Editor's Note In this study, nonhierarchical modeling to measure hospital performance frequently misclassified average-quality hospitals as low quality, and hierarchical modeling misclassified low-quality hospitals as average. At low hospital case volumes, hierarchical modeling missed 90.6% of low-quality hospitals, and nonhierarchical modeling missed 65.3%. However, 38.9% of hospitals classified as low-quality…

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Editor's Note Suboptimal postoperative outcomes are the primary driver of high overall costs of care after bariatric surgical procedures, this study finds. The study included morbidly obese patients who underwent laparoscopic vertical sleeve gastrectomy (74 patients) or laparoscopic Roux-en-Y gastric bypass (270 patients) at a single institution from 2010 to…

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Editor's Note Postoperative outcomes in the Veterans Affairs (VA) health system have consistently improved for the past 15 years, this study finds. In this analysis of nearly 705,000 patients undergoing noncardiac surgical procedures at 143 hospitals, absolute rates and likelihood of complications, mortality, and failure to rescue significantly decreased 40%…

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Editor's Note At 10 years, prostate cancer mortality was low irrespective of the treatment, and with no significant difference among monitoring (1.5 deaths/1,000 person years), surgery (0.9/1,000), or radiotherapy (0.7/1,000), finds this study. Radical prostatectomy and external beam radiotherapy were associated with lower incidences of disease progression and metastases than…

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Editor's Note In this study of patients having transcatheter aortic valve replacement (TAVR), younger age, male gender, history of diabetes, and moderate to severe residual aortic regurgitation were significantly associated with an increased risk of infective endocarditis. Patients who developed endocarditis had high rates of in-hospital and 2-year mortality. Of…

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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 The Joint Commission on September 7 released its 2017 ORYX Performance Measurement Reporting Requirements for accredited hospitals. Hospitals will report on 5 chart-abstracted measures and a choice of 6 of 13 electronic clinical quality measures (eCQMs). Critical access and small hospitals may choose the six eCQMs from 13…

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Editor's Note The Centers for Medicare & Medicaid Services (CMS) on September 8 announced that it will give physicians and other clinicians more options in the first year to comply with the new Medicare Access and CHIP Reauthorization Act (MACRA) quality payment program.  During 2017, providers will be able to…

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Editor's Note The nation’s top performing states for healthcare quality according to the Agency for Healthcare Research and Quality’s updated State Snapshots are: Main Massachusetts Wisconsin New Hampshire Minnesota. State Snapshots is an interactive online resource that provides data on how each state and the District of Columbia perform on…

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Editor's Note This study found a strong association between spinal anesthesia and lower 30-day mortality along with a shorter length of stay after total hip and knee replacements. Of 10,868 patients analyzed, 8,553 had spinal anesthesia and 2,315 had general anesthesia. The 30-day mortality rate was 0.19% in the spinal…

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