The OHIO Rule in the OR
Imagine surgical flow with fewer instrument exchanges.
D
o cases take so long
that the circulator
keeps a diary? Does
the turnover time allow for
naps? If so, you need to send
your surgeons and staff to
OHIO, which stands for Only
Handle It Once. Noted psy-
chiatrist Edward Hallowell,
MD, popularized this time-saving principle in a Harvard Business
Review article, "Overloaded Circuits: Why Smart People
Underperform" (osmag.net/rhgsr9).
Act on it, file it or throw it away
Think of ways you can apply the OHIO principle to both work and
home. When you encounter an object or matter that requires action,
handle the object only once until the task is completed — right then
and there, without delay. For example, at home, when picking up your
mail from the mailbox, sort out the junk mail and dispose of it outside
your house into the trash once and for all. Don't sift through the
envelopes only to put them down and revisit them again. Your aim is
to handle the junk once so it won't require further action. When open-
ing the mail, don't open envelopes and place them aside only to get to
them later. Once you open the letter, do 1 of 3 things: act on it, file it or
throw it away. No piles — they grow like weeds. Shuffling less paper
will save you hours over the course of a month (you'll also pay your
bills on time!).
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Cutting Remarks
John D. Kelly IV, MD
Only Handle It Once
