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Process-optimized operating room: implementation of an integrated OR system into clinical routine.

The surgeon's working environment has changed continuously in recent years regarding the technical complexity of the components in use in the operating room (OR). Parallel to this development, demands for process-optimized procedures have also grown constantly. The impetus for these changes was the beginning of use of minimally invasive techniques in surgery. In contrast, overall development of the OR itself has been slight or nonexistent. What we are typically confronted with currently is an OR outfitted with high-tech medical equipment, whereas only to a limited extent can the design of the OR itself be regarded as ergonomic or holistic. This situation has spread to related specialties as well, and represents a general tendency. Whereas dentists, for example, already enjoy the benefits of a centralized management and operation workplace, this development has not yet reached a satisfactory level for surgeons.

Facility Design and Construction↗

Emerging benefits of integrated IT systems.

Technological innovation in healthcare is occurring at a rapid pace both in terms of clinical systems and systems that affect the overall management of an organization's operations. Electronic health records are currently in the spotlight for the Bush administration as the federal government is in the beginning phases of cultivating a national health information network. At the same time, chief executive officers and chief information officers around the country are focused on improving all of their IT operations right now.

Capital Expenditures↗

The virtual laboratory: regional clinical diagnostics for integrated delivery systems.

With the rise of integrated delivery systems (IDSs), hospital laboratories need to transform themselves to better serve these large regional systems. Four factors are driving this need for transformation: the decline in the customer base of hospital clinical laboratories, the expanding number of test options, the need to control costs, and the proliferation of new technologies. In the future, clinical diagnostic capabilities will be available via integrated regional laboratory systems, or "virtual laboratories". The virtual laboratories serving IDSs will consist of a control center to manage laboratory services across the system, a core laboratory to perform large-volume testing and all testing that does not require a rapid turnaround, satellite laboratories for quick-turnaround testing, and a range of point-of-care testing options. Developing these virtual laboratories will pose challenges, including a redeployment of resources and a reengineering of testing policies and procedures. Success in implementing a virtual laboratory also will depend on the development of effective information systems technology to link the laboratory's components.

Clinical Laboratory Information Systems↗

Integrating strategic planning and quality management in a multi-institutional system.

Integrating total quality management (TQM) into the strategic planning process of a multi-institutional health system is a high priority. Through the strategic plan, system leadership gives TQM concepts prominence and visibility and provides strategic directions for their implementation. The Sisters of Providence Health System recently developed an approach to integrating TQM into its System Strategic Plan. Implementation priorities include more formalized direction for TQM by the system board, intensive TQM educational programs, greater consistency of quality information and outcome measures, and more focused attention to patient needs.

Catholicism↗

Nurse executives champion change in integrated health systems.

When facilities join integrated health systems, nurse executives must increase their focus on governance, staff education, financial analysis, mentorship, and planning to maintain strong patient advocacy across a continuum of care.

Decision Making, Organizational↗