Editor's Note In high-risk hip fracture patients, an Enhanced Recovery After Surgery (ERAS) program lowers mortality rates, reduces hospital stays, and results in fewer complications, finds this study presented July 23 at the American College of Surgeons 2018 Quality and Safety Conference in Orlando, Florida. Results showed that ERAS: cut…

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Editor's Note During a 5-year quality improvement project, an academic medical center’s bariatric surgery program lowered its rates of postoperative complications and readmissions, surgical site infections (SSIs) and urinary tract infections (UTIs), and bleeding despite doubling its surgical volume, finds this study presented July 23 at the American College of…

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Anyone who has been involved in an OR design and construction project knows it is a labor-intensive, time-consuming effort—and usually far from seamless. There’s almost always something no one thinks of until it is too late, and the staff must learn to live with the flaws. But a multidisciplinary team…

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Preadmission testing (PAT) has been shown to reduce day-of-surgery delays and unnecessary testing that drive up the cost of healthcare. But it takes time and patience to put an effective PAT process in place. Sharon Ulep, MBB, CMCA, CPHQ, principal for healthcare strategy and consulting, Plante Moran, Southfield, Michigan, who…

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Not all hospitals have a preadmission testing (PAT) process, and even when they do, communication breakdowns and inefficiencies can make the process ineffective. Recognizing that the PAT process at Yale New Haven Hospital, New Haven, Connecticut, needed a makeover was the first step in launching an improvement project that led…

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Editor's Note Surgeon-reported complications in morbidity and mortality (M&M) conferences and the Agency for Healthcare Research and Quality (AHRQ) Patient Safety Indicators (PSIs) are complementary approaches for identifying adverse events and informing quality improvement efforts, this study finds. Of 6,563 surgical hospitalizations analyzed, 647 (9.9%) had at least one complication…

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Editor's Note Patients with diabetes are more likely to have adverse outcomes after surgery, and greater risks are associated with increasing HbA1c levels, this study finds. Of 7,565 patients analyzed, 30% had diabetes and 37% had prediabetes. After adjustments, diabetes was linked to increased: 6-month mortality (9% in patients with…

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Editor's Note Malnourished hospitalized surgical and medical patients who participated in a nutrition quality improvement (QI) program had improved readmission rates and length of stay (LOS), but surgical patients had a significantly greater reduction in readmissions than medical patients, in this study. Of 1,269 patients analyzed, 288 were surgical patients…

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Editor's Note This retrospective study of patients undergoing bariatric surgery found that hospitals with the largest reductions in serious postoperative complications had the greatest decrease in Medicare payments. Researchers ranked 562 hospitals (37,329 patients) into quintiles. The top 20% of hospitals had a decrease in average serious complication rate of…

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Editor's Note Increased use of neuraxial anesthesia for total hip and knee patients was linked to lower hospitalization costs in this study. National data on 808,237 total knee and 371,607 total hip replacements were used in the analysis. Multivariable associations were measured between hospital neuraxial anesthesia volume (quartiles) and outcomes…

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