New instrument shows promise as low-cost alternative to robot
Researchers at the University of Michigan (U-M), Ann Arbor, have invented a new surgical instrument with the goal of addressing a vast, unmet need in minimally invasive surgery. For less than a thousand dollars, this platform technology—currently being commercialized by the start-up FlexDex Surgical—offers capabilities similar to those of the…
Cost data persuade surgeons to be more frugal
Surgeons usually don’t have a high awareness of costs, partly because they haven’t had an easy way to know them. An unfortunate byproduct of this lack of knowledge can be higher OR costs. “Imagine what it’s like if, when you go to the grocery store, there are no price tags,…
Efforts to improve FCOTS may reduce overutilized OR time
Ccommon cost-saving strategies in the OR include increasing workflow efficiency, reducing turnover times, implementing standardized preoperative protocols, and improving surgical case scheduling and first case on-time starts (FCOTS). These interventions aim to decrease under- and overutilized time in the OR, but there is conflicting evidence about their economic value. Many…
Effect of multiple complications on postop mortality rates
Editor's Note Failure to rescue occurs predominantly in patients who have more than one complication with a dose-response relationship as complications accrue, this study finds. More than 266,000 patients in the Veterans Affairs Surgical Quality Improvement Program were included in the analysis. Of those who had a complication, more than half…
Safety of PACU discharge without motor function assessment after spinal anesthesia
Editor's Note Discharge from the postanesthesia care unit (PACU) without assessment of lower limb motor function after spinal anesthesia for total hip or knee arthroplasty did not increase length of hospital stay or readmissions but significantly reduced time in the PACU (0.40 vs 1.56 hours), this study finds. This multicenter…
Value-based reforms linked to readmission reduction
Editor's Note Hospital participation in value-based reforms was associated with greater reductions in 30-day readmissions, this study finds. In this analysis of 2,837 hospitals between 2008 and 2015, researchers found that participation in one or more voluntary Medicare value-based reforms, which included the Meaningful Use of Electronic Health Records program,…
Study: QI measures reduce readmissions, cost savings vary
Editor's Note Quality improvement (QI) measures can be effective in reducing readmissions, relative to the status quo, but cost savings vary, this meta-analysis finds. In this review of 50 QI studies, interventions reduced readmissions by an average of 12.1% for heart failure patients and 6.3% among the general population. However,…
Postop program reduces delirium risk, LOS for elderly
Editor's Note Older patients who had major abdominal surgery and received interventions that included daily orienting communication, oral and nutritional assistance, and early mobilization were less likely to experience delirium and had a shorter hospital length of stay (LOS), this study finds. A total of 377 patients were included in…
Effect of early discharge after surgery on costs
Editor's Note Early postoperative discharge after major inpatient surgery was associated with lower total surgical episode payments in this study. In this analysis of 639,943 Medicare beneficiaries undergoing colectomy, coronary artery bypass grafting (CABG), or total hip replacement, payments were significantly lower in hospitals with lowest vs highest length of…
Top 10 Patient Safety Concerns for 2017
Healthcare is striving to become an industry of high-reliability organizations, and part of being a high-reliability industry means staying vigilant and identifying problems proactively. ECRI Institute’s annual Top 10 list helps organizations identify looming patient safety challenges and offers suggestions and resources for addressing them. ECRI Institute relied on event…
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