Knowledge sharing can save a lot of time, effort and money in health care.It's been proven at King Edward VII Memorial Hospital through its partnership with Johns Hopkins Medical Institute in Baltimore, Maryland.Two years ago Marek Mirski, chairman of the anaesthesiology department at JHMI, was hired as a consultant by KEMH.In the period since, he's given lectures in his specialty area of anaesthetics.Dr Mirski also consults with health care workers with a view of improving efficiency. He's made six visits to KEMH over the past two years, holding consultative discussions with various groups in the hospital.The first was held with two other JHMI physicians.“In many respects it was hanging our own laundry, showing what problems we've encountered at our institution and what paths or remedies we attempted what worked and what didn't,” he said.Although KEMH is a very different type of hospital to JHMI there were many lessons that could be learned and ways of approaching concerns that could be adopted, Dr Mirski added.He said there are between 50 and 60 operating rooms at JHMI and six at KEMH both hospitals face a similar challenge in making the rooms run efficiently.“You have surgical staff posting operations. Surgical staff would like to schedule operations when they have time themselves,” he said. “They have their own clinical time and operating time so they get blocks in the schedule.“Then the nursing room anaesthesia and pre-op (staff who prepare patients for operations), all have to work together to have the patients stream in, have the operation, then go back to recovery. It sounds simple but operationally there are many areas where things get hung up.”There is difficulty in scheduling patients as, once the physician is in the operating room things might be held up, not only due to complications in the actual surgery but for operational matters.“Say you start at 7.30 and you have another case at ten, but the operation goes until one because there was a delay in the operating room, because the equipment wasn't there. The surgeon thought he needed X, Y and Z but only X and Y were there, while Z was still being processed. Why? Because one of the sterilising machines is down and so only one is working.“Sometimes the patient themselves is not prepared because, unknown to the anaesthesiologist, the person has eaten when they should not have or they failed to disclose a particular condition and so now the surgery is held up until there is verification from the lab that it's safe to continue,” he said.Such scenarios on the face of it can be easily solved by the hospital implementing specific step-by-step rules or protocols.However, Dr Mirski warned: “Protocols can be great but they can also be burdensome and they can make efficiency work against you.“You have to try to get the correct protocols that make sense for the type of environment that you have. For example some of our problem areas at Hopkins may not adapt here but at least seeing how we approached our problems and avoiding some of the potholes we stepped in, allows your institution to be more efficient in how it expedites its solutions.”During his most recent visit here, Dr Mirski lectured on spinal cord injuries. Read Body & Soul in January for that story.