Is disruptive behavior inherent to the surgeon or environment?
Editor's Note Unclear policies and urgent competing responsibilities in the OR create stress, suggesting that the environment is the primary contributor to disruptive behavior by the surgeon, this study finds. Of 314 reports of disruptive behavior from surgical, medical, and other specialties, which included both the reporter account and involved…
Patient factors tied to postop opioid consumption
Editor's Note In this study of opioid-naïve patients having major surgery, researchers found a number of patient characteristics associated with greater opioid use in the first month after surgery. Of 1,181 patients analyzed, the following were significantly associated with increased postoperative opioid consumption: younger age nonwhite race lack of college…
Sleep deprivation in acute care surgeons
Editor's Note Acute and chronic sleep deprivation patterns are common in acute care surgeons and worsen on post-call day 2, finds this study. In this analysis of 1,421 nights for 17 acute care surgeons, the average amount of sleep was 6.54 hours, with 64.8% of sleep patterns categorized as acute…
US News publishes 2019-2020 top hospitals list
Editor's Note The US News & World Report on July 30 released its 2019-2020 Best Hospitals Honor Roll. The top five are: Mayo Clinic, Rochester, Minn Massachusetts General Hospital, Boston Johns Hopkins Hospital, Baltimore Cleveland Clinic New York-Presbyterian Hospital/Columbia and Cornell, New York City. In the specialty rankings: University of…
Study debunks ‘July Effect’ in cardiac surgery
Editor's Note The “July Effect”−the idea that more errors occur in July because of the influx of new interns and residents starting their in-hospital training−does not apply to cardiac surgery, this study finds. For more than 470,000 cardiac procedures analyzed (coronary bypass, aortic valve, mitral valve, thoracic aortic aneurysm), in-hospital…
Legal and ethical questions temper excitement about AI--Part 2
As part of a special series on artificial intelligence (AI), OR Manager is taking a deep dive into the many facets of this new technology and its impact on patient care. In this issue we continue our examination of the challenges related to AI, which began in last month’s issue…
Consider all angles when choosing AI technology
This article concludes OR Manager’s special series on artificial intelligence (AI). Parts 1 and 2 (May 2019 and June 2019) introduced AI, defining the different types of technology and describing its many current and potential applications for surgery. The series also presented examples of AI (June and July 2019). We…
Facilitate and innovate: Ensuring speedy but safe product reviews
Surgeons are the biggest factor in any effort to streamline and standardize the purchase of new surgical devices—and thereby lower costs. But surgeons often balk at getting involved in product review and selection because of the additional demands on their time. Two leading healthcare organizations have moved past this stumbling…
Tackling the opioid crisis through community teamwork
The opioid epidemic has risen to alarming proportions in the United States, claiming 46,000 lives in 2018. Studies and federal reports documenting evidence of narcotics overuse and addiction in patients have built momentum to curb prescribing habits. Responding to these trends, a Midwestern orthopedic practice launched a multiphase project to…
Preop opioid, benzodiazepine use linked to postop mortality, opioid consumption
Editor's Note Use of opioids and benzodiazepines 6 months before surgery was associated with increased short- and long-term mortality and an increased rate of persistent postoperative opioid consumption, this study finds. In this analysis of 41,170 noncardiac surgical cases in 27,787 patients in Iceland, preoperative prescriptions for opioids only were…
