At Virginia Commonwealth University System (VCU Health) in Richmond, we are using quality standards to establish operational definitions for elements of Enhanced Recovery After Surgery (ERAS). This article describes what those standards are and how they are implemented. Previous articles in this series appeared in the October 2019 and November…

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In the never-ending quest to improve patient care, we are always seeking better ways to process medical devices. Many leading experts now recommend transitioning from high-level disinfection (HLD) to sterilization for semicritical items. Semicritical items are instruments or objects that contact mucous membranes or nonintact skin of a patient, but…

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A strong labor and delivery (L&D) department is a key driver of hospital success. L&D not only contributes significantly to hospital profitability, it plays an important role in establishing and cementing patient loyalty. And as hospitals increasingly take responsibility for community health, an effective birth program can make a measurable…

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Editor's Note Infection after surgery during postoperative days 0 to 30 is significantly associated with long-term infection and mortality, this study finds. In this analysis of 659,486 patients from the Veterans Health Administration, 3.6% had a 30-day infection, 6.6% had a long-term infection, and 3.8% died during follow-up. At any…

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Editor's Note Every year, Perioperative Nurse Week focuses attention on the work of more than 160,000 nurses who advocate for surgical patients. During the week, perioperative nurses are honored by colleagues and communities to highlight the ways in which nurses are working to improve patient safety−before, during, and after surgery−in…

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Editor's Note In this study, a new machine learning Complexity Score algorithm outperformed three commonly used risk scores in predicting postoperative morbidity, 30-day readmission, 90-day readmission, and postoperative surper-use. Study patients underwent colectomy, abdominal aortic aneurysm repair, coronary artery bypass grafting, total hip or knee replacement, or lung resection. The…

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Editor's Note Incorporating medical scribes into surgical practices to reduce time surgeons spend on patient documentation and managing electronic health records increases the number of patients seen by surgeons and residents in outpatient clinics, finds this study presented October 29 at the American College of Surgeons Clinical Congress 2019 in…

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Editor's Note The American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) Surgical Risk Calculator accurately predicted four quality-of-life outcomes that transcend traditional measures of successful surgery and now reflects the expected effects of surgery on an older patient’s ability to function independently, finds this study presented October…

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Editor's Note Surgeons can better understand the effect of a patient's postoperative physical activity on their recovery by capturing passively-collected accelerometer data from their patients’ smartphones, finds this study presented October 28 at the American College of Surgeons Clinical Congress 2019 in San Francisco. Patients enrolled in the study downloaded…

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Editor's Note Delaying a cholecystectomy for acute cholecystitis more than 3 days after admission increased the rate of complications, hospital readmissions, and lengthened hospital stays, in this study presented October 30 at the American College of Surgeons Clinical Congress 2019 in San Francisco. Using 2012 to 2016 ACS National Surgical…

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