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Sponge Solution Remains Elusive

Cheryl Clark, for HealthLeaders Media, June 13, 2011
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Ken Welch, MD, chief medical officer for Banner Estrella Medical Center, a 214-licensed-bed hospital in Phoenix, says he and other Banner officials were so impressed with Harder’s results that all 23 Banner hospitals in seven states will launch her protocols by the end of the year. His system did so in January.

“In looking at innovation, we decided to look around and see who was doing this the best and borrow it,” he says. When Harder came to Banner to present her findings, Welch says, Banner was sold.

But it wasn’t easy. Harder’s new protocol for safe surgery calls for preoperative briefing, which includes each member of the surgical team saying hello to the others, even if they had worked together on five other cases the same day. Members just joining the team exchange names as part of their introduction to the team. Some of the surgeons pushed back.

“The initial thing we heard was, ‘We already do a time-out,’ and they thought saying hello is hokey, but we observed that these time-outs were done in a variety of ways, and there needed to be consistency with specific things that happen to make sure everyone is focused,” Welch says.

“The literature says that by naming the person and having contact, you stop talking about the son’s basketball game, and instead, you say, ‘Hi Lori, let’s get ready for this case.’ That gives Lori a very subtle but definite cue that she’s part of this, and if she sees something wrong,” Welch explains, “she will be more willing to say, ‘Doc, maybe we’re off the count. We didn’t get the number we were looking for.’” 

The bottom line, Welch says, is that everyone on the surgical team should “have what you need, need what you have, and know where all of it is at all times.”

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