Editor's Note Physical activity in total joint patients did not change at 6 months after surgery and small-moderate improvement was found at 12 months, despite large improvements in pain and quality of life, this meta-analysis finds. A total of seven studies (336 patients) were analyzed. Reasons for the lack of…

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Editor's Note From 2008 to 2014, rates of postoperative readmissions declined for both Hospital Readmission Reduction Program targeted procedures (total hip and total knee replacements)--from 6.8% to 4.8%--and nontargeted procedures (colectomy, lung resection, abdominal aortic aneurysm repair, coronary artery bypass graft, aortic valve replacement, and mitral valve repair)--from 17.1% to…

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Editor's Note This survey of 800 patients identified a range of potential barriers and benefits to using mobile health technology to enhance recovery after surgery. Potential barriers included: protecting personal health information technology effectiveness and failure preference for face-to-face interaction with their surgeons level of effort required ability of older…

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Editor's Note Postoperative pain trajectories can identify patients at risk for 30-day readmissions and emergency department (ED) visits, and are not mediated by postdischarge complications, this study finds. In this analysis of 211,231 surgical procedures (45.4% orthopedic, 37.0% general, and 17.6% vascular), the 30-day unplanned readmission rate was 10.8%, and…

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Organizations that have adopted the perioperative surgical home (PSH) model of patient care have reaped the benefits of improved outcomes and a healthier bottom line. In particular, the PSH has a proven track record for colorectal surgery and orthopedic surgery. In part 1 of this two-part series (OR Manager, August…

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Editor's Note Early postoperative hyperglycemia was linked to increased readmissions after gastrointestinal surgery in insulin-dependent diabetic patients, but elevated preoperative hemoglobinA1c was not, this study finds. Higher preoperative hemoglobinA1c levels were associated with increased postoperative glucose level checks and insulin use as well as lower rates of postoperative complications. Though…

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Editor's Note An Enhanced Recovery after Surgery (ERAS) program for colorectal surgery patients shortened hospital length of stay by more than half, reduced complications by more than one-third, and cut costs by some $11,000 per procedure, finds a study presented July 23 at the American College of Surgeons 2017 Quality…

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Uncertainties pepper the healthcare landscape, but the shift to value-based care is expected to continue, even though momentum may slow under the current administration. That means perioperative services leaders must continue to explore new care delivery options such as the perioperative surgical home (sidebar, p 17). “The demand for value…

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Editor's Note Comparing rates, characteristics, and costs of hospital readmissions across all ages and insurance types, researchers from Beth Israel Deaconess Medical Center, Boston, found that of more than 12.5 million patients discharged in 2013, approximately 1.8 million were readmitted within 30 days. Medicare patients accounted for 56% of readmissions,…

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Editor's Note The American Society of Colon and Rectal Surgeons and the Society of American Gastrointestinal Endoscopic Surgeons have jointly published new clinical practice guidelines on enhanced recovery after colon and rectal surgery. The enhanced recovery protocol is multidisciplinary, including physicians, nurses, physical therapists, and dietitians and involves all aspects of care…

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