Patient, personnel, induction factors that affect OR start times
Editor's Note Though patient and personnel factors affect the order of case induction, induction time is most dependent on patient factors, this study finds. Of 15,823 cases analyzed, predictors of later patient induction included add-on case, ASA class 3 or more, neuraxial anesthesia, and CRNA staffing. In 11,093 (70.1%) cases,…
Hospital-based care coordination strategies linked to CMS star ratings
Editor's Note Care coordination strategies were found to be associated with high overall hospital quality star ratings from the Centers for Medicare & Medicaid Services (CMS) in this study. A total of 710 general acute care noncritical access hospitals that received star ratings and responded to the 2015 American Hospital…
Establishing quality standards for ERAS care elements
At Virginia Commonwealth University System (VCU Health) in Richmond, we are using quality standards to establish operational definitions for elements of Enhanced Recovery After Surgery (ERAS). This article describes what those standards are and how they are implemented. Previous articles in this series appeared in the October 2019 and November…
Mayo Clinic Care Network reduces hospital stays with ERPs
Editor's Note An Enhanced Recovery Pathway (ERP) created by the Mayo Clinic’s colorectal surgery service a decade ago has now been adopted by other surgical services in seven medical centers that are members of the Mayo Clinic Care Network, the October 15 Harvard Business Review reports. The ability of each…
Editorial
Our series on Enhanced Recovery After Surgery (ERAS), which began last month with an overview of its history and perioperative pathway, continues in this issue with examples of improved outcomes and the roles played by perioperative team members (see p 18). ERAS, known to speed recovery and increase patient satisfaction,…
The role of the OR in ERAS pathway implementation
The US has been on a journey for the last several years to reduce the cost of healthcare. In 2017, the percent of gross domestic product attributed to healthcare goods and services was at 17.9%. This is expected to reach as much as 19.4% by the year 2027.1 Factors contributing…
Association between heart failure and postop mortality in ambulatory surgery patients
Editor's Note In this study, heart failure with or without symptoms was associated with an increased risk of postoperative mortality at 90-days and complications at 30-days in ambulatory surgery patients. In this analysis of 355,121 patients having noncardiac ambulatory surgical procedures, 90-day mortality was 2% in patients with heart failure…
Enhanced Recovery After Surgery: The new standard for perioperative care
Enhanced Recovery After Surgery (ERAS®) is a comprehensive, multifaceted, and multidisciplinary approach to the care of the surgical patient. ERAS bundles evidence-based elements to facilitate a faster recovery with fewer complications.1 Spanning the continuum of perioperative care, ERAS elements include: • patient engagement and education • preoperative optimization of nutrition…
Say goodbye to skin injuries in surgical patients
Hospital-acquired pressure injuries (HAPIs) fall under the care management serious event category, and the literature suggests the incidence of a pressure injury following surgery or a procedure may contribute to more than half of all hospital-related skin injuries. Furthermore, the Centers for Medicare & Medicaid Services (CMS) has defined numerous…
Superior patient-centered care crucial for complex outpatient procedures
About 2 years ago I was diagnosed with prostate cancer. As I researched the treatment alternatives, I became very concerned about the complications associated with traditional surgical prostatectomy or radiation. Then I learned that I might be eligible for an outpatient procedure: high-intensity focused ultrasound (HIFU). Although HIFU is relatively…
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