Surgery/Specialties
In reducing complications, plan on less revenue
One would think that reducing surgical complications would lower a hospital’s costs in addition to being the right thing to do. But the hospital’s bottom line can be seriously affected. The loss can be substantial unless new surgical volume is added to make up for the loss, a new analysis…
A surgeon blasts dangerous care, calls for ’transparency revolution’
Does your OR have a Hodad, a Raptor, or a Shrek? These are handles for dangerous surgeons that Martin Makary, MD, MPH, describes in his scathing new book, Unaccountable. Dr Makary, a surgeon and patient safety leader at Johns Hopkins, advocates a “transparency revolution” to make data public and motivate…
Reducing variation in total knee replacements
A new study in the journal Health Affairs of total knee replacement (TKR) confirms that wide variations in care exist among hospitals based on factors such as geographic location. The High Value Healthcare Collaborative found significant variations in TKR among the 5 participating health care systems. Among these were length…
Managing the costs of explanted spine hardware
During spinal surgery, it is sometimes necessary to implant and then remove, or explant, instrumentation in the same procedure. Explantation occurs when an implanted plate or spacer does not fit, or implanted screws are too loose or too short. Explanted instrumentation cannot be reused and must be discarded, adding to…
New US total joint registry signing up hospitals
A new hip or knee implant comes on the market. Surgeons would like to start using it. But the cost is higher than current implants the hospital is using. Will it offer better outcomes for patients? The answer has been hard to come by. If there is outcomes data, it…
BMP use up sharply, but outcomes not improved
Use of bone morphogenic protein (BMP) has risen sharply in the past decade, adding costs without evidence of better outcomes, according to a study in the February 2012 issue of Spine. BMP use rose rapidly, from 5.5% of lumbar fusions in 2003 to nearly a third (28.1%) of procedures in…
Tracking TASS: Registry eyes an elusive target
Cataract surgery, almost exclusively outpatient, can have a serious complication if instruments retain a chemical residue after cleaning. It is known as TASS, for toxic anterior segment syndrome. Ophthalmologists say it is rare, but there are no consistent data to indicate when, where, and how often TASS occurs. The Food…
For implants, balancing choice and cost control
Negotiating with orthopedic vendors can be frustrating as OR leaders strive to balance competing agendas among companies, surgeons, and the hospital. Kimberley Murray, MS, RN, CNOR, administrator for the orthopedic and spine service line at St. Joseph’s Hospital (SJH) in Syracuse, New York, reduced frustration by adopting a program that…
A critical eye on Infuse use studies
A leading spine journal is casting a critical eye on industry-supported research that has led to widespread use of Medtronic's controversial bone growth product Infuse. The June 2011 issue of Spine Journal carries a strongly worded editorial about the trial designs, reporting bias, and peer review shortfalls that the authors…
New risk calculator predicts bariatric surgery morbidity
Anew risk calculator allows surgeons to model and predict the risk of complications for individual patients after bariatric surgery, a new study reports. Available free online, the risk calculator will aid in surgical decision making and help patients better prepare for their surgery by understanding the true risks and benefits,…
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