lead aprons."
• Investing in a low-dose C-arm.
• Certifying all nurses in advanced cardiac life support (ACLS) and
pediatric advanced life support (PALS).
