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…

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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…

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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…

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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…

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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…

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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…

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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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Editor's Note Delaying a cholecystectomy for acute cholecystitis more than 3 days after admission increased the rate of complications, hospital readmissions, and lengthened hospital stays, in this study presented October 30 at the American College of Surgeons Clinical Congress 2019 in San Francisco. Using 2012 to 2016 ACS National Surgical…

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Editor's Note A state-mandated policy restricting opioid prescriptions in Vermont greatly reduced opioid prescribing and use by surgical patients at the University of Vermont Medical Center without affecting patient satisfaction with their postoperative pain management, finds this study presented October 29 at the American College of Surgeons Clinical Congress 2019…

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Editor's Note The Joint Commission on October 29 announced that the deadline for onboarding to the Direct Data Submission (DDS) Platform for submission of CY 2019 electronic clinical quality measures (eCQMs) is December 20. Organizations that submitted CY 2018 eCQMs through the DDS Platform do not need to be onboarded…

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