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…
Use of medical scribes improves workflow of surgeons, residents in an outpatient setting
Editor's Note Incorporating medical scribes into surgical practices to reduce time surgeons spend on patient documentation and managing electronic health records increases the number of patients seen by surgeons and residents in outpatient clinics, finds this study presented October 29 at the American College of Surgeons Clinical Congress 2019 in…
ACS NSQIP risk calculator predicts four outcomes for geriatric surgical patients
Editor's Note The American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) Surgical Risk Calculator accurately predicted four quality-of-life outcomes that transcend traditional measures of successful surgery and now reflects the expected effects of surgery on an older patient’s ability to function independently, finds this study presented October…
Smartphone data helps surgeons understand their patients' postop recovery
Editor's Note Surgeons can better understand the effect of a patient's postoperative physical activity on their recovery by capturing passively-collected accelerometer data from their patients’ smartphones, finds this study presented October 28 at the American College of Surgeons Clinical Congress 2019 in San Francisco. Patients enrolled in the study downloaded…
Cholecystectomy tied to better outcomes when performed soon after admission
Editor's Note Delaying a cholecystectomy for acute cholecystitis more than 3 days after admission increased the rate of complications, hospital readmissions, and lengthened hospital stays, in this study presented October 30 at the American College of Surgeons Clinical Congress 2019 in San Francisco. Using 2012 to 2016 ACS National Surgical…
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