Surgery
CDC urges communities, hospitals to prepare for spread of coronavirus
Editor's Note In a February 25 telebriefing, the Centers for Disease Control and Prevention (CDC) warned that the novel coronavirus (COVID-19) will spread in the US, and hospitals and communities should begin ramping up their preparedness efforts, AHA Today reports. The CDC urged communities to implement non-pharmaceutical interventions or community…
Effect of total joint bundled payment program on patient selection
Editor's Note In this study, researchers found little to no significant change in the characteristics of patients having total hip and knee replacement surgery after the Centers for Medicare & Medicaid Services introduced the mandatory bundled payment programs in selected metropolitan statistical areas. The analysis included a matched set of…
CMS proposes changes to total joint bundled payment program
Editor's Note The Centers for Medicare & Medicaid Services (CMS) on February 20 issued a rule proposing changes to the Comprehensive Care for Joint Replacement (CJR) program, which bundles payments to acute care hospitals for hip and knee replacement surgical procedures. CMS proposes extending the CJR model for an additional…
Breathing easier in a smoke-free health system
Controlling electrosurgical smoke is a major challenge in many ORs. In 1996, the National Institute for Occupational Safety and Health published a policy on controlling smoke from lasers and electrosurgical procedures, and over the years, studies have linked adverse health effects with electrosurgical smoke exposure. Yet healthcare providers have differing…
Using project management principles to hardwire ERAS protocols
Implementation of Enhanced Recovery After Surgery (ERAS) at Virginia Commonwealth University (VCU) Health System in Richmond has been achieved through project and change management tools that transform the current state to the desired future state. To hardwire ERAS protocols in the OR as well as the ambulatory and acute care…
Using smartphones to capture patient differences in postop physical recovery
Editor's Note Metrics derived from smartphone accelerometer data can capture differences in postoperative physical recovery in surgical patients, this study finds. In this analysis of 62 patients, smartphone accelerometer data showed decreases in daily exertional activity in 17 who experienced a postoperative event (eg, complication, reoperation) up to 6 weeks…
Association of geriatric-specific characteristics with postop readmissions
Editor's Note In this study from the University of Virginia, new geriatric-specific characteristics were found to raise the risk of elderly surgical patients having unplanned readmissions within a month of leaving the hospital. The four geriatric-specific risk factors for readmission include: cognitive impairment requiring another person to sign the patient’s…
AORN releases COVID-19 tool kit
Editor's Note AORN on February 14 released a new coronavirus (COVID-19) tool kit to support OR decision-making for the safety of healthcare workers and patients. The toolkit includes: World Health Organization updates Centers for Disease Control & Prevention updates ECRI Institute-Coronavirus Outbreak Preparedness Center resources Journal of the American Medical…
Frailty as a predictor of postop mortality, new disability
Editor's Note In this Canadian study, older patients with frailty were significantly more likely to die or experience a new disability within 90 days after surgery. This prospective multicenter study included 702 patients, 65 years or older, having elective noncardiac surgery; 645 patients completed follow up. Frailty status was determined…
Standardized pathway for outpatient ambulatory fracture surgery
Editor's Note In this study, an outpatient fracture pathway greatly improved the efficiency and timeliness of care, and it reduced costs. A total of 187 patients during the preintervention period and 308 patients during the intervention period were eligible for the ambulatory pathway. Those managed as outpatients increased from 1.6%…
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