Safety A care transition poses a danger point for patients—failing to “hand off” needed information from one clinician to another can lead to significant morbidity and mortality. The Joint Commission was so concerned about handoffs that in 2017 it issued a sentinel event alert on the topic. “Handoffs are a safety…
In 2017, the Joint Commission issued a Sentinel Alert Event on the problem of inadequate handoff communication, focusing attention on this vital aspect of care. (See related story, p 22.) Clinicians and leaders agree that handoffs are important, but implementing them effectively can be challenging, particularly in the fast-paced perioperative…
Enhanced Recovery After Surgery The implementation of Enhanced Recovery After Surgery (ERAS) is based on the concept of organizing care around the patient, addressing medical condition needs to optimize readiness for surgery and reducing the likelihood of postoperative complications. Efficacy is measured by how well we perform according to these…
Keeping up with Medicare’s regulatory and reporting requirements for ambulatory surgery centers (ASCs) can be as difficult as ensuring physicians arrive to start their cases on time. “Regulations can change frequently,” says Gina Throneberry, MBA, RN, CASC, CNOR, director of education and clinical affairs for the Ambulatory Surgery Center Association…
When you have a problem, are you empowered to solve it? What happens when staff encounter an obstacle? Cleveland Clinic’s Tiered Huddle process empowers all caregivers to see problems and tackle issues on their own or escalate them for assistance. The tiered huddles have energized teams to work across the…
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…
Our series on Enhanced Recovery After Surgery (ERAS), which began last month with an overview of its history and perioperative pathway, continues in this issue with examples of improved outcomes and the roles played by perioperative team members (see p 18). ERAS, known to speed recovery and increase patient satisfaction,…
The US has been on a journey for the last several years to reduce the cost of healthcare. In 2017, the percent of gross domestic product attributed to healthcare goods and services was at 17.9%. This is expected to reach as much as 19.4% by the year 2027.1 Factors contributing…
Internal surgical staplers made headline news in 2019. Reports discussed the little-known US Food and Drug Administration database housing tens of thousands of stapler-related problem reports and covered the agency’s recent proposal to reclassify staplers as Class II devices, instead of the more lightly regulated Class I. ECRI Institute named…
Enhanced Recovery After Surgery (ERAS®) is a comprehensive, multifaceted, and multidisciplinary approach to the care of the surgical patient. ERAS bundles evidence-based elements to facilitate a faster recovery with fewer complications.1 Spanning the continuum of perioperative care, ERAS elements include: • patient engagement and education • preoperative optimization of nutrition…
