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February 2019
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Government payment policies linked to hospital performance fail to improve CAUTI rates

Editor's Note This study found no evidence that value-based incentive programs (VBIPs), which link financial incentives or penalties to hospital performance, had any measurable association with changes in catheter-associated urinary tract infection (CAUTI) rates. Researchers at Boston University School of Medicine analyzed 592 hospitals across the country, and found that…

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By: Judy Mathias
February 14, 2019
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Use of ‘hot spotting’ to identify high-cost surgery patients

Editor's Note Because a subset of patients are responsible for a disproportionate share of Medicare spending, targeting high-cost patients (ie, “hot spotting”) for cost containment efforts would be an effective strategy to reduce costs in surgical patients, this study finds. Using Medicare claims data from 2010 to 2013, University of…

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By: Judy Mathias
February 14, 2019
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Effect of referring high-risk patients to local high-quality hospitals

Editor's Note In this study, complication rates and Medicare payments were significantly lower for high-risk surgical patients treated at local high-quality hospitals. Analyzing elderly Medicare patients having any of four elective inpatient surgical procedures between 2012 and 2014, researchers found that one-fourth of high-risk patients had surgery at a low-quality…

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By: Judy Mathias
January 23, 2019
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Researchers pinpoint factor that predicts unplanned readmissions

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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By: Judy Mathias
January 17, 2019
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Effect of Medicare ACOs on spending for inpatient surgery

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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By: Judy Mathias
January 14, 2019
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Disruptive innovation in supply chain: Impact of Amazon Business and technology, Part 1

Supply chain is the lifeblood of the OR, so any disruption in the flow of that lifeblood can lead to outcomes ranging from dissatisfaction with backorders to chaos if a new implant doesn’t arrive on time. But disruption also can be a positive force, especially if it supports flow. When…

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By: Cynthia Saver, MS, RN
January 14, 2019
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Editorial

Early in a new year, there’s a tendency to reflect on how past events might inform the future. The January issue of OR Manager looked at 2018 legislative changes and their potential impact on healthcare. In just the past few weeks, several legal and financial actions have already changed the…

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By: Elizabeth Wood
January 14, 2019
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Early 'victories' forecast bright future for business awardee

Each year at the OR Business Management Conference, an outstanding leader receives the Best in OR Business Award. The 2019 award will be presented to Tracy Raymond, MHA, BHA, CRCST, CHL, perioperative services business manager at Amita Health Saint Joseph Medical Center (formerly Presence Saint Joseph), a 480-bed hospital in…

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By: Elizabeth Wood
January 14, 2019
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Comprehensive ROI pitch helps to procure OR equipment

Multiple requests for new equipment and technology—usually from surgeons but also sometimes from staff—are not uncommon. As part of their due diligence, OR leaders must determine whether the return on investment (ROI) justifies the purchase. Doing ROI calculations systematically—and involving key stakeholders—can help ensure that the organization makes the best…

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By: Cynthia Saver, MS, RN
January 14, 2019
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Surgical VAC mines new software for deeper look at products

After transitioning from a paper-based data and operations management system to one that uses relational database software, Lahey Hospital and Medical Center (LHMC) in Burlington, Massachusetts, saved more than $1 million in product purchases in 2017. The surgical value analysis committee (VAC) evaluated 150 product requests and managed the conversion…

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By: Robert Dolan, MD,, Kristen Murphy, MBA, and Edward Aiello
January 14, 2019
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