Improving prediction of adverse surgical outcomes with machine learning algorithm
Editor's Note In this study, a new machine learning Complexity Score algorithm outperformed three commonly used risk scores in predicting postoperative morbidity, 30-day readmission, 90-day readmission, and postoperative surper-use. Study patients underwent colectomy, abdominal aortic aneurysm repair, coronary artery bypass grafting, total hip or knee replacement, or lung resection. The…
Postop opioid prescribing, use drop after state imposed regulations
Editor's Note A state-mandated policy restricting opioid prescriptions in Vermont greatly reduced opioid prescribing and use by surgical patients at the University of Vermont Medical Center without affecting patient satisfaction with their postoperative pain management, finds this study presented October 29 at the American College of Surgeons Clinical Congress 2019…
Can machine learning predict 6-month mortality in cancer patients?
Editor's Note In this study, machine learning algorithms accurately identified cancer patients who were at risk of 6-month mortality. Of 26,525 cancer patients analyzed, machine learning models based on structured electronic health record data accurately predicted short-term mortality risk with good discrimination and positive predictive value. When the gradient boosting…
Mayo Clinic Care Network reduces hospital stays with ERPs
Editor's Note An Enhanced Recovery Pathway (ERP) created by the Mayo Clinic’s colorectal surgery service a decade ago has now been adopted by other surgical services in seven medical centers that are members of the Mayo Clinic Care Network, the October 15 Harvard Business Review reports. The ability of each…
The role of the OR in ERAS pathway implementation
The US has been on a journey for the last several years to reduce the cost of healthcare. In 2017, the percent of gross domestic product attributed to healthcare goods and services was at 17.9%. This is expected to reach as much as 19.4% by the year 2027.1 Factors contributing…
Decreased postop opioid prescribing not linked to patient’s satisfaction with surgeon
Editor's Note This study found that opioid prescribing can be decreased by more than 50% and not adversely affect patients’ satisfaction scores with their surgeons. Of 996 patients surveyed on their satisfaction with their surgeons before (period A) and after (period B) an educational intervention that resulted in decreased opioid…
Association between heart failure and postop mortality in ambulatory surgery patients
Editor's Note In this study, heart failure with or without symptoms was associated with an increased risk of postoperative mortality at 90-days and complications at 30-days in ambulatory surgery patients. In this analysis of 355,121 patients having noncardiac ambulatory surgical procedures, 90-day mortality was 2% in patients with heart failure…
Joint Commission reviewing CMS final rules on discharge planning, burden reduction
Editor's Note The Joint Commission announced on October 9 that it is reviewing discharge planning and burden reduction changes announced in the Centers for Medicare & Medicaid Services’ (CMS) final rules published September 30. Any changes to Joint Commission accreditation requirements for deemed programs will go through the CMS iterative…
CMS releases final rule on discharge planning
Editor's Note The Centers for Medicare & Medicaid Services (CMS) on September 26 released a final rule that revises discharge planning requirements for hospitals, the September 26 Becker’s Clinical Leadership & Infection Control reports. Among the requirements: Hospitals must prioritize patients’ care goals and treatment preferences during discharge planning. Hospitals…
Enhanced Recovery After Surgery: The new standard for perioperative care
Enhanced Recovery After Surgery (ERAS®) is a comprehensive, multifaceted, and multidisciplinary approach to the care of the surgical patient. ERAS bundles evidence-based elements to facilitate a faster recovery with fewer complications.1 Spanning the continuum of perioperative care, ERAS elements include: • patient engagement and education • preoperative optimization of nutrition…
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