 low patient satisfaction due to unnecessary wait times. Standardizing O.R. procedures increases awareness among O.R. team members of areas needing attention, leading to significant improvements, Emerick said.
•	Reducing overstock saves money: By applying supply chain theory to one item alone, researchers at the University of Texas MD Anderson Cancer Center-Houston calculate the center will save $21,500 the first year of implementation and $15,500 in subsequent years. To conduct the study, researchers chose the Arrow 12 Fr. Triple lumen central venous catheter, used in surgical cases where rapid infusion of blood or blood products is anticipated. Although these procedures typically are scheduled in one of five specific O.R.s, the catheter was unnecessarily stocked in all 30 O.R.s and the ambulatory care center. Because the catheters expire, overstocking leads to waste, notes lead author Charles E. Cowles, Jr., M.D., M.B.A., assistant professor of anesthesiology and perioperative medicine. Calculating how many catheters would be required – including factoring in ordering time – researchers determined only 10 catheters should be stocked, whereas the hospital had 49 in stock. Savings would be significant if the supply chain theory is applied to the thousands of items overstocked in hospitals nationwide, researchers note.
•	Putting out the fire: Fire usually doesn’t top the list of potential O.R. concerns, yet approximately 600 surgical fires occur in the United States every year. More than two-thirds of these fires are caused by electrosurgical equipment and the use of supplemental oxygen is a factor in most cases. To reduce or prevent O.R. fires, physician anesthesiologists and other surgical team members at the University of Florida, Jacksonville, focused on improving policies, education and training, as well as communications to create a culture of safety. Lead author Linda W. Young M.D., M.S., UF Health, Jacksonville, said the group developed a tool to identify patients at high risk of experiencing a surgical fire and employed other risk-reduction strategies, including electronic prompts with the electronic medical record, periodic fire drills and provision of education to surgical staff members. Researchers are still tabulating the data, but have noted a reduction in incidents due to the increase in awareness and adherence to the protocol.
•	Comparing apples to apples: Being able to benchmark clinical productivity allows anesthesiology groups and hospitals/facilities to identify areas for possible improvement. But it is important to compare the benchmarking data of similar facilities in order to provide meaningful comparisons. Researchers from several institutions surveyed the members of the Association of Academic Anesthesiology Chairs about anesthesiology clinical work by facility. This resulted in benchmarking data based on 143 different facilities accounting for more than 2.5 million cases. Comparing like facilities, the results showed that shorter surgical duration at children’s, community and smaller facilities led to more units billed per hour of care, resulting in fewer billed hours for similar productivity per O.R., said lead author Amr Abouleish, M.D., M.B.A., professor of anesthesiology at University of Texas Medical Branch, Galveston.
	Standardizing preoperative evaluations: To improve care, lower costs and reduce morbidity and mortality (death and other problems that can occur during surgery), Georgia Regents University in Augusta developed protocols towards the creation of a “surgical home,” including computer-assisted health screening questionnaires for various scenarios. With the increasing focus on the surgical home concept, which facilitates coordinated and integrated care, the goal is to standardize preoperative evaluation to ensure careful triage and appropriate treatment as well as decrease unnecessary actions. For example, the protocol guides nursing and anesthesia staff on tests and measures needed before surgery, and clarifies which medications patients should avoid on the day of surgery. About 65 percent of hospital expenses are due to morbidity and mortality, and administrators anticipate the cost of the new system will be offset by savings from minimizing redundancy, avoiding surgery delays and cancellations and improved reimbursement coding, said lead author Mary E. Arthur, M.D. associate professor in the Department of Anesthesiology and Perioperative Medicine. The ASA applauds the effort, having recently committed more than $500,000 in support and scholarship to jumpstart the development of a learning collaborative of health care organizations working to improve surgical care through the Perioperative Surgical Home (PSH) model.
Anyone who's played a game, any game of marbles knows the objective is to win as many marbles of your opponents as you can so that you can **have more marbles, as many marbles as possible.**

That's it. That's all there is to it. Win marbles, grow your marble pile.

