Uncertainties pepper the healthcare landscape, but the shift to value-based care is expected to continue, even though momentum may slow under the current administration. That means perioperative services leaders must continue to explore new care delivery options such as the perioperative surgical home (sidebar, p 17). “The demand for value…

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Editor's Note Using patient-specific preoperative variables, a validated logistic regression model predicted transfusions in total hip and knee patients in this study. The model identified preoperative hemoglobin, total hip arthroplasty, and females 65 years of age and older as predictors of perioperative transfusions. The model also may help identify those…

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Editor's Note Ketamine does not decrease delirium or lower levels of pain in older adults after major surgery and might cause harm by inducing hallucinations and nightmares, this study finds. A total of 672 patients were randomly assigned to a placebo group (222 patients), a 0.5 mg/kg ketamine group (227),…

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Editor's Note In this study, the use of preoperative and postoperative elements of a Perioperative Surgical Home model in total knee and hip patients was associated with improvements in operational outcomes. The study included 1,225 patients in a preintervention PSH group and 1,363 in a postintervention PSH group. Compared with…

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Editor's Note In this French study, the majority of ICU patients had at least one organ failure at the time of death. Of 698 patients analyzed, 84% had one or more organ failures and 89% required at least one organ support at the time of death. Deaths were considered unexpected…

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Editor's Note Implementation of a Perioperative Surgical Home (PSH) program for patients undergoing ambulatory laparoscopic cholecystectomy in a Kaiser Permanente practice model was associated with significantly reduced length of stay and unplanned hospital admission in this study. The analysis included 878 patients in the preimplementation period and 1,082 in the…

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Editor's Note In this study, Vanderbilt University Medical Center researchers created an automated system to identify diabetic patients, detect insulin administration, check for glucose measurement, and remind anesthesiologists to check intraoperative glucose. Implementation of the automated reminder system: improved glucose monitoring from 61.6% to 87.3% of cases reduced PACU hyperglycemia…

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When leaders at Memorial Healthcare, a 154-bed community hospital in Owosso, Michigan, wanted to get a jump on preparing for bundled payments, they chose to focus on total hip and knee surgery. Creating a perioperative surgical home (PSH) for this patient population paid off in enhanced patient satisfaction and reductions…

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Editor's Note Assigning certain anesthesiologists to specific surgeons affected team performance and turnaround time in this study. Researchers assessed the relationship between turnaround times and assignment of anesthesiologists to surgeons using a Monte Carlo simulation. They constructed managerial decision tables for the assignments, and defined a decision algorithm based on…

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Editor's Note The Surgical Apgar Score (SAS) was found to be significantly predictive but weakly discriminative for major complications and death after emergency high-risk abdominal surgery in this study. The risk of major complications, death, and ICU admission increased significantly with decreasing SAS (P < .001). The score’s c-statistics were…

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