Editor's Note In this study, data show that Veterans Affairs (VA) hospitals have a similar or more favorable quality compared with non-VA hospitals. Data for 129 VA and 4,010 non-VA hospitals were evaluated on 17 outcome measures (9 Agency for Healthcare Research and Quality Patient Safety Indicators [PSIs], 4 mortality…

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Healthcare lags behind other industries when it comes to innovation. That’s partly because new treatments must be vetted for safety and efficacy, and partly because fee-for-service reimbursement sparked little incentive for creativity and efficiency. Under value-based purchasing, OR leaders have more opportunity to be innovative, but first they must understand…

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One of the biggest challenges for OR managers is efficient use of OR blocks. OR managers struggle to balance revenue and utilization targets with surgeon and staff preferences. The result is underutilized OR time, unnecessary costs, and dissatisfied staff. “Let’s face it, our block allocation process isn’t very efficient,” says…

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Major changes at a facility such as reorganizing service lines or adding new ORs can be highly disruptive, cutting into productivity and potentially loss of revenue. What can OR managers do to avoid this situation? At Vanderbilt University Medical Center in Nashville, OR leaders were facing several simultaneous challenges: planning…

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Editor's Note A study of 14 South Carolina hospitals found the use of a 19-item surgical checklist developed by the World Health Organization resulted in a 22% decrease in postoperative mortality over 3 years, compared with hospitals not participating in the checklist program. In the 14 participating hospitals, mortality was…

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Editor's Note This study validates a methodology, using the Veterans Affairs Surgical Quality Improvement Program (VASQIP) risk calculator, to identify patients with a high risk of 30-day mortality after elective surgery who may benefit from referral for tertiary care. The methodology predicted that 16% (90 of 565) of patients would…

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Editor's Note Hospital surgical readmissions are primarily explained by patient- and procedure-specific factors and less by broader specialty and hospital effects, this study finds. There was no correlation between specialty-specific readmissions for general and orthopedic, general and vascular, and vascular and orthopedic procedures. Within specialties, there were modest correlations between…

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Editor's Note In this study, discontinuity in nursing care was high and negatively impacted patient outcomes. The analysis of 3,892 medical-surgical inpatients found that discontinuity of nursing care declined from nearly 100% in the first 24 hours, to 70% at 36 hours, and to 50% by the 10th postadmission day.…

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Editor's Note Managing appendicitis with antibiotics on an outpatient basis shows promise as a safe, effective, lower-cost alternative to surgery, this study finds. Of 30 patients involved in the trial, 15 were randomized to antibiotics and 14 to appendectomy. A total of 14 patients in the antibiotic group were discharged from…

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Editor's Note In this study, an automated harm trigger system developed by the Adventist Health System Patient Safety Organization (Altamonte Springs, Florida) enabled the identification of patients who may have been harmed or at risk for harm. Nurse reviewers analyzed electronic health records of current patients with positive triggers to…

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