Editor's Note In this study, postoperative delirium had a negative association with 30- and 90-day cognition in all participating patients. However, patients with preoperative cognitive impairment had an improvement in cognition at 30 and 90 days after surgery, but this increase was attenuated if the patient experienced postoperative delirium. This…

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Editor's Note A new blog post featured in the Joint Commission’s "High Reliability Healthcare" examines four essential steps for developing a reporting culture and why they are important. The steps are: Establish trust: Leaders should help create personal responsibility by establishing clear performance expectations for employees in an environment where…

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Editor's Note The widely used “LACE index,” which assesses a patient’s risk of hospital readmission, has a “blindspot” because it fails to consider whether patients are on Medicaid, West Virginia University researchers say. LACE stands for length of stay, acuity, comorbidity, and emergency department. To assess the predictive value of…

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Editor's Note ICU readmission risk for surgical patients can be predicted using a simple, clinical nomogram based on seven demographic and physiologic variables, this study finds. Of 3,109 patients admitted to the ICU by general surgery, transplant, trauma, and vascular surgery services, there were 141 (5%) unplanned readmissions within 72…

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Editor's Note The Food & Drug Administration (FDA) on January 8 announced the recall by Sun Pharmaceutical Industries, Inc (Cranbury, New Jersey) of three lots of Vecuronium Bromide for Injection, 10 mg (lyophilized powder) (Lots: JKS0443A, JKS0444A, JKS0477A), and one lot of Vecuronium Bromide for Injection, 20 mg (lyophilized powder)…

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Editor's Note Though Medicare Accountable Care Organizations (ACOs) have had some success in reducing spending for medical care, they have not had similar success with surgical spending, this study finds. Of 341,675 patients at 427 ACO hospitals and 1,024,090 patients at 1,531 non-ACO hospitals analyzed, average baseline payments were similar…

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Editor's Note The Joint Commission on January 9 announced that it is seeking feedback on its newly proposed requirements for antimicrobial stewardship at Medication Management (MM) standard MM.09.01.03. The requirements apply to ambulatory healthcare organizations and office-based surgery practices. The proposed requirements align with current recommendations from scientific and professional…

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Editor's Note Education of surgical interns on postoperative analgesia was effective in preparing them for judicious opioid prescribing, this study finds. An education session on postoperative analgesia prescribing was presented to 31 incoming surgical interns by surgical residents. Before the education session was started, few interns felt comfortable prescribing opioids…

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Editor's Note The American Society of Anesthesiologists (ASA) has published a new “Practice Advisory for Perioperative Visual Loss Associated with Spine Surgery 2019,” which updates the Practice Advisory published by the ASA in 2012. The purpose of the Advisory is to enhance awareness and reduce the frequency of perioperative visual…

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Editor's Note Medicare’s Hospital Readmissions Reduction Program (HRRP), which penalizes readmissions for several targeted conditions, has been credited with lowering readmission rates; however, these reductions now appear to be overstated, this study finds. A concurrent change in electronic transaction standards that increased diagnostic coding allowed hospitals to document a larger…

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