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…
Postop infection linked to risk of long-term infection, mortality
Editor's Note Infection after surgery during postoperative days 0 to 30 is significantly associated with long-term infection and mortality, this study finds. In this analysis of 659,486 patients from the Veterans Health Administration, 3.6% had a 30-day infection, 6.6% had a long-term infection, and 3.8% died during follow-up. At any…
ECRI Institute opposes proposed ban of EtO sterilization
Editor's Note ECRI Institute on November 7 announced that it opposes a total ban of commercial ethylene oxide (EtO) sterilization operations because it could result in widespread shortages of sterile medical devices. Hospitals around the country reported device shortages after a large Illinois-based sterilization plant closed because of state environmental…
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…
FDA: Class I recall of Philips Medical System’s Forte Gamma Camera System
Editor's Note The Food & Drug Administration (FDA) on November 4 identified Philips Medical System’s (Cleveland) recall of its Forte Gamma Camera System as Class I, the most serious. The recall was initiated because of the potential for the detector, which weighs 660 pounds, to become detached from the device…
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…
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…
Postop opioid prescribing, use drop after state imposed regulations
Editor's Note A state-mandated policy restricting opioid prescriptions in Vermont greatly reduced opioid prescribing and use by surgical patients at the University of Vermont Medical Center without affecting patient satisfaction with their postoperative pain management, finds this study presented October 29 at the American College of Surgeons Clinical Congress 2019…
12-hour call shifts improve patient outcomes, lower costs
Editor's Note An acute-care surgery model that caps surgeon call shifts at 12 hours instead of 24 hours for covering surgical emergencies has led to shorter hospital stays, lower infection rates, and lower overall costs for patients with acute appendicitis, finds this study presented October 30 at the American College…
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