Over the last 5 years, the perioperative surgical home (PSH) model has attracted increasing interest from OR directors, anesthesiologists, and surgeons. This team-based, patient-centered approach coordinates all phases of surgical care, from preoperative assessment through intraoperative care and postdischarge recovery. According to the American Society of Anesthesiologists, PSH initiatives have…

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Editor's Note A system-wide, multipronged pain management and opioid reduction program significantly reduced postoperative opioid discharge prescriptions written for more than 5 days, this study finds. Surgeon education, monitoring, and incentives lead to a shift from longer-term to shorter-term prescriptions for patients after surgery, reducing postoperative opioid prescriptions of more…

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Editor's Note Increased adherence to an Enhanced Recovery After Surgery (ERAS) protocol after total hip arthroplasty (THA) and total knee arthroplasty (TKA) was associated with a decrease in postoperative complications in this study from Spain. However, only a few interventions were linked to decreased complications In this analysis of 6,146…

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Editor's Note The effectiveness of non-steroidal anti-inflammatory drugs (NSAIDs) in managing pain, healing, and recovery after bone fracture depends on when you take them, this study from McGill University finds. The researchers found that NSAIDs are most effective in promoting postoperative healing when taken during the active phase of the…

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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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Editor's Note In this study, a software app that tracks perioperative controlled substance use and is integrated into the electronic health and pharmacy records and database systems was associated with a decrease in management errors. This analysis includes data on missing controlled substance medications, controlled substance kits, and witness return…

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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…

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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…

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Editor's Note Ketamine use has grown as a pain management alternative to opioids, but more than one in three patients experience side effects such as hallucinations and visual disturbances, finds this study, which was presented October 21 at the Anesthesiology 2019 annual meeting in Orlando, Florida. Duke University researchers categorized…

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Editor's Note Patients having blood drawn by courteous healthcare providers were significantly more likely to say their pain was well-controlled, finds this study presented October 20 at the Anesthesiology 2019 annual meeting in Orlando, Florida. Analyzing responses from 4,740 adult patients on questions about pain control (range from 1 to…

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