More than 120 centers throughout the US have bloodless surgery programs to serve patients who refuse blood transfusions for religious and other reasons. The practice, which began more than 50 years ago, has evolved through research on blood conservation and new techniques to minimize the need for transfusions. The Joint…

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When Kimberley Murray, MS, RN, CNOR, administrator for the orthopedic and spine service line at St Joseph’s Hospital (SJH) in Syracuse, New York, set up a successful system for negotiating with orthopedic vendors on total hip and knee replacement surgery, she knew that spine implants would be the next mountain…

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One would think that reducing surgical complications would lower a hospital’s costs in addition to being the right thing to do. But the hospital’s bottom line can be seriously affected. The loss can be substantial unless new surgical volume is added to make up for the loss, a new analysis…

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Does your OR have a Hodad, a Raptor, or a Shrek? These are handles for dangerous surgeons that Martin Makary, MD, MPH, describes in his scathing new book, Unaccountable. Dr Makary, a surgeon and patient safety leader at Johns Hopkins, advocates a “transparency revolution” to make data public and motivate…

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A new study in the journal Health Affairs of total knee replacement (TKR) confirms that wide variations in care exist among hospitals based on factors such as geographic location. The High Value Healthcare Collaborative found significant variations in TKR among the 5 participating health care systems. Among these were length…

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During spinal surgery, it is sometimes necessary to implant and then remove, or explant, instrumentation in the same procedure. Explantation occurs when an implanted plate or spacer does not fit, or implanted screws are too loose or too short. Explanted instrumentation cannot be reused and must be discarded, adding to…

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A new hip or knee implant comes on the market. Surgeons would like to start using it. But the cost is higher than current implants the hospital is using. Will it offer better outcomes for patients? The answer has been hard to come by. If there is outcomes data, it…

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Use of bone morphogenic protein (BMP) has risen sharply in the past decade, adding costs without evidence of better outcomes, according to a study in the February 2012 issue of Spine. BMP use rose rapidly, from 5.5% of lumbar fusions in 2003 to nearly a third (28.1%) of procedures in…

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Cataract surgery, almost exclusively outpatient, can have a serious complication if instruments retain a chemical residue after cleaning. It is known as TASS, for toxic anterior segment syndrome. Ophthalmologists say it is rare, but there are no consistent data to indicate when, where, and how often TASS occurs. The Food…

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Negotiating with orthopedic vendors can be frustrating as OR leaders strive to balance competing agendas among companies, surgeons, and the hospital. Kimberley Murray, MS, RN, CNOR, administrator for the orthopedic and spine service line at St. Joseph’s Hospital (SJH) in Syracuse, New York, reduced frustration by adopting a program that…

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