Editor's Note In this study, an interdisciplinary program that includes a coordinated approach by healthcare professionals in surgery, geriatrics, and anesthesiology was associated with improved postoperative outcomes for high-risk older patients having elective abdominal surgery. Compared with a control group (143 patients), older patients participating in the Perioperative Optimization of…
Healthcare providers are straddling a variety of payment models while many regulatory changes remain in flux under the Trump Administration. Although the shift from fee-for-service to value-based payment began some years ago, not everyone is on board. Opinions about bundled payments also remain mixed, despite reports of improved outcomes and…
Editor's Note Hospitals with the largest reductions in serious complications after bariatric surgery had the greatest decrease in per-patient Medicare payments, this study finds. Analyzing 37,329 Medicare patients undergoing bariatric surgery from 2005 to 2006 and 2013 to 2014, researchers found a strong association between reductions in complications and decreased…
Editor's Note This analysis of 10 surgical procedures accrued into the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) between 2008 and 2015, identified which procedures improved the most from QI efforts and which needed more. Hepatectomy demonstrated the greatest improvement across the greatest number of outcomes…
Editor's Note A restrictive blood transfusion strategy (HGB <7.5 g/dL) was equivalent to a liberal strategy (HGB <9.5 g/dL in the OR or ICU and HGB<8.5 g/dL in the non-ICU ward) with regard to mortality and major disability in cardiac surgery patients who had a moderate-to-high risk of death, this…
Perioperative services leaders seeking to improve safety and efficiency without sacrificing quality may want to turn to remote video auditing (RVA), which is being successfully used in hospital ORs and ambulatory surgery centers (ASCs). “We’ve seen improved patient safety, efficiency, and cleaning processes,” says Sheldon Newman, MD, executive vice chairman…
Peer review is a hot topic in the quality arena as many ambulatory surgery centers (ASCs) strive to create meaningful and sustainable evaluation of their providers. “As a surveyor, I can tell you peer review trips everybody up,” says Ann Geier, MS, RN, CNOR, CASC, chief nursing officer of Surgical…
Editor's Note Clinical Advice Service (CAS), a nurse-run telephone triage service for after-hour calls, developed at the Stanford University School of Medicine, provides well-coordinated care to neurosurgery patients while reducing physician workload, this study finds. Between July 2016 and June 2017, CAS nurses received 1,021 after-hours calls from neurosurgery patients.…
Editor's Note The Food and Drug Administration (FDA) on November 6 cleared a new complete blood cell count (CBC) test that can be run in more healthcare settings and offers faster results for patients and providers. The FDA granted premarket clearance and a Clinical Laboratory Improvement Amendments of 1988 (CLIA)…
Editor's Note Robotic-assisted nephrectomy is more expensive and takes longer than conventional laparoscopic nephrectomy and confers no additional benefits, this study finds. The proportion of robotic-assisted nephrectomies increased from 1.5% in 2003 to 27% in 2015. Of 23,753 patients analyzed, no significant differences were found in major postoperative complications between…