Injections were slowly delivered from a zero-dead-volume syringe fitted with a curved 19G retrobulbar injection needle (Beaver-Visitec, Waltham, MA, USA), which was threaded through the loop suture to reach the posterior pole. The loop suture was progressively closed as the needle was withdrawn to minimize leakage of solution from the injection site, then finally fully closed and tied off. Note that the HyA solution was prepared (by mixing HyA precursors with crosslinker) immediately before its injection to avoid polymerization in the needle. Topical moxifloxacin hydrochloride solution (Vigamox; Alcon, Ft. Worth, TX, USA) was applied prophylactically to the incision site, the lid retractor removed, and any blood or fluid gently cleared away with sterile gauze. Diffusers were replaced and the guinea pigs were allowed to recover from anesthesia. TopicalInterview with a quality leader: Kate Goonan on performance excellence. Interview by Pamela K. Scarrow.
Kathleen Jennison Goonan, MD, is Executive Director of the Mongan Institute for Health Policy, Center for Performance Excellence (CPE) at Massachusetts General Hospital. CPE guides transformational change in healthcare management and helps leaders, administrators, and practitioners in the healthcare workforce nationwide achieve and sustain performance excellence (http://www.mghcpe.org). An internist trained at the Massachusetts General Hospital, she has more than two decades' experience leading healthcare quality assessment and improvement initiatives. Before joining the CPE in 2002, she held a number of senior executive positions, including Senior Vice President of the Institute for Healthcare Improvement. Dr. Goonan has served as a judge for the Malcolm Baldrige National Quality Award, the Joint Commission's Codman Award, and for