Current Trends and Issues in Operations Management Current Trends and Issues in Operations Management Introduction Operation management is a wide discipline which deals with the management of organization functions effectively. The concept of operation management introduces the relationship between the operational planning processes and operational basic elements within the organization. In modern operations management, there is a great emphasis on the quality of products Monden,
The information should not be construed as dictating an exclusive course of treatment or procedure to be followed. Ensuring patient safety in the operating room begins before the patient enters the operative suite and includes attention to all applicable types of preventable medical errors including, for example, medication errorsbut surgical errors are unique to this environment.
Steps to prevent wrong-site, wrong-person, wrong-procedure errors, or retained foreign objects have been recommended, starting with structured communication between the patient, the surgeon sand other members of the health care team.
Introduction Potentially preventable surgical errors have received increasing attention in recent years, although they appear to occur relatively infrequently compared with other types of medical errors. The Joint Commission has collected data on reported sentinel events since with wrong-site surgery consistently ranked as the most frequently cited reason 1.
Inthe year for which most recent data are available, there were wrong-site surgery sentinel events reviewed. Classic examples in the specialty of obstetrics and gynecology include wrong procedures, such as tubal ligation without consent.
Terminology The term wrong-site surgery is used to refer to any surgical procedure performed on the wrong patient, wrong body part, wrong side of the body, or at the wrong level of the correctly identified anatomic site 2.
The following terms can be used to describe the various specific errors: Wrong-patient surgery describes a surgical procedure performed on a different patient than the one intended to receive the operation. Systems Approach Particularly because of the potential for serious harm from surgical errors, vigorous efforts are required to eliminate or reduce their frequency.
Preventing a surgical error appears to be amenable to a systems approach involving a team effort by all individuals participating in the surgical process. Although all members of the surgical team share this responsibility, the primary surgeon should oversee these efforts.
The Joint Commission has identified the following factors that may contribute to an increased risk of wrong-site surgery: Multiple surgeons involved in the case Multiple procedures during a single surgical visit Unusual time pressures to start or complete the procedure Unusual physical characteristics, including morbid obesity or physical deformity A common theme in cases of wrong-site surgery involves failed communication between the surgeon sthe other members of the health care team, and the patient.
Communication is crucial throughout the surgical process, particularly during the preoperative assessment of the patient and the procedures used to verify the operative site. Effective preoperative patient assessment includes a review of the medical record or imaging studies immediately before starting surgery.
To facilitate this step, all relevant information sources, verified by a predetermined checklist, should be available in the operating room and rechecked by the entire surgical team before the operation begins. A briefing is important for assigning essential roles and establishing expectations.
Introduction of each person in the operating room by name and role, even if team members are familiar, is recommended for improved communication. Time outs may include not only verification of the patient and the surgical site, but also relevant medical history, allergies, administration of appropriate preoperative antibiotics, and deep vein thrombosis prophylaxis.
The team must address missing information or discrepancies before starting the procedure. Marking the operative site Procedures that require marking of the incision or insertion site include those where there is more than one possible location for the procedure or when performing the procedure would negatively affect quality or safety.
According to the Joint Commission, the site does not need to be marked in cases where bilateral structures such as ovaries are removed 3.
Although the Joint Commission does not require a specific site marking method, each facility should be consistent in the method it uses ensuring that the mark is unambiguous. World Health Organization Surgical Safety Checklist Another useful tool to promote patient safety in the surgical setting is the surgical safety checklist published by the World Health Organization.
It is inappropriate to place total reliance on the surgeon to identify the correct surgical site or to assume that the surgeon should never be questioned. The risk of error may be reduced by involving the entire surgical team in the site verification process and encouraging any member of that team to point out a possible error without fear of ridicule or reprimand.
Patient Involvement A relatively new but essential element of the overall process is the formal enlistment of the patient in the effort to avert errors in the operative arena.
Involving the patient in this manner requires personal effort by the surgeon to educate the patient during the preoperative evaluation process. The patient, who has the greatest stake in avoiding errors, thus becomes integrally involved in helping ensure that errors are avoided.
Granting Privileges for New Procedures New techniques and new equipment are important components for developing and delivering the best quality care in the operating room, but they also represent sources of potential surgical error. Whenever possible, a surgeon who is incorporating a new surgical technique should be proctored or supervised by a colleague more experienced in the technique until competency has been satisfactorily demonstrated.
In some circumstances, however, a technique may be so innovative that no other surgeon at that facility has more experience. In such situations, it may be necessary to require reciprocal proctoring at another hospital or grant temporary privileges to someone from another hospital to supervise the applicant.
The surgeon performing the procedure should have already documented skills and experience in the related surgical arena.
When new equipment is introduced, all members of the surgical team must be trained on and practice with the new equipment as appropriate for the extent of their involvement, and all personnel involved must be aware of all safety features, warnings, and alarms of the device.
Any informational material eg, user manuals, operating instructions provided by the manufacturer of the equipment should be carefully reviewed by the principal users and should be familiar to anyone using the equipment.
Labels attached to the device or plastic cards summarizing instructions for proper use may be helpful until everyone involved is comfortable with the new equipment. All necessary adaptors, attachments, and supplies should be in the room or readily available before beginning surgery with the new equipment.
Any recommended protective devices, such as eye shields or special draping material, should be used for the safety of all concerned. The lead surgeon using the new equipment should have demonstrated competency in the use of the device, resulting in the granting of privileges.Current environment and operation It is very important to consider the working environment when determining the position of a business.
This is one area that was put in consideration when determining the position of the Safaricom Company (Dan ).
)The environment in which users run programs. For example, the DOS environment consists of all the DOS commands available to users. The Macintosh environment, on the other hand, is a graphical user interface that uses icons and menus instead of commands.
There is a thin line between operating. As operations managers work in multidisciplinary environments, they must be aware of and effectively respond to the challenges presented by globalization, sustainability, ethical conduct, effective communication, and system design.
An operations manager must ensure that the long-term strategies of his company are satisfied and also monitor the organization's impact on the social, cultural and economic environment.
Managers must create strategies to manage relationships between customers and employees.
And the hostile environment is described as a territory where forces hostile to the U.S. military have control and can react in opposition to any operations U.S. troops would conduct, whether in a wartime situation or a peacekeeping operation.
August 20, TRAINING AND DOCTRINE COMMAND (TRADOC) G-2 Operational Environments to The Strategic Environment for Unified Land Operations 4 Through , the Army will face many unique OEs and simultaneous decisive action operations will be.