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to prevent severe injury. Staff learn about the fire triangle (fuel, oxygen and heat) and that turning off the fuel source is the first step if a fire breaks out. They learn to use saline or distilled water to put out a fire, and to never try to blow it out. They learn to watch out for prep that may have pooled in a drape or dripped into a patient's hair, or somewhere else that may take longer to dry. And maybe most importantly, they learn to never let an impatient physician try to short-change the needed drying time. There are hundreds of surgical fires in the U.S. every year, but there's never been one at Stony Point or its sister surgery center in West Creek. Bruce and his keepers plan to keep it that way. Realistic drills The emphasis on realism at Stony Point extends to other areas of patient safety, as well. For mock code-blue scenarios, they arrange ahead of time with the local county emergency medical services and fire department, so staff experience actually calling 911. "We might simulate a scenario where someone has just had surgery but has decompensated in PACU," says Mr. Stanford. Staff need to clearly explain the situation to an operator, and paramedics are dis- patched to the surgery center to help walk everyone through the whole scenario — all the way up to loading a mannequin into the ambulance, Mr. Stanford explains. "We try to be as scenario-based as possible, trying to think of things you might actually see in a surgery center," he says. "It's more realis- tic, and it helps build team relationships." After all, the worst scenario is to be caught unprepared, he points out. The center also conducts annual disaster drills, covering what needs to be done in the event of an earthquake, tornado or hurricane. An active-shooter drill with the local sheriff's department is in the 3 8 • O U T PA T I E N T S U R G E R Y M A G A Z I N E • S E P T E M B E R 2 0 1 7