Reducing Disposable Surgical Items: Decreasing Environmental Impact and Costs at a Children's Hospital, a Pilot Study.

Introduction: United States landfill waste generated in the operating room (OR) is estimated to be three billion tons per year. The goal of this study was to analyze the environmental and fiscal impact of right-sizing surgical supplies at a medium-sized children's hospital using lean methodology to reduce physical waste generated in the operating room.

Methods: A multidisciplinary task force was created to reduce waste in the OR of an academic children's hospital.

Applying LEAN Healthcare in Lean Settings: Launching Quality Improvement in Resource-Limited Regions.

Background: Lean methodology is frequently utilized in high income settings to maximize capacity and operational efficiency during process improvement (PI) initiatives. To date there has been little published on the application of these techniques in low- and-middle-income countries (LMIC) despite the potential benefits in resource limited settings. We describe a pilot project developed in 2018 to promote sustainable operating theater efficiency at two hospitals in Abuja, Nigeria.

Utilizing technology to improve intraoperative family communication.

Purpose: To create and assess satisfaction with an electronic-medical-record (EMR) integrated communication system designed to optimize perioperative communication with families.

Methods: We built a tool in the EMR's intraoperative nursing navigation screen for sending customized or standardized text pages to families in English or Spanish. Preoperatively, families were given text pagers with instructions and a hospital map to facilitate leaving the waiting area.

Pacifier restriction and exclusive breastfeeding.

Objective: We tested the hypothesis that removing pacifiers from routine distribution in our mother-baby unit (MBU) would be associated with greater breastfeeding initiation or exclusivity during the birth hospitalization.

Methods: We retrospectively compared exclusive breastfeeding, breastfeeding plus supplemental formula feeding, and exclusive formula feeding rates for 2249 infants admitted to the MBU at our university teaching hospital during the 5 months before and 8 months after restriction of routine pacifier distribution. Formula supplementation, if not medically indicated, was discouraged per standard practice, but access to formula was not restricted.

Project HealthDesign: stimulating the next generation of personal health records.

Project HealthDesign is a national program designed to rethink the power and potential of personal health to rethink the power and potential of personal health records. It intends to stimulate development of new personal health management tools by harnessing the content of the personal health record and making advice, recommendations, and data-tracking tools available to lay people. The program goals include creating a set of prototype personal health records applications, deriving the core functions needed to support interoperable 'plug-and-play' resources for managing health challenges, and addressing the ethical, legal, and social issues that confront the development of computer tools to promote health actions.