Editor's Note This study finds that where surgical patients go after they are discharged varies widely, and that variation leads to huge differences in how much their care costs. Variation in postacute care spending between lowest and highest quintiles differed 129% for total hip replacement, 103% for coronary artery bypass…

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Editor's Note In this review article, researchers conclude that implementation of Enhanced Recovery after Surgery (ERAS) programs results in major improvements in clinical outcomes and cost savings, which makes ERAS an important example of value-based care applied to surgery. ERAS practices include: changes from overnight fasting to carbohydrate drinks 2…

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Editor's Note The ECRI Institute on January 9 released its 2017 Top 10 Hospital C-Suite Watch List. The list includes both technologies and critical technology use issues that hospital leaders should be aware of. Included in the list are: an initiative to improve outcomes and costs of abdominal surgery hospital…

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Editor's Note Introduction of the Perioperative Surgical Home (PSH) model for patients having ambulatory laparoscopic cholecystectomy at a Kaiser Permanente facility was associated with decreased length of stay and unplanned hospital admissions in this study. A total of 878 patients were included in the preimplementation period, and 1,082 in the…

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Editor's Note Enhanced recovery after surgery (ERAS) and fast track surgery protocols were associated with a significant reduction in postoperative lung, urinary tract, and surgical site infections, compared with conventional protocols in this study. ERAS and fast track protocols also were linked to a significant decrease in hospital length of…

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Editor's Note In this study, the composite outcomes of death, stroke, myocardial infarction, renal failure, or repeat revascularization at 5 year follow-up were similar for patients who had off-pump and on-pump coronary artery bypass grafting (CABG) procedures. The researchers also found no significant difference in cost or quality of life…

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Editor's Note In this multi-state study examining the relationship between nurse-reported safety culture and the patient experience, researchers found that modifiable aspects of a hospital’s culture can influence the achievement of high HCAHPS scores in nursing and global domains, which directly impact hospital reimbursement. Three safety culture domains were related…

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Editor's Note Overlapping surgical procedures are safe and provide the same outcomes for patients as non-overlapping procedures, this study finds. The analysis of 10,614 overlapping surgical procedures performed at the Mayo Clinic, Rochester, Minnesota, found no difference in the rates of postoperative complications or deaths within a month after surgery,…

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Editor's Note The Surgical Apgar Score (SAS) was found to be significantly predictive but weakly discriminative for major complications and death after emergency high-risk abdominal surgery in this study. The risk of major complications, death, and ICU admission increased significantly with decreasing SAS (P < .001). The score’s c-statistics were…

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Editor's Note Surgical residents who perceived negative effects of The Accreditation Council for Graduate Medical Education’s duty hour policies on patient safety were more likely to violate duty hour policies, this study finds. Of 4,554 residents in 184 programs analyzed: 25.3% felt the current duty hour policies negatively affected patient…

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