Editor's Note After opioid prescribing recommendations were implemented for a single surgical procedure, laparoscopic gall bladder removal, opioid prescribing decreased for four other surgical procedures in this study. The analysis involved 1,158 patients, 558 who had surgery before the opioid recommendations were implemented and 600 after implementation. Opioid prescription size…

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Social and demographic factors play a huge role in any patient’s overall health and recovery from surgery. When treating patients who lack health insurance, family support, or language/literacy skills—among many other possible disadvantages—providing safe patient care can extend well beyond clinical aspects. OR managers and their staffs may take on…

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Editor's Note Preoperative opioid use was associated with significantly increased risks of early revisions and 30-day readmissions after total knee and total hip arthroplasties, this study finds. The study included 324,154 patients in a 1-year follow-up group and 159,822 in a 3-year follow-up group. For total knee patients, the hospital…

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Editor's Note Lowering the default number of opioid pills prescribed in an electronic health record (EHR) system is a simple, effective, inexpensive, and potentially scalable intervention to change prescriber behavior and decrease the amount of opioids prescribed postoperatively, finds this study. In this analysis of 1,447 procedures before the default…

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Editor's Note Use of postacute care in skilled nursing facilities (SNFs) for total hip replacement (THR) and coronary artery bypass grafting (CABG) patients was not associated with changes in readmission rates, in this study. Of 176,994 CABG patients at 804 hospitals and 233,955 THR patients at 1,220 hospitals, SNF use…

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Editor's Note Preventability of readmissions changes with time, this study finds. Readmissions within the first week after discharge were more likely to be preventable by hospital-based interventions, whereas later readmissions were less likely to be preventable and more amenable to ambulatory and home-based interventions. This analysis of 822 patients readmitted…

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Editor's Note The ECRI Institute on May 17 announced that Boston Medical Center had won the 2018 Health Devices Achievement Award for its patient-centric mobile pulmonary care app. The ICOUGH Recovery app guides patients through the hospitals postoperative pulmonary care protocol, which focuses on: Incentive spirometry Coughing and deep breathing…

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Can hospital leaders and surgeons partner to reduce opioid use while maintaining high patient satisfaction scores? Leaders at OSS Orthopaedic Hospital in York, Pennsylvania, answer that question with a yes. Meghan McNelly, PharmD, MHA, FACHE, who was director of pharmacy at OSS when the opioid-reduction project started, says that from…

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Editor's Note For veterans having surgical procedures performed in the VA healthcare system, homelessness is an important risk factor for unplanned readmission, finds this study. Analyzing 232,373 surgical procedures performed on 199,879 patients, researchers found that 5,068 of the procedures were performed on homeless patients. The rate of readmission within…

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Editor's Note Opioid abuse or dependence after major surgical procedures was associated with increased readmission rates and healthcare utilization. Of 16,016,842 patients in the National Readmission Database analyzed, 94,903 (0.6%) had diagnoses of opioid abuse or dependence. Comparing patients with and without opioid abuse or dependence, researchers found that patients…

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