Safety/Quality
Data-use practices linked to successful implementation of ERPs
Editor's Note In this study, the most important data-use practice associated with successful implementation of enhanced recovery pathways (ERPs) was data feedback to frontline providers of process and outcome measures. Of 140 hospitals analyzed, 52% reported previous ERP implementation, with wide variations in data-use practices. Feedback of process and outcome…
Hospital-based care coordination strategies linked to CMS star ratings
Editor's Note Care coordination strategies were found to be associated with high overall hospital quality star ratings from the Centers for Medicare & Medicaid Services (CMS) in this study. A total of 710 general acute care noncritical access hospitals that received star ratings and responded to the 2015 American Hospital…
FDA updates device failure linked to Getinge’s Maquet/Datascope Intra-aortic Balloon Pumps
Editor's Note The Food and Drug Administration (FDA) on November 19 updated the device failure associated with Getinge’s Maquet/Datascope Intra-aortic Balloon Pumps (IABPs) in a letter to health care providers. Since 2017, the FDA has received more than 75 reports of the IABPs shutting down while running on battery. Five…
Preop patient frailty, operative stress linked to postop mortality
Editor's Note Even minor surgical procedures are associated with high risks for mortality in patients who are frail, finds this study. In this retrospective analysis of 432,828 patients in the Veterans Administration Surgical Quality Improvement Program, frailty was associated with increased 30-, 90-, and 180-day mortality across all levels of…
Daily Tiered Huddles help prioritize and resolve OR problems
When you have a problem, are you empowered to solve it? What happens when staff encounter an obstacle? Cleveland Clinic’s Tiered Huddle process empowers all caregivers to see problems and tackle issues on their own or escalate them for assistance. The tiered huddles have energized teams to work across the…
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…
Data-driven surgical scheduling system improves efficiency
Editor's Note Compared to the historical mean (HM) scheduling approach, the data-driven regression modeling (RM) method improves multiple measures of operative suite efficiency and personnel satisfaction without adversely affecting clinical outcomes, this study finds. The HM approach included case duration of the most recent 4 years, and the RM system…
Analysis of OR efficiency in ASCs vs hospital outpatient departments
Editor's Note Ambulatory surgery center (ASC) outpatient procedures were more efficiently performed than those performed at a hospital outpatient department (HOP) in this study. Of 220 procedures included in the study (114 ASC, 106 HOP): mean turnover time was 29.8 minutes for HOP vs 24.5 for ASC ancillary time was…
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…
Use of medical scribes improves workflow of surgeons, residents in an outpatient setting
Editor's Note Incorporating medical scribes into surgical practices to reduce time surgeons spend on patient documentation and managing electronic health records increases the number of patients seen by surgeons and residents in outpatient clinics, finds this study presented October 29 at the American College of Surgeons Clinical Congress 2019 in…
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