Tag: Discharge Planning

Medicare may overpay for postop care

Editor's Note Medicare may be overpaying surgeons for postoperative care they provide to patients, according to a new Rand Corporation analysis in the January 23 New England Journal of Medicine. The authors of the analysis suggest that federal officials should incorporate ways to more objectively measure the amount of postoperative…

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By: Judy Mathias
January 23, 2020
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Virtual physical therapy rehab vs traditional care after TKA

Editor's Note A virtual system for in-home physical therapy (PT) provided similar patient outcomes after total knee arthroplasty (TKA), with lower costs than traditional in-person PT, finds this study. A total of 306 TKA patients were randomly assigned to have traditional PT, either at home or at clinic visits, or…

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By: Judy Mathias
January 16, 2020
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Study challenges concerns about HRRP

Editor's Note This study from the division of cardiology at Dallas’ University of Texas Southwestern Medical Center and the Yale School of Medicine, New Haven, Connecticut, challenges concerns about Medicare’s Hospital Readmission Reduction Program (HRRP)--ie, that it leaves patients more vulnerable and increases postdischarge mortality rates. Analyzing inpatient and outpatient…

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By: Judy Mathias
January 16, 2020
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Reinvent and reap the rewards of improved handoffs--Part 2

An effective handoff helps ensure care transitions are safe and efficient, but achieving the ideal handoff can be challenging. Part 1 of this two-part series provided an overview of the role of handoffs in the perioperative setting (OR Manager, January 2020, 22-23, 25). This article offers best practices for successful…

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By: Cynthia Saver, MS, RN
January 13, 2020
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Develop standard work for successful ERAS implementation

At Virginia Commonwealth University (VCU) Health System in Richmond, implementation of Enhanced Recovery After Surgery (ERAS) incorporates principles of Lean thinking, a management methodology that emphasizes “…maximize[ing] customer value while minimizing waste. Simply, lean means creating more value for customers with fewer resources,” according to the Lean Enterprise Institute.1 Several…

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By: OR Manager
January 13, 2020
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Reinvent and reap the rewards of improved handoffs--Part 1

A care transition poses a danger point for patients—failing to “hand off” needed information from one clinician to another can lead to significant morbidity and mortality. The Joint Commission was so concerned about handoffs that in 2017 it issued a sentinel event alert on the topic. “Handoffs are a safety…

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By: OR Manager
December 17, 2019
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Providing cost-benefit analysis for ERAS-related solutions

Enhanced Recovery After Surgery The implementation of Enhanced Recovery After Surgery (ERAS) is based on the concept of organizing care around the patient, addressing medical condition needs to optimize readiness for surgery and reducing the likelihood of postoperative complications. Efficacy is measured by how well we perform according to these…

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By: OR Manager
December 17, 2019
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Association of postop MI with high mortality rates after vascular surgery

Editor's Note Despite high rates of patients discharged with cardioprotective medications, the long-term burden of postoperative myocardial infarction (MI) after major vascular surgery is substantial, with a high mortality rate in the following year, this study finds. Of 26,231 vascular surgery patients analyzed, factors linked to an increased risk of postoperative…

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By: Judy Mathias
December 9, 2019
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Hospital-based care coordination strategies linked to CMS star ratings

Editor's Note Care coordination strategies were found to be associated with high overall hospital quality star ratings from the Centers for Medicare & Medicaid Services (CMS) in this study. A total of 710 general acute care noncritical access hospitals that received star ratings and responded to the 2015 American Hospital…

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By: Judy Mathias
November 21, 2019
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Establishing quality standards for ERAS care elements

At Virginia Commonwealth University System (VCU Health) in Richmond, we are using quality standards to establish operational definitions for elements of Enhanced Recovery After Surgery (ERAS). This article describes what those standards are and how they are implemented. Previous articles in this series appeared in the October 2019 and November…

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By: OR Manager
November 18, 2019
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