Editor's Note Because a subset of patients are responsible for a disproportionate share of Medicare spending, targeting high-cost patients (ie, “hot spotting”) for cost containment efforts would be an effective strategy to reduce costs in surgical patients, this study finds. Using Medicare claims data from 2010 to 2013, University of…
Editor's Note Though Medicare Accountable Care Organizations (ACOs) have had some success in reducing spending for medical care, they have not had similar success with surgical spending, this study finds. Of 341,675 patients at 427 ACO hospitals and 1,024,090 patients at 1,531 non-ACO hospitals analyzed, average baseline payments were similar…
After transitioning from a paper-based data and operations management system to one that uses relational database software, Lahey Hospital and Medical Center (LHMC) in Burlington, Massachusetts, saved more than $1 million in product purchases in 2017. The surgical value analysis committee (VAC) evaluated 150 product requests and managed the conversion…
Editor's Note In the first 2 years of Medicare’s Comprehensive Care for Joint Replacement (CJR) program, there was a modest reduction in spending per procedure without an increase in complication rates, this study finds. Comparing costs associated with 280,161 joint replacement procedures in 803 hospitals required to participate in the…
Editor's Note Antimicrobial treatment of asymptomatic organisms identified in preoperative urine cultures was not associated with reductions in the risk for postoperative infections, including urinary tract infections (UTIs) and surgical site infections (SSIs), this study finds. In this analysis of 68,265 patients in 109 Veterans Affairs hospitals who had cardiac,…
A greater focus on cost cutting and improving quality of care, a rise in outpatient procedures, and increased demand for cost and quality transparency were among the major healthcare trends projected for 2018. It’s safe to say these will continue to dominate in 2019 and beyond. A year ago, all…
Editor's Note Participation in the Comprehensive Care for Joint Replacement (CJR) bundled payment program was associated with changes in care delivery and compensation practices, this study finds. This survey of 73 orthopedic surgeons found that those practicing in CJR hospitals were more likely to report their hospitals had implemented programs…
Multiple requests for new equipment and technology—usually from surgeons but also sometimes from staff—are not uncommon. As part of their due diligence, OR leaders must determine whether the return on investment (ROI) justifies the purchase. Doing ROI calculations systematically—and involving key stakeholders—can help ensure that the organization makes the best…
Editor's Note Colectomy patients participating in a preoperative prehabilitation program had positive physiologic effects and experienced fewer complications, this study finds. The prehabilitation program−Michigan Surgical and Health Optimization Program (MSHOP)−engages patients in four activities before surgery: Physical activity, pulmonary rehabilitation, nutritional optimization, and stress reduction. For the study, patients were…
Many healthcare organizations have adopted Lean processes to save money, improve workflow, and reduce waste. But it’s not just process change that drives success. It’s the individuals—especially those on the front lines—who work together to identify problems and solutions. It’s also ongoing efforts to sustain changes once they have been…