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We instituted a multidisciplinary educational and operational quality improvement initiative to assess the effect of process interventions on reducing OR door openings and, by extension, surgical site infections. From 2009 to 2012, we conducted an initial trial to gather information and identify reasons for door openings followed by a three-phase investigation that evaluated a total of 102 orthopedic hip and knee procedures in which we counted door openings from the time of incision to the closing of the capsule. We analyzed the effectiveness of door opening deterrents (eg, a pull shade, magnetic yellow caution tape across the door frame) and changes in traffic processes (eg, clear-covered implant carts). The interventions and process changes showed a 50% reduction in door openings compared to the baseline.
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Rovaldi et al. (2015) studied this question.
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