Editor's Note Screening elderly patients preoperatively using the Vulnerable Elders Surgical Pathways and Outcomes Assessment (VESPA) tool helped identify patients at higher risk of postoperative complications in this study. A total of 736 patients 70 years of age or older were assessed in a preoperative clinic from July 9, 2008,…

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Editor's Note Early postoperative hyperglycemia was linked to increased readmissions after gastrointestinal surgery in insulin-dependent diabetic patients, but elevated preoperative hemoglobinA1c was not, this study finds. Higher preoperative hemoglobinA1c levels were associated with increased postoperative glucose level checks and insulin use as well as lower rates of postoperative complications. Though…

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Editor's Note A new study finds a big drop in smoking rates when surgeons get involved in helping patients quit before surgery through the "Strong for Surgery" program. The study was presented July 23 at the 2017 American College of Surgeons (ACS) Quality and Safety Conference. Strong for Surgery is…

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Editor's Note An Enhanced Recovery after Surgery (ERAS) program for colorectal surgery patients shortened hospital length of stay by more than half, reduced complications by more than one-third, and cut costs by some $11,000 per procedure, finds a study presented July 23 at the American College of Surgeons 2017 Quality…

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Uncertainties pepper the healthcare landscape, but the shift to value-based care is expected to continue, even though momentum may slow under the current administration. That means perioperative services leaders must continue to explore new care delivery options such as the perioperative surgical home (sidebar, p 17). “The demand for value…

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Editor's Note The American Society of Colon and Rectal Surgeons and the Society of American Gastrointestinal Endoscopic Surgeons have jointly published new clinical practice guidelines on enhanced recovery after colon and rectal surgery. The enhanced recovery protocol is multidisciplinary, including physicians, nurses, physical therapists, and dietitians and involves all aspects of care…

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Editor's Note In this study, the use of preoperative and postoperative elements of a Perioperative Surgical Home model in total knee and hip patients was associated with improvements in operational outcomes. The study included 1,225 patients in a preintervention PSH group and 1,363 in a postintervention PSH group. Compared with…

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As part of the shift to value-based care, a logical step for healthcare organizations is to adopt enhanced recovery after surgery (ERAS) protocols. The literature supporting the use of ERAS is growing, with many studies demonstrating that it leads to shorter length of stay (LOS) and fewer complications. Results of…

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Editor's Note A home-based preoperative training program decreased hospital length of stay (LOS), reduced costs, and was well accepted by patients, this study finds. Elements of the Michigan Surgical Home and Optimization Program include improving the patient’s diet, reducing stress, breathing exercises, smoking cessation, and an emphasis on light physical…

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Editor's Note Implementation of a frailty screening initiative was associated with reduced mortality in this study. After implementing the initiative in 9,153 surgical patients, overall 30-day mortality for all patients, frail and nonfrail, decreased from 1.6% to 0.7%. Postoperative mortality decreased significantly in frail patients at 30 (12.2% to 3.8%),…

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