Orthopedic PSH a prime model for value-based care--Part 1
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…
Outcomes, costs associated with appendectomy in safety-net hospitals
Editor's Note Safety-net hospitals treat a disproportionate number of patients with advanced appendicitis and use laparoscopy less often, but their rates of morbidity and costs are similar to other hospitals, this study finds. In this analysis of 349 nonfederally funded hospitals in California performing 274,405 appendectomies, safety-net (compared with non-safety-net)…
New guidelines published on enhanced recovery after colon, rectal surgery
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…
Influence of nurse leaders on professional practice environment
Editor's Note Nurse leaders are integral in enhancing professional practice environments, and their influence links structures necessary for an environment that supports outcomes, this study finds. In this analysis of 30 nurse leaders and 169 clinical nurses at a 247-bed acute care Magnet hospital, leaders perceived their influence from “often”…
Development of quality indicators to assess emergency general surgery
Editor's Note Development of and adherence to quality indicators by providers may improve the quality of emergency general surgery, for which current outcomes are modifiable, finds this study. Of 25 quality indicators developed and rated as valid, there were 13 for patient-level and 12 for hospital-level quality. Adherence with 18…
CMS star ratings not linked to surgical outcomes
Editor's Note High Centers for Medicare & Medicaid Services (CMS) Overall Hospital Quality Star Ratings were not associated with improved patient outcomes in advanced laparoscopic abdominal surgery, this study finds. Morbidity at low-star hospitals was higher for colorectal surgery but not for bariatric or hiatal hernia surgery, and no significant…
Survey: Physicians unprepared for MACRA
Editor's Note A survey of 1,000 physicians by the American Medical Association and KPMG finds that fewer than one in four believe they are well prepared to meet the 2017 requirements of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), KPMG.com reported on June 28. MACRA reshapes how…
Analysis finds unplanned returns to the OR overestimated
Editor's Note In this single institution study, the most common reasons for unplanned return to the OR (uROR) were infection and hemorrhage. However, the researchers found that a large number of cases were incorrectly classified as uROR, when they were instead planned reoperations without adequate documentation. Using uROR as reported…
Surgical ‘ICU boarders’ get less attention from physicians, caregivers
Editor's Note Surgical ICU patients boarding in alternative ICUs because of overcrowding are often seen at the end of rounds, receive fewer face-to-face assessments from physicians, and are given less bedside attention by ICU provider teams, this study finds. The researchers found that: caregivers spent about 16% less time on…
Value-based purchasing not linked to improvements in quality
Editor's Note In this study, Medicare’s Hospital Value-Based Purchasing (HVBP) program was not associated with improvements in quality measures of clinical process or patient experience. HVBP also was not associated with a significant reduction in two of three mortality measures (ie, acute myocardial infarction or heart failure). It was associated…
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