Across the US, surgical services are estimated to comprise around 20% of national health spending and typically generate up to 70% of total health system revenue.1, 2 That makes surgical services the largest revenue generator for a hospital, supporting access to numerous other healthcare services. Considering the average hospital has…

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Leaders at Virginia Commonwealth University (VCU) Health System in Richmond started the journey to become an Enhanced Recovery After Surgery (ERAS) hospital in 2016 with the following problem statement: Across surgical specialties, and regardless of superior surgical technique, perioperative care, and anesthesia care, patients can experience extended length of hospital…

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Strategies that can achieve the aims of excellence in clinical care, fewer complications, and reduced costs are sorely needed, and the comprehensive implementation of an Enhanced Recovery After Surgery (ERAS) program can help achieve these aims in the surgical population. ERAS pathways have been found to reduce morbidity, hospital stay,…

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On January 1, 2020, the Centers for Medicare & Medicaid Services (CMS) began reimbursing healthcare providers for total hip arthroplasty performed in outpatient hospital settings and total knee arthroplasty in ambulatory surgery centers (ASCs), thereby opening the floodgates for explosive growth in outpatient total joint arthroplasty (TJA). About a million…

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Editor's Note An expert panel from the American Association of Hip and Knee Surgeons on July 15 issued guidelines that include recommendations for when hospitals and surgical centers can resume elective orthopedic procedures. A set of 30 recommendations are presented in four categories: General—includes criteria based on factors, such as…

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Editor's Note The Joint Commission announced July 1 that it has made two sets of standards changes for deemed-status hospitals and critical access hospitals. The first set of changes, which went into effect July 1, was made in response to hospital deeming renewal applications with the Centers for Medicare &…

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Editor's Note In this study, Yale researchers found that endotheliopathy and platelet activation might be important factors in the pathophysiology of COVID-19-associated coagulopathy. The researchers examined the blood of 68 COVID-19 patients, 48 of them in ICU and 20 receiving care in a hospital unit, along with 13 disease free…

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Enhanced Recovery After Surgery (ERAS) is arguably the greatest advancement in surgery in the last 20 years. But even healthcare leaders who support the use of ERAS to achieve better outcomes can find it daunting to implement the protocols throughout their hospital systems. Standardizing practices across areas that have historically…

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Editor's Note The American College of Surgeons (ACS) on April 17 announced that the ACS, AORN, American Society of Anesthesiologists (ASA), and American Hospital Association (AHA) together developed a roadmap to guide readiness, prioritization, and scheduling for safely resuming elective surgery. Highlights of the roadmap include: Implementing a policy for…

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Editor' Note The American College of Surgeons (ACS) on April 17 released a new document, “Local Resumption of Elective Surgery Guidance,” to help healthcare facilities prepare to resume elective surgery once COVID-19 has peaked in their area. The document includes four categories: COVID Awareness—addresses the community’s COVID-19 numbers, including prevalence,…

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