Throughput inefficiencies are a growing problem in surgical services departments. Patients are held in the OR because there is no room in the postanesthesia care unit (PACU), and patients are held in the PACU because there are no beds available in the patient care unit or because outpatients having major…

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Cost mitigation has become a priority in the American healthcare industry, and addressing inefficiencies is a popular way to curb the high cost of medical care. Decreasing turnover time between cases may pave the way for additional cases to be scheduled, theoretically leading to increased revenue for the hospital. However,…

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Editor's Note In this study, researchers reviewed literature from a 10-year period and found no consensus on what defines a high-performing healthcare delivery system or healthcare organization. High performance was variably defined across different dimensions, including: quality (93% of articles) cost (67%) access (35%) equity (26%) patient experience (21%) patient…

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Editor's Note After implementation of an anesthesia information management system (AIMS)-based mandatory quality assurance process for reporting of intraoperative adverse events at two academic medical centers, documented adverse events decreased significantly, this study finds. Over a 2-year period after implementation of mandatory reporting, the adverse event rate at Thomas Jefferson…

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Editor's Note There is wide cost variation for five common surgical procedures in the US, this study finds. Cost observed-to-expected ratios ranged widely: 14.9-fold for colectomy 5.5-fold for coronary artery bypass graft (CABG) 12.5-fold for lung resection 10.6-fold for total knee arthroplasty 28.0-fold for cesarean section. High-cost hospitals were more…

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Organizations that have adopted the perioperative surgical home (PSH) model of patient care have reaped the benefits of improved outcomes and a healthier bottom line. In particular, the PSH has a proven track record for colorectal surgery and orthopedic surgery. In part 1 of this two-part series (OR Manager, August…

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Perioperative services that implement the TeamSTEPPS program—Team Strategies and Tools to Enhance Performance and Patient Safety—can see a range of benefits such as a better reporting culture, improved operational efficiency, and increased staff satisfaction, suggest emerging data presented in recent webinars and at a national conference. TeamSTEPPS was jointly developed…

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Editor's Note This study from the Joint Commission finds that criteria for assessing whether outcome measures are accurate and valid enough to use for public reporting, payment, and accreditation are not well-defined. The authors propose four criteria to assess outcome measures: Strong evidence should exist that good medical care leads…

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Editor's Note When colorectal surgical patients, who were given a single dose of antibiotic before surgery and re-dosing if the procedure lasted longer, were compared to patients given additional antibiotics for 24 hours postoperatively, infection rates were identical, this study finds. A total of 965 patients were included in this…

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Editor's Note In this study, patients diagnosed on the day of surgery as moderate to high risk for obstructive sleep apnea (OSA) had similar rates of adverse respiratory events (ie, perioperative hypoxemia and difficult airway management) as patients who had been diagnosed with OSA previously. However, those diagnosed with OSA…

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