Editor's Note In this article, the American College of Surgeons and the Johns Hopkins Medicine Armstrong Institute for Patient Safety and Quality, which launched the Agency for Healthcare Research and Quality (AHRQ) Safety Program for Improving Surgical Care and Recovery (ISCR) in 2016, announce that they are expanding the scope…

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Editor's Note A virtual system for in-home physical therapy (PT) provided similar patient outcomes after total knee arthroplasty (TKA), with lower costs than traditional in-person PT, finds this study. A total of 306 TKA patients were randomly assigned to have traditional PT, either at home or at clinic visits, or…

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Editor's Note Reproductive hazards are present in the OR and may contribute to pregnancy complications and infertility in female surgeons, this review finds. Hazards include radiation, surgical smoke, working conditions, sharps injuries, anesthetic gases, and intraoperative use of toxic agents. Studies comparing female surgeons with the general population show increased…

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Editor's Note The safety of bariatric surgery has improved since 1993, and there has been a growth in the number of bariatric procedures performed, this study finds. However, utilization has only marginally increased. Of an estimated 1,903,273 patients who had bariatric surgery between 1993 and 2016, the mean age was…

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Editor's Note This study finds that robotic surgery increased dramatically from 2012 to 2018 and has diffused widely across a broad range of common procedures. This trend was associated with a decrease in the use of open and laparoscopic minimally invasive procedures. In this analysis of 169,404 patients in 73…

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At Virginia Commonwealth University (VCU) Health System in Richmond, implementation of Enhanced Recovery After Surgery (ERAS) incorporates principles of Lean thinking, a management methodology that emphasizes “…maximize[ing] customer value while minimizing waste. Simply, lean means creating more value for customers with fewer resources,” according to the Lean Enterprise Institute.1 Several…

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Of the approximately 57 million surgical procedures performed annually in the US, it is estimated that hospital inpatient procedures (overnight admissions) account for less than 20% of cases. Many procedures once performed in hospital outpatient surgery departments (HOPDs) have moved to ambulatory surgery centers (ASCs) over the past 15 years,…

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Starting the first cases of the day on time is key for maintaining the OR schedule. A delay in first case on-time starts (FCOTS) can lead to less OR utilization, greater facility costs, and dissatisfaction among physicians, OR staff, and patients. It’s a problem in many surgical suites, but when…

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Editor's Note In this study, researchers found that over a 3-year period, compared to no participation, participation in Medicare’s Bundled Payments for Care Improvement (BPCI) program was associated with a 1.6% decrease in average lower extremity joint replacement spending with no changes in quality, driven by early participants. When looking…

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Editor's Note The Food & Drug Administration (FDA) on December 19, 2019, identified the recall by Smiths Medical ASD, Inc of its Medfusion 4000 Syringe Pumps as Class I, the most serious. The recall was initiated because of malfunctioning low-battery alarms, which may lead to an interruption of therapy. The…

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