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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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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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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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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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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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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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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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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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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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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