Bariatric surgery improves the heart
Editor's Note Bariatric surgery provides more benefits for obese patients than weight loss; it also reverses subclinical heart dysfunction, finds this study presented December 5 at EuroEcho 2019, a scientific congress of the European Society of Cardiology in Vienna, Austria. The study included 38 obese patients who had bariatric surgery…
Association of duty hour reform with outcomes of patients treated by new surgeons
Editor's Note Duty hour reform had no significant effect on 30-day mortality achieved by new vs experienced surgeons, but there was an increase in resources needed for patient care after reform, this study finds. A total of 1,483,074 Medicare patients having general and orthopedic surgery were analyzed before and after…
Data-use practices linked to successful implementation of ERPs
Editor's Note In this study, the most important data-use practice associated with successful implementation of enhanced recovery pathways (ERPs) was data feedback to frontline providers of process and outcome measures. Of 140 hospitals analyzed, 52% reported previous ERP implementation, with wide variations in data-use practices. Feedback of process and outcome…
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…
Preop patient frailty, operative stress linked to postop mortality
Editor's Note Even minor surgical procedures are associated with high risks for mortality in patients who are frail, finds this study. In this retrospective analysis of 432,828 patients in the Veterans Administration Surgical Quality Improvement Program, frailty was associated with increased 30-, 90-, and 180-day mortality across all levels of…
Daily Tiered Huddles help prioritize and resolve OR problems
When you have a problem, are you empowered to solve it? What happens when staff encounter an obstacle? Cleveland Clinic’s Tiered Huddle process empowers all caregivers to see problems and tackle issues on their own or escalate them for assistance. The tiered huddles have energized teams to work across the…
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…
Joint Commission’s new Speak Up campaign focuses on patients’ rights
Editor's Note The Joint Commission on November 13 announced a new Speak Up campaign that focuses on the right of patients to be informed about and make decisions on their care. “Speak Up For Your Rights” offers free materials to download and give to patients and their families, including: An…
Analysis of OR efficiency in ASCs vs hospital outpatient departments
Editor's Note Ambulatory surgery center (ASC) outpatient procedures were more efficiently performed than those performed at a hospital outpatient department (HOP) in this study. Of 220 procedures included in the study (114 ASC, 106 HOP): mean turnover time was 29.8 minutes for HOP vs 24.5 for ASC ancillary time was…
Improving prediction of adverse surgical outcomes with machine learning algorithm
Editor's Note In this study, a new machine learning Complexity Score algorithm outperformed three commonly used risk scores in predicting postoperative morbidity, 30-day readmission, 90-day readmission, and postoperative surper-use. Study patients underwent colectomy, abdominal aortic aneurysm repair, coronary artery bypass grafting, total hip or knee replacement, or lung resection. The…
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