Effect of postop hyperglycemia, preop hemoglobin on outcomes in diabetic patients
Editor's Note Early postoperative hyperglycemia was linked to increased readmissions after gastrointestinal surgery in insulin-dependent diabetic patients, but elevated preoperative hemoglobinA1c was not, this study finds. Higher preoperative hemoglobinA1c levels were associated with increased postoperative glucose level checks and insulin use as well as lower rates of postoperative complications. Though…
Colorectal ERAS improves outcomes, reduces costs
Editor's Note An Enhanced Recovery after Surgery (ERAS) program for colorectal surgery patients shortened hospital length of stay by more than half, reduced complications by more than one-third, and cut costs by some $11,000 per procedure, finds a study presented July 23 at the American College of Surgeons 2017 Quality…
Hybrid OR experts plus exhibit equal exceptional education
Each year, the OR Manager Conference showcases the latest hybrid OR technology along with expert advice from clinicians and manufacturers. The 2017 conference (October 2-4 in Orlando, Florida) will feature an extensive exhibit and opportunities to interact with the Hybrid OR Steering Committee members (sidebar, p 15): • Monday, 2…
Orthopedic PSH a prime model for value-based care--Part 1
Uncertainties pepper the healthcare landscape, but the shift to value-based care is expected to continue, even though momentum may slow under the current administration. That means perioperative services leaders must continue to explore new care delivery options such as the perioperative surgical home (sidebar, p 17). “The demand for value…
Electronic scheduling system radically improves OR workflow
Between the expanding population and the increasing number of surgical procedures being performed, demand for surgical services is climbing. One study has predicted a 14% to 47% increase in surgical demand across all surgical fields by 2020. Given the high cost of operations, an efficient workflow is paramount, and there…
Reducing robotic OR turnover times with a pit stop model
Editor's Note Concepts from motor racing pit stops, including role definition, task allocation, task sequencing, and a visual cue for ease-of-use, created efficient and sustainable approaches for decreasing robotic OR turnover times in this study. Average turnover time was 99.2 minutes before introducing the pit stop model and 53.2 minutes…
Outcomes, costs associated with appendectomy in safety-net hospitals
Editor's Note Safety-net hospitals treat a disproportionate number of patients with advanced appendicitis and use laparoscopy less often, but their rates of morbidity and costs are similar to other hospitals, this study finds. In this analysis of 349 nonfederally funded hospitals in California performing 274,405 appendectomies, safety-net (compared with non-safety-net)…
New guidelines published on enhanced recovery after colon, rectal surgery
Editor's Note The American Society of Colon and Rectal Surgeons and the Society of American Gastrointestinal Endoscopic Surgeons have jointly published new clinical practice guidelines on enhanced recovery after colon and rectal surgery. The enhanced recovery protocol is multidisciplinary, including physicians, nurses, physical therapists, and dietitians and involves all aspects of care…
Influence of nurse leaders on professional practice environment
Editor's Note Nurse leaders are integral in enhancing professional practice environments, and their influence links structures necessary for an environment that supports outcomes, this study finds. In this analysis of 30 nurse leaders and 169 clinical nurses at a 247-bed acute care Magnet hospital, leaders perceived their influence from “often”…
Development of quality indicators to assess emergency general surgery
Editor's Note Development of and adherence to quality indicators by providers may improve the quality of emergency general surgery, for which current outcomes are modifiable, finds this study. Of 25 quality indicators developed and rated as valid, there were 13 for patient-level and 12 for hospital-level quality. Adherence with 18…
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