Performance Improvement

Latest Issue of OR Manager
March 2019
Home Safety/Quality > Quality Improvement > Performance Improvement

Mortality rates lower in areas with more primary care physicians

Editor's Note Communities in the US with more primary care physicians had lower mortality rates than those with fewer physicians, this study finds. Results showed a: 51.5 day increase in life expectancy for every 10 additional primary care physicians per 100,000 people 19.2 day increase in life expectancy for every…

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By: Judy Mathias
February 21, 2019
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Surgical transfer unit allows patients to bypass ED

There are few things more disheartening for patients than having to board in the emergency department (ED) for long periods while waiting for a bed. ED boarding can also delay treatment and adds to overcrowding and backups. Erlanger Health System, based in Chattanooga, Tennessee, decided to tackle this problem head…

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By: Catherine Spader, RN
February 20, 2019
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Prioritizing patient safety unites and empowers OR team--Part 1

Communication breakdowns in the perioperative environment are a factor in 70% of events that adversely affect patients. Sometimes those breakdowns occur because OR staff are reluctant to voice their concerns in an environment that is hierarchical and intimidating. However, when an organization adopts patient safety first (PSF) initiatives, adverse outcomes…

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By: Iris Llewellyn
February 20, 2019
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Study: Measuring patient steps after surgery predicts LOS

Editor's Note Using Fitbit activity monitors to improve assessment of daily ambulation, this study found that each step taken towards 1,000 steps the day after major surgery resulted in significantly lower odds of a prolonged hospital length of stay (LOS). This analysis of 100 patients at Cedars-Sinai Medical Center, Los…

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By: Judy Mathias
February 13, 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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Automated text messages improve joint replacement outcomes

Editor's Note An automated text messaging system increased patient engagement with home-based exercise and promoted faster recovery after knee and hip replacements, this study finds. In this analysis of 159 patients (83 controls, 76 intervention) having total knee or hip replacement surgery, those receiving timely texts showed improvement in the…

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By: Judy Mathias
January 22, 2019
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Predicting ICU readmission of surgical patients

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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By: Judy Mathias
January 16, 2019
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Surgical intern education decreases postop opioid prescribing

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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By: Judy Mathias
January 14, 2019
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Endoscopic vs open vein-graft harvesting for CABG procedures

Editor's Note No significant difference was found between endoscopic and open vein–graft harvesting in the risk of major adverse cardiac events, in this study. This analysis of 1,150 patients in 16 Veterans Affairs cardiac surgery centers found that during a median follow-up of 2.78 years, the primary outcome of a…

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By: Judy Mathias
January 10, 2019
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New structure puts SPD staff on firmer footing

Perioperative leaders, including those in the sterile processing department (SPD), need to know when to make sweeping—not just incremental—changes to improve workflow and optimize the talents of their staff. Sometimes gains in productivity and staff satisfaction depend not only on identifying process improvements but also on placing staff in areas…

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By: Cynthia Saver, MS, RN
December 13, 2018
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