What would it be like to be inside a high-performing perioperative system? We may hold different opinions; I certainly have mine.

Recently that opinion was reinforced during a visit to a hospital that has been participating in NSQIP for several years, and which has steadily improved its performance on a number of categories.

How did this perioperative system get to where it is today?  I believe that, several years ago, the chief of surgery began to worry that surgical quality was not what it needed to be, but could not prove it. When NSQIP came along, he recognized that it would provide the credible yardstick for comparing his hospital’s complication rates to other hospitals’.  The results confirmed his fears.  Let’s just say they weren’t pretty…

The good news was that the results fired up the surgeons, who, like surgeons everywhere, crave reliable data.  But simply getting the surgeons to commit to an improvement program wasn’t going to be enough: He also needed to win the hearts, the minds and the enthusiastic participation of the nurses.  To accomplish that, he decided to improve the quality of dialogue between the physicians and the nurses through a dose of Team Resource Management delivered by a former airline pilot.

These steps alone would not have been sufficient.  After all, many hospitals – though not enough, in my opinion –are following a similar path.  What’s really different about this perioperative system is its internally generated commitment to grow its capabilities and, in doing so, to further transform its culture and thus to further improve outcomes.  It’s a virtuous cycle.

So, what’s it like inside the perioperative system at this hospital? Here’s what I learned from several people with whom I spoke: Read more about this article »