Practical guide for improving performance.

Research has established that health care is not error free. The question facing perioperative units, as well as all health care services, is how to minimize the human factors that impact quality and safety. This two-part series on performance improvement in perioperative services was intended to help answer this question. Achieving performance excellence starts with a supportive work culture. The human issues of teamwork, communication, and leadership are crucial to achieving performance excellence. Next, perioperative caregivers must accept that all people make mistakes so systems and processes can be designed to be more "forgiving" of errors. Last, a planned and systematic approach must be used to measure, analyze, and improve performance. Successful implementation of performance improvement calls for strong partnerships between physicians, managers, and staff members. Performance excellence requires that everyone work together to ensure that perioperative care is safe, effective, appropriate, customer focused, and efficient.