PACU finds its flow in better patient management
The postanesthesia care unit (PACU) is no longer used just to recover patients after surgery. Multiple departments use it for various procedures, from electroconvulsive therapy (ECT) to regional blocks, as well as to ease emergency department (ED) overcrowding. This makes it difficult to manage bed availability, OR scheduling, and patient…
Checklist compliance soars to 100% after 'red rule' implementation
Most OR leaders believe the World Health Organization (WHO) Surgical Safety Checklist can help prevent surgical errors and complications. But although many hospitals have formally adopted the WHO checklist, fewer ORs use it consistently. At Signature Healthcare Brockton Hospital, a nonprofit teaching facility south of Boston, we addressed this issue…
Case cancellations drop dramatically with refined preop screening
Lexington Medical Center in West Columbia, South Carolina, has had an annual average 3% growth in surgical volume since 2011 and is planning to add six ORs over the next 3 years. That’s a good position to be in. However, the ability of the organization to support continued surgical growth…
Adding new business to the ASC, one procedure at a time—Part 3
Total joint procedures are gradually moving to ambulatory surgery centers (ASCs) as technology, medical expertise, and cost pressures combine to make the ASC an increasingly attractive alternative to an acute care hospital. The key to success for these and other complex procedures, experts say, is a combination of careful planning,…
Impact of bariatric surgery before joint replacement
Editor's Note Bariatric surgery performed before hip or knee replacement can reduce in-hospital and 90-day postoperative complications, finds this study presented March 14 at the American Academy of Orthopedic Surgeons annual meeting in San Diego. Compared with morbidly obese patients who did not have bariatric surgery before joint replacement, those…
AHRQ data show drop in hospital-acquired conditions
Editor's Note There were about 3.1 million fewer hospital-acquired conditions (HACs) between 2010 and 2015, according to a newly released report from the Agency for healthcare Research and Quality (AHRQ). Most of the decline was because of a: 42% reduction in adverse drug events 23% drop in pressure ulcers 15%…
FDA: Class I recall of Medtronic implantable drug infusion pumps
Editor's Note The Food and Drug Administration (FDA) on March 14 categorized the recall by Medtronic (Minneapolis) of its SynchroMed II and SynchroMed EL implantable drug infusion pumps as Class I, the most serious. The pumps are being recalled because a software problem may cause unintended delivery of drugs during…
Study: Preop epidural injections increase SSI risk after spinal fusion
Editor's Note Lumbar spinal fusion performed within 3 months after lumbar epidural steroid injections was associated with a statistically significant increase in postoperative infections in this study. The association was not found when surgery was performed more than 3 months after steroid injections. Of 88,540 patients analyzed, infection rates were:…
Effect of home-based vs inpatient rehab on mobility after total knee
Editor's Note The use of inpatient rehabilitation compared with a monitored home-based program did not improve mobility at 26 weeks after total knee surgery, this study finds. In the study, 81 patients received 10 days of hospital inpatient rehabilitation followed by an 8-week home-based program, and 87 patients received only…
ECRI Institute releases top 10 patient safety concerns
Editor's Note The ECRI Institute on March 13 released its 2017 Top 10 Patient Safety Concerns for Healthcare Organizations. This year’s list includes: Information management in electronic health records Unrecognized patient deterioration Implementation and use of clinical decision support Test result reporting and follow-up Antimicrobial stewardship Patient identification Opioid administration…