Editor's Note Patients whose surgeons had more coworker reports about unprofessional behavior in the 36 months before their surgical procedures had a significantly increased risk of complications, this study finds. In this analysis of 13,653 patients having surgical procedures performed by 202 surgeons in two academic medical centers, 1,583 (11.6%)…

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Blood loss during labor and delivery (L&D) and surgical procedures can lead to serious complications that might be prevented with early detection; however, detection can be challenging. For example, clinicians have traditionally estimated blood loss visually—a subjective and often inaccurate process. Humans’ eyes simply aren’t good at making precise measurements,…

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Editor's Note Physician-to-physician variation in electronic health record (EHR) documentation could result in patient harm and clinical inefficiencies, this study finds. The study by University of Michigan researchers included EHR data from 170,332 encounters led by 809 physicians in 237 practices and interviews with 40 physicians in 10 practices. The…

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Editor's Note Hospitals with low failure to rescue (FTR) rates had significantly more staffing resources than hospitals with high FTR rates, this study finds. In this analysis of 44,567 surgical patients in the Michigan Quality Surgical Collaborative, hospital FTR rates across low, middle and high tertiles were 8.9%, 16.5%, and…

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Editor's Note In this study, patients who had transcatheter aortic valve replacement (TAVR) for bicuspid compared with tricuspid aortic stenosis had no significant difference in mortality, but they had a 30-day increased risk of stroke. In this cohort of 2,691 matched pairs of patients having TAVR for bicuspid vs tricuspid…

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Editor's Note The majority of differences in outcomes between new and experiences surgeons are associated with the context in which care is delivered and patient complexity, rather than inexperience, this study finds. A total of 694,165 Medicare patients treated by 8,503 experienced surgeons were matched to 68,036 treated by 2,119…

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Editor's Note The American College of Surgeons on June 6 called for interested hospitals to join a new cohort of the Agency for Healthcare Research and Quality (AHRQ) Safety Program for Improving Surgical Care and Recovery (ISCR). In the program, presented in collaboration with the Johns Hopkins Medicine Armstrong Institute…

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Editor's Note The opioid epidemic has expanded the pool of overdose-death donors (ODDs) for heart transplantation. Even though ODDs have higher rates of hepatitis C, cardiac allograft quality indices are favorable, and recipient outcomes are similar to those with non-ODD hearts, this study finds. Of 15,904 heart transplant donors analyzed,…

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Editor's Note Multimodal analgesia with minimal opiates improved pain control and significantly decreased opiate use and opiate-related adverse effects after discharge from elective total hip replacement surgery, finds this study. The 235 patients analyzed received one of three discharge pain regimens: Group A: scheduled-dose multimodal analgesia (ie, acetaminophen, meloxicam, gabapentin)…

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Editor's Note There is a substantial economic value for policy and organizational expenditures for physician burnout reduction programs, this study finds. A conservative base-case model estimates that about $4.6 billion in costs is attributable to physician burnout each year in the US because of physician turnover and reduced clinical hours.…

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