Editor's Note Failure to rescue occurs predominantly in patients who have more than one complication with a dose-response relationship as complications accrue, this study finds. More than 266,000 patients in the Veterans Affairs Surgical Quality Improvement Program were included in the analysis. Of those who had a complication, more than half…

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Editor's Note Trauma centers verified by the American College of Surgeons Committee on Trauma (ACS-COT) have fewer complications among pediatric, elderly, and severely injured patients, finds this study. The odds of experiencing any major complication were more than 3.0 times greater for elderly patients in trauma centers without ASC-COT verification…

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Editor's Note Ketamine does not decrease delirium or lower levels of pain in older adults after major surgery and might cause harm by inducing hallucinations and nightmares, this study finds. A total of 672 patients were randomly assigned to a placebo group (222 patients), a 0.5 mg/kg ketamine group (227),…

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Editor's Note According to statistics from the Agency for Healthcare Research and Quality (AHRQ), in 2014, 17.2 million hospital visits (inpatient and outpatient) included surgical procedures. More than half (57.8%) occurred in a hospital-owned outpatient surgery setting, and the remaining (42.2%) were inpatient. Private insurance was the primary payer for…

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Editor's Note Temperatures above 90o F were associated with a 28.9% increase in odds for surgical site infections (SSIs) compared to temperatures less than 40o F in this study. Analyzing data on millions of patients in the National Inpatient Sample database from 1998 to 2011, researchers found that SSIs were seasonal, with…

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Accurate OR case scheduling is a key performance indicator that is challenging to manage. The published literature often focuses on scheduling algorithms using historical data, the surgeon’s own estimate, or a mix of similar procedures. This mathematical approach neglects the cultural, economic, behavioral, and process challenges that impact attempts to…

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Editor's Note A mandatory change from surgical skull caps to bouffant caps in the OR did not reduce surgical site infections (SSIs), this study finds. In this analysis of 15,000 class I (clean) surgical procedures performed 13 months before and 13 months after surgical skull caps were banned at a…

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Editor's Note After emergency general surgery, frailty is associated with increased rates of mortality, discharge to an institution, and resource use, this Canadian study finds. Of 77,184 patients analyzed, 19,779 were frail. Death within 1 year of surgery occurred in 33.5% of frail patients, compared with 19.8% of nonfrail patients. Risk…

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Editor's Note A survey of public perceptions of overlapping surgery found that only a small minority of the general public is aware of the practice. Of 1,454 respondents, 56 (3.9%) were aware of overlapping surgery, and 440 (31%) supported or strongly supported the practice. The majority believed attending surgeons should…

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Editor's Note This study finds that video-based coaching is feasible for supplementing intraoperative teaching of residents to perform surgery. Teaching in a video-based coaching session was compared with teaching points made during a corresponding OR case. Teaching in video-based coaching sessions was more resident centered. Surgeons were more inquisitive about…

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