Step 4i) Complete Preparedness and/or Process Assessment for Each Target

Benefits:

I.  Assessments show the situation at specific points of care, the standards of care, and how the site compares to standards. This puts everyone at the same starting place 

II. This reinforces the defined goal at each target and gives everyone a common goal

Investment required:

I. Education and training: 

II. Time:  

a) Department heads and administration:  Pre-assessment explanation of procedure (1 hour)

b) Department heads: Review of assessment evening before assessment: (1 hour)

c) Department(s):  Pre-assessment explanation of procedure (1 hour/everyone in department), post-assessment 1:1 discussion with anyone who had concerns about items + (2-3 hours total), post-assessment presentation (2 hours/ everyone in department)

III. Financial: 

Solutions: One Standard tools:

I. Airway management:

     a) Preparedness to manage an airway at points of care are assessed in the One Standard Assessment and Report I and II

      b) Evaluation of actions at points of care are compared to actions needed for safe airway management. These are assessed in One Standard Actions Assessment at points of care in the perioperative area. (Draft form)

II) The first step to reduce and prevent surgical site infections is to understand the guidelines (SSIP). There is a link to these in the "Links to outside resources" tab.  A solid second step is understanding the processes involving skin antisepsis and perioperative antibiotics at the site. This may be difficult in situations where job descriptions are incomplete, protocols sparce, and ambiguity is common. 

 The One Standard: Perioperative Workflow Assessment shows the needed elements of these processes as well as timing and who is responsible for the task. These processes have many moving parts; thus, the assessment is not perfect, but it is good. By using the workflow and updating it with information from providers and staff at the site, weak links and inconsistencies will be revealed to both the assessors and the staff. It will be clear that all of the elements in the assessment must be accounted for and that timings must be perfect. With a copy of the workflow that shows the site as it is, a new workflow is made that covers all essential elements of the processes. This has responsibilities, actions, tasks, and timings. From this a protocol is written and job descriptions can be updated. Infrastructure is strengthened because when providers and staff are assigned responsibilities, management assigns itself oversite and the duty to make sure staff and providers have the tools and capacity to do their job.

3) Identification and treatment of shock, not done but assessment will ~easily fit into workflows format