Editor's Note An Enhanced Recovery after Surgery (ERAS) program for colorectal surgery patients shortened hospital length of stay by more than half, reduced complications by more than one-third, and cut costs by some $11,000 per procedure, finds a study presented July 23 at the American College of Surgeons 2017 Quality…
Editor's Note Reporting of surgical site infections (SSIs) after pancreatic surgery should distinguish between superficial and organ-space infections, which will require different preventative strategies, this study finds. Results showed that risk factors for superficial and organ-space SSIs after pancreatic surgery differed. Preoperative biliary stenting was an independent risk factor for superficial…
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…
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)…
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…
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”…
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…
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…
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…
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…