It wouldn't be considered winning if they exchanged marbles, wouldn't it?

You started with ten marbles, you ended with ten. How is that winning? 

So yes, the game was to win all twenty marbles, take all ten of your opponent's to increase your pile. That is the essence of every marble game. It's something that shouldn't even have to be explained in the show, thank god it wasn't, would've eaten up time.In order to try and create some sort of club competition in 2020 following the Coronavirus, all being well we'll hold a Club Championship based on the Sandygate Loop.
The plan is that in each of July, August and September there will be two events held, for a total of six available races. To qualify, each runner will have to have completed at least three races, and if they complete more it will be the best three events to count.
The scoring system will be based on age grading, so if an individual scores 55% on race 1, 58% on race 2 and 53% on race 3, their total would be 166%. There will be a mens and ladies competition and the winner would be the member with the highest total percentage, the second placed finisher would be the one with the second highest total percentage, and so on.
This is a great way to test yourself over a challenging four mile course, as well as a great Trotter social get-together!
The four mile course starts and finishes at the Sandygate Inn, in Kingsteignton, and follows quiet country lanes on a circular loop.
We will be continuing with staggered start times again this year of 6.50pm and 7pm with the view that most people taking part will finish closer together. Anyone running under 32 minutes is asked to start at 7pm.
Parking is available in the pub car park and there is an option to stay for a meal and a drink afterwards.
NOTE: As this is an internal Trotter event, club kit does not need to be worn to comply with the club championship rules!The Best Tips To Remember When Buying A Refurbished Vehicle
Owning a vehicle comes with some form of traveling freedom and raises your status in society. However, there comes a time when the only choice you have is to buy a used vehicle for different reasons. That is why it is essential to consider checking out the deals at Ford Dealership Huntsville-based. Nonetheless, if you do not understand how to purchase a refurbished vehicle, you may lose a substantial amount of money and time.
Compare Prices
There is a wide variety of remodeled vehicles in today’s market. Therefore, before you settle on any of them, it is always advisable to compare different prices. If you want a specific model, comparing how much various dealers are offering, it would be appropriate. The critical point here is to have a precise budget showing how much is available to get the vehicle you want. It would also be recommendable to remember other ownership expenses, including insurance and maintenance. Therefore, price should not be the ultimate deciding factor.
Source Locally
You would be surprised to learn the number of dealers and car owners offering used motors in your locality. Therefore, before you travel far, ensure you have combed your area enough to identify a renovated vehicle that suits your needs. Nonetheless, you need to make some considerations to ensure you get the car you desire. Consider the dealer’s distance from you, the vehicle’s mileage, and any added features.
Embrace Inspection By A Qualified Mechanic
One of the grave mistakes you can commit when buying a used car is driving off without having it checked and inspected by a mechanic. Most buyers forget this inspection because, in some cases, they are required to make out-of-pocket payments for the mechanic’s services. The same may happen to you, where you are required to cover the inspection expenses. Nevertheless, having the vehicle inspected and checked can save you substantial amounts in the long term. The inspection may come as an offer if you buy the car from a dealer, but you must ensure the offer is in the agreement.
Do Not Go For The Looks
You can attest that some dealers can give a vehicle a serious touch-up on the exterior and interior but never touch the mechanical parts. When it comes to buying a used car, looks can be deceiving. The machine may look enticing on the outside, but the engine and other essential parts are at their dead-end. That is why a test drive is of the essence – it helps you ensure that the vehicle is functioning as expected. Additionally, you need to be clear about how you intend to use the motor, whether you are shopping online or face-to-face. If you need a commuter machine, there is no need to look at trucks. If you want a heavy-duty vehicle, it would be implausible to check out sports cars.
Forgetting the above-explained tips can land you in trouble and even cost you a lot when buying a refurbished vehicle. One of the crucial things is to