Introduction The global 2019 coronavirus pandemic (COVID-19) is setting unprecedented demands on the nation and the military and surgical services. Surgical demands include a large backlog of surgical cases, strain on available resources, and the need for additional measures to prevent exposure. The purpose of this project was to evaluate the feasibility, duration, adverse events, and potential gains associated with using a Turbett Sterilization Pod (TSP) for total joint replacements. Materials and Methods A multidisciplinary team used the Plan–Do–Study–Act model to guide this project. A time–motion study was completed in the operating room (OR) to measure the average time required to set up surgical instrumentation for total joint replacement cases that required 12 or more instrument trays. We compared the amount of time it took to complete the setting up of instrumentation using the traditional method versus the TSP method. The traditional method consisted of unwrapping each surgical tray, checking for holes in the blue wrapper, and placing the tray on the back table. In the case of the TSP, the door of the pod was opened, and the instrument trays were transferred directly to the back table. We measured the time the staff took to perform the task using each of these methods. Results When compared to the traditional method, the use of the TSP resulted in improved turnover time, decreased room setup time, reduced environmental waste, and eliminated both the effect of damage to wrappers and the time previously spent wrapping surgical trays. Conclusion The TSP minimizes the time needed by the staff to set up an OR suite for a total joint replacement, therefore permitting them to focus more on direct patient care. This time improvement suggests that all surgical specialties, including those requiring greater than 12 traditional instrument sets, may experience reduced turnover time between cases. The use of the TSP is one means to help rectify the OR backlog brought on by COVID-19.
The existence of lengthy wait lists, a not uncommon condition found in many public community mental health services, prompted a small team that was performing the intake function for its clinic to launch a pilot project of Brief Therapy. Amidst a traditionally oriented service and in the face of understandable skepticism, this team constructed a coherent plan of action founded upon the solution focused model of brief therapy. Not only did the results more than validate the team's initial expectations, they so impressed their management team with their data, that even in times of marked fiscal restraint, the Brief Therapy Program was expanded.
In solution-focused brief therapy, the client is considered the expert in identifying his or her hopes and goals. The interviewer's role is to facilitate the articulation of hopes and the building of these hopes into change. This article shows how each client action presents multiple opportunities for solutionfocused therapists to perform their role. Microanalysis of actual therapeutic dialogue, by two collaborating practitioners, reveals how opportunities are identified, how options for solution-focused responding are generated, how the preferred opportunities and responses are selected, and how rationales for the particular selection may be usefully shared and compared. The most practical application for this study of opportunities lies in the continual refinement of solution-focused interviewing skills in the contexts of training, supervision, and perpetual learning.In the course of a single therapy session, clients provide a myriad of statements, any one of which could be the focus of a response by a therapist. Indeed, as this article will show, numerous choices are presented within a single client utterance. No matter what theory or model informs a therapist's practice, he or she must make decisions about how to respond to a client. The question is, what informs that decision? Fiske (2007), a solution-focused practitioner, states that "many students (and teachers) view an understanding of theory as necessary in defining a therapeutic approach" (p. 319). While many clinicians may choose to follow the dictates of a theory to guide clinical response, solution-focused brief therapy practitioners build their responses on what clients say. The assumption that we make is that clients' utterances are useful and it is our job to determine how to use them productively.This stance requires that we listen carefully to clients. Moreover, this stance requires that we discern what is useful in clients' statements, make choices about what we will respond to, determine how to best respond, and decide what rationale Organizing the Solution-Focused Interview 63 drives that decision. For the past two years, the authors have collaborated together in studying how we listen for choices, how and why we choose the responses to clients that we do. We have found this process not only helpful to us as practitioners, but also useful to those whom we train. This article details the background, process, and results of that collaboration. BACKGROUND
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