Editor's Note Healthcare managers’ top priority needs to focus on work environment design to improve preoperative throughput and OR first-case on time starts, this study finds. Two main barriers were identified−lack of equipment and availability of equipment in the preoperative area. Four vital sign monitors with wheels were purchased, as were…

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Editor's Note Selective nonoperative management of abdominal gunshot wounds is an acceptable and effective treatment for patients with less severe injuries that do not involve major organ damage or significant blood loss, this study finds. Of 922 patients with abdominal gunshot wounds analyzed, 707 had an immediate laparotomy and 215…

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Editor's Note In this study from the Massachusetts General Hospital, Boston, major intraoperative adverse events were independently associated with a two-fold increase in readmissions. Of 9,274 surgical procedures analyzed, 921 resulted in readmission. Of these, 183 had confirmed intraoperative adverse events, 73 of which were major events. Procedures with major…

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Editor's Note In this study, hospitals reduced costs associated with percutaneous coronary interventions (PCIs) when cardiologists performed the procedures through the radial artery and discharged patients on the same day. The analysis of 280,000 Medicare patients found that an average cost of $13,389 for the radial artery approach with same-day…

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There is a lot of buzz in the healthcare community about a newcomer to the accreditation process. For many years, the Joint Commission was the first choice for providing accreditation for hospitals in the US. But Norway-based Det Norske Veritas (DNV) is gaining ground, representing more than 350 hospitals and…

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Cancellation of surgical cases, especially prescheduled elective surgeries, is a pervasive problem that reduces OR utilization and hospital revenue. The estimated direct and indirect annual cost of such cancellations across the US is approximately $39 billion per year, with an average OR cost between $20 and $65 per minute. Facilities…

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Editor's Note Even mild postoperative pulmonary complications (PPCs) are associated with increased early postoperative mortality, ICU admission, and length of stay, finds this study. Of 1,202 ASA physical status 3 patients from seven academic medical centers included in the analysis, at least one PPC occurred in 401 patients. All patients…

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Editor's Note In this study of patients undergoing total hip or knee replacement, smoking was associated with an increased risk of infectious complications that required further surgery. In addition, the amount that a patient had smoked, regardless of current smoking status, significantly contributed to increased risk of readmission. A total…

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Editor's Note Anastomotic leaks and postoperative ileus had significantly higher associations with 30-day patient outcomes after colon resection than surgical site infections (SSIs), urinary tract infections, and venous thromboembolism, this study finds. In 26,682 patients undergoing colon resection, the most common postoperative complications were ileus (11.8%), bleeding (7.6%), and incisional…

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Editor's Note The American College of Surgeons (ACS) in collaboration with Johns Hopkins has launched a new multimillion dollar surgical quality improvement initiative funded and guided by the Agency for Healthcare Research and Quality. The new program will enable hospitals to implement Enhanced Recovery after Surgery (ERAS) protocols, which have…

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