Lean production is a process management philosophy that examines organizational processes from a customer perspective with the goal of limiting the use of resources to those processes that create value for the end customer. Lean manufacturing emphasizes increasing efficiency, decreasing waste, and using methods to decide what matters rather than accepting preexisting practices. A rapid improvement team at Lehigh Valley Health Network, Allentown, Pennsylvania, implemented a plan, do, check, act cycle to determine problems in the central sterile processing department, test solutions, and document improved processes. By using A3 thinking, a consensus building process that graphically depicts the current state, the target state, and the gaps between the two, the team worked to improve efficiency and safety, and to decrease costs. Use of this methodology has increased teamwork, created user-friendly work areas and processes, changed management styles and expectations, increased staff empowerment and involvement, and streamlined the supply chain within the perioperative area.

A culture of patient safety requires commitment and full participation from all staff members. In 2008, results of a culture of patient safety survey conducted in the perioperative division of the Lehigh Valley Health Network in Pennsylvania revealed a lack of patient-centered focus, teamwork, and positive communication. As a result, perioperative leaders assembled a multidisciplinary team that designed a safety training program focusing on Crew Resource Management, TeamSTEPPS, and communication techniques. The team used video vignettes and an audience response system to engage learners and promote participation. Topics included using preprocedural briefings and postprocedural debriefings, conflict resolution, and assertiveness techniques. Postcourse evaluations showed that the majority of respondents believed they were better able to question the decisions or actions of someone with more authority. The facility has experienced a marked decrease in the number of incidents requiring a root cause analysis since the program was conducted.

Hospital‐acquired pressure injuries are a patient safety concern and can be costly for health care organizations. A multidisciplinary team of senior leaders, managers, nurses, and educators from departments that care for perioperative patients created an evidence‐based perioperative pressure injury prevention bundle that includes skin and risk assessments, visual and electronic health record cues, prophylactic protection of at‐risk skin, communication among providers and leaders regarding patient risk and injury throughout hospitalization, staff member education, compliance audits, root cause analyses, and wound care team follow‐up. The prevention bundle resulted in a 50% reduction in perioperative pressure injuries the first calendar year after implementation and a zero‐incidence rate for perioperative pressure injuries for at least a two‐year period. This article discusses hospital‐acquired pressure injuries related to the perioperative setting and outlines the full perioperative pressure injury prevention bundle.