The OHIO OR
The OHIO principle is especially effective in surgery. Robert E. Booth,
MD, noted knee surgeon and efficiency master, conveyed the OHIO
mindset to me years ago. Dr. Booth recognized how much time we
waste in the OR when we pass instruments back and forth during the
course of a case. What if, he wondered, we only handled each instru-
ment once? We'd minimize instrument exchanges and save lots of time.
When Dr. Booth performs a knee arthroplasty, he employs the
periosteal elevator and the electrocautery and the saw blade only once.
There's no time wasted with redundant instrument handoffs. OHIO
(and skill) let Dr. Booth execute surgeries in hyper-efficient fashion.
As an arthroscopist, I apply OHIO whenever possible. In the past, when I
performed an arthroscopic rotator cuff repair, I used a shaver blade to
resect the subacromial bursa and decorticate the greater tuberosity. After
the bursectomy, I would customarily exchange the shaver for a burr in
order to perform the acromioplasty, and then return to the shaver for more
tuberosity preparation. With the OHIO principle, I now use the shaver
blade once — for all its necessary applications. I simply resect the bursa,
then immediately proceed to the tuberosity before I introduce the burr.
Imagine the diminished transactions and handoffs resulting from
implementation of OHIO. Cases will start to flow more lyrically and be
completed in less time. An added bonus of fewer instrument
exchanges: less occasion for error and sharps injuries. The discipline
of applying OHIO to your life will result in more time, less clutter and
the increased satisfaction of knowing that you completed tasks in
timely fashion. Now where did I put that letter from Publishers
Clearing House. I may already be a winner!
OSM
Dr. Kelly (johndak4@gmail.com) is an orthopedic surgeon/sports-shoulder
specialist who practices in Philadelphia, Pa.
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