Editor's Note Implementation of Lean system redesigns was associated with a significant and sustained wait list reduction from 33.4 days to 12.0 days for patients waiting for elective general surgery procedures at a Veterans Affairs medical center, this study finds. The study covered FY 2012 to 2014. At the same…

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Editor's Note In this review article, researchers conclude that implementation of Enhanced Recovery after Surgery (ERAS) programs results in major improvements in clinical outcomes and cost savings, which makes ERAS an important example of value-based care applied to surgery. ERAS practices include: changes from overnight fasting to carbohydrate drinks 2…

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Editor's Note Enhanced recovery after surgery (ERAS) and fast track surgery protocols were associated with a significant reduction in postoperative lung, urinary tract, and surgical site infections, compared with conventional protocols in this study. ERAS and fast track protocols also were linked to a significant decrease in hospital length of…

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Like a football team gathering to confirm tactical details before a play, surgical staff often form a huddle to ensure readiness of the providers, patient, and equipment for the upcoming procedure. In a twist on the traditional huddle the day before surgery, staff at the Hospital of Central Connecticut (HOCC)…

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Editor's Note Assigning certain anesthesiologists to specific surgeons affected team performance and turnaround time in this study. Researchers assessed the relationship between turnaround times and assignment of anesthesiologists to surgeons using a Monte Carlo simulation. They constructed managerial decision tables for the assignments, and defined a decision algorithm based on…

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Editor's Note Overlapping surgical procedures are safe and provide the same outcomes for patients as non-overlapping procedures, this study finds. The analysis of 10,614 overlapping surgical procedures performed at the Mayo Clinic, Rochester, Minnesota, found no difference in the rates of postoperative complications or deaths within a month after surgery,…

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Editor's Note This study finds that general surgery residents strongly prefer work hour policies that allow them the flexibility to work longer hours when needed to provide patient care over the standard, more restrictive work schedules required by the Accreditation Council for Graduate Medical Education. The preference for flexibility becomes…

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Performance improvement teams (PITs) have helped many businesses resolve workflow or other obstacles impeding efficiency. For perioperative services, PITs consist of a multidisciplinary group of frontline personnel associated with a defined process. PITs often have a key facilitator and are sponsored by leadership. Missions and goals are created, progress is…

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Editor's Note Using a computerized mathematical model, Johns Hopkins researches investigated whether they could improve heart and lung transplants by transferring patients from low- to high-volume transplant centers. Among the findings: For heart transplants, 10 lives were saved after one center closure, and 240 lives were saved after up to…

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Editor's Note A total of 86% of general public respondents to a national survey want 16-hour shifts for first-year residents to remain, and 80% support dropping the maximum shift limit for second-year residents and above from 28 hours to 16 hours. The survey was conducted by Public Citizen, an independent…

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