Editor's Note Hospitals with better nursing work environments and above-average staffing levels were associated with better surgical value (ie, lower mortality with similar costs), especially for higher-risk patients, researchers from the University of Pennsylvania, Philadelphia, found. The study compared outcomes and patient costs at 35 focal hospitals recognized nationally as…

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Editor's Note Analyzing data from the National Cancer Data Base, researchers found that rectal cancer patients who had surgery at precisely 8 weeks (56 days) after the end of combined chemoradiotherapy had the best overall survival and successful removal of their residual tumors. This 6-year study of nearly 12,000 patients…

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Editor's Note Cardiac complications are the leading cause of death within 30 days after noncardiac surgery. This article reviews what is known about perioperative cardiac complications (ie, from induction of anesthesia to within 30 days after surgery), preoperative methods of predicting complications, perioperative cardiac interventions, and postoperative monitoring. The researchers…

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Editor's Note The Joint Commission and AABB (formerly known as the American Association of Blood Banks) have announced a partnership to provide a joint hospital certification program for patient blood management. The voluntary certification will be available in 2016 and is based on the AABB Standards for a Patient Blood…

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Editor's Note A condition known as “post hospital syndrome” (PHS) is a significant risk factor for readmissions in patients who undergo elective ambulatory surgery, this study finds. Post hospital syndrome (PHS) is defined as having been hospitalized within 90 days before surgery. During hospitalization, patients are often sleep deprived and…

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Editor's Note Referred to as the “July phenomenon,” the influx of new surgical residents and interns at the beginning of the academic year is assumed to be associated with poor outcomes. This study of nearly 1.5 million patients who had emergency general surgery either early (July-August)  or late (September-June) in…

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Editor's Note Resident involvement in surgery is associated with comparable patient morbidity and lower mortality outcomes than procedures without residents, this study finds. The analysis used data from the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP). The findings provide a reassuring answer to patients, attending surgeons,…

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Editor's Note The 2014 Institute of Medicine report calls for restructuring of Medicare funding for graduate medical education to incorporate pay-for-performance methods. However, to evaluate and financially reward residency programs based on performance, performance must be defined and measurable. This study assesses general surgery residency program performance using outcomes, including…

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Editor's Note A surgeon’s transformational leadership skills were associated with improved OR team behavior, in this study. Each one-point increase in a surgeon’s transformational score corresponded to three times more information-sharing behaviors and nearly five and a half times more voice behaviors among the team members. With each one-point increase…

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Editor's Note This is the first study to use a human factors and systems engineering approach to evaluate contributors to readmissions after complex surgical procedures. Previous studies on readmissions have neglected the patient perspective, the authors say. Factors identified by patients and clinician providers that may have contributed to readmissions…

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