Performance Improvement

Latest Issue of OR Manager
January 2018
Home Safety/Quality > Quality Improvement > Performance Improvement

Where are you on the value-based care continuum?

Healthcare providers are straddling a variety of payment models while many regulatory changes remain in flux under the Trump Administration. Although the shift from fee-for-service to value-based payment began some years ago, not everyone is on board. Opinions about bundled payments also remain mixed, despite reports of improved outcomes and…

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By: Elizabeth Wood
December 14, 2017
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Impact of reducing postop complications in bariatric Medicare patients

Editor's Note Hospitals with the largest reductions in serious complications after bariatric surgery had the greatest decrease in per-patient Medicare payments, this study finds. Analyzing 37,329 Medicare patients undergoing bariatric surgery from 2005 to 2006 and 2013 to 2014, researchers found a strong association between reductions in complications and decreased…

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By: Judy Mathias
December 12, 2017
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Examining surgical outcomes to identify procedures needing additional QI efforts

Editor's Note This analysis of 10 surgical procedures accrued into the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) between 2008 and 2015, identified which procedures improved the most from QI efforts and which needed more. Hepatectomy demonstrated the greatest improvement across the greatest number of outcomes…

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By: Judy Mathias
November 29, 2017
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Study: Restrictive vs liberal blood transfusion outcomes in cardiac surgery patients

Editor's Note A restrictive blood transfusion strategy (HGB <7.5 g/dL) was equivalent to a liberal strategy (HGB <9.5 g/dL in the OR or ICU and HGB<8.5 g/dL in the non-ICU ward) with regard to mortality and major disability in cardiac surgery patients who had a moderate-to-high risk of death, this…

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By: Judy Mathias
November 16, 2017
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Remote video auditing: A path to compliance and safety

Perioperative services leaders seeking to improve safety and efficiency without sacrificing quality may want to turn to remote video auditing (RVA), which is being successfully used in hospital ORs and ambulatory surgery centers (ASCs). “We’ve seen improved patient safety, efficiency, and cleaning processes,” says Sheldon Newman, MD, executive vice chairman…

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By: Cynthia Saver, MS, RN
November 15, 2017
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Constructive Culture + Performance Improvement = Patient Safety and Favorable Outcomes

After this session, you will be able to: 1. Utilize methods to conduct a safety assessment questionnaire (SAQ), debrief, and two-question survey. 2. Identify opportunities for improvement using outcomes data. 3. Describe a plan using outcomes data to improve surgical results and enhance the safety culture. Why this is important:…

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Peer review inspires high performance from providers

Peer review is a hot topic in the quality arena as many ambulatory surgery centers (ASCs) strive to create meaningful and sustainable evaluation of their providers. “As a surveyor, I can tell you peer review trips everybody up,” says Ann Geier, MS, RN, CNOR, CASC, chief nursing officer of Surgical…

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By: Leslie Flowers
November 15, 2017
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Nurse-run telephone triage service for after-hour calls by neurosurgery patients

Editor's Note Clinical Advice Service (CAS), a nurse-run telephone triage service for after-hour calls, developed at the Stanford University School of Medicine, provides well-coordinated care to neurosurgery patients while reducing physician workload, this study finds. Between July 2016 and June 2017, CAS nurses received 1,021 after-hours calls from neurosurgery patients.…

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By: Judy Mathias
November 10, 2017
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FDA clears new, faster CBC test

Editor's Note The Food and Drug Administration (FDA) on November 6 cleared a new complete blood cell count (CBC) test that can be run in more healthcare settings and offers faster results for patients and providers. The FDA granted premarket clearance and a Clinical Laboratory Improvement Amendments of 1988 (CLIA)…

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By: Judy Mathias
November 10, 2017
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Study: No advantages to robotic-assisted nephrectomy

Editor's Note Robotic-assisted nephrectomy is more expensive and takes longer than conventional laparoscopic nephrectomy and confers no additional benefits, this study finds. The proportion of robotic-assisted nephrectomies increased from 1.5% in 2003 to 27% in 2015. Of 23,753 patients analyzed, no significant differences were found in major postoperative complications between…

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By: Judy Mathias
October 31, 2017
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Improving readability of discharge instructions linked to fewer follow-up phone calls

  Editor's Note Making discharge instructions easier to read resulted in fewer phone calls from traumatic injury patients after discharge, finds this study presented October 25 at the American College of Surgeons Clinical Congress 2017 in San Diego. A total of 1,006 patients were included in the study, 493 in…

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By: Judy Mathias
October 31, 2017
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Case Studies in Perioperative Performance Improvement

As reform pressures continue to mount, the healthcare industry is rapidly shifting from “pay for volume” to “pay for value” business models. In fact, CMS projects that by 2018, bundled payments will be applied to 50 percent of all diagnosis-related groups, while 90 percent of all remaining fee-for-service care will…

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