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The Leadership Role: Designing Perioperative Surgical Services for Safety and Efficiency

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Surgical Patient Care

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Abstract

Despite continued national and international efforts focusing on improving the quality and safety of healthcare, adverse events and near misses continue to occur at an alarming rate. Perioperative care involves a high risk for these adverse events. To improve the quality and safety of perioperative care requires a top-down redesign, integrating quality and safety into all aspects of perioperative services. Key elements of this redesign include building a safety culture, designing the infrastructure for safety, hiring for safety and promoting safety norms, engaged leadership and collaboration, educating personnel about the science of safety, and designing work processes to minimize the potential for error. Resources can be acquired by presenting a business case. And, resistance can be minimized by emotional engagement, maximizing efficiency, leveraging peer support, and using audit and feedback. This comprehensive view of redesigning perioperative services is essential for improving the safety, quality, and value of patient care.

“Every system is perfectly designed to get the results it gets.”

—Paul Batalden, MD

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Author information

Authors and Affiliations

  1. The University of Iowa, College of Nursing, 50 Newton Road, Iowa City, IA, 52242, USA

    Victoria M. Steelman PhD, RN, CNOR, FAAN

  2. Doctors Hospital of Augusta, 3651 Wheeler Road, Augusta, GA, 30909, USA

    Martha D. Stratton MSN, MHSA, RN, CNOR, NEA-BC

Authors
  1. Victoria M. Steelman PhD, RN, CNOR, FAAN
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  2. Martha D. Stratton MSN, MHSA, RN, CNOR, NEA-BC
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Corresponding author

Correspondence to Victoria M. Steelman PhD, RN, CNOR, FAAN .

Editor information

Editors and Affiliations

  1. Department of Surgery Ascension Saint Agnes Hospital Armstrong Institute for Patient Safety & Quality, Johns Hopkins University School of Medicine, Baltimore, MD, USA

    Juan A. Sanchez

  2. Children’s Cardiomyopathy Foundation and Kyle John Rymiszewski Research Scholar, Children’s Hospital of Michigan, Wayne State University School of Medicine, Detroit, MI, USA

    Paul Barach

  3. Department of Surgery Center for Healthcare Studies Institute for Public Health and Medicine Feinberg School of Medicine, Northwestern University, Chicago, IL, USA

    Julie K. Johnson

  4. Division of Cardiovascular Surgery Johns Hopkins All Children’s Heart Institute Johns Hopkins All Children’s Hospital, Johns Hopkins University, Saint Petersburg, FL, USA

    Jeffrey P. Jacobs

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Steelman, V.M., Stratton, M.D. (2017). The Leadership Role: Designing Perioperative Surgical Services for Safety and Efficiency. In: Sanchez, J., Barach, P., Johnson, J., Jacobs, J. (eds) Surgical Patient Care. Springer, Cham. https://doi.org/10.1007/978-3-319-44010-1_19

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  • DOI: https://doi.org/10.1007/978-3-319-44010-1_19

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