Editor's Note In this study, Yale researchers found that endotheliopathy and platelet activation might be important factors in the pathophysiology of COVID-19-associated coagulopathy. The researchers examined the blood of 68 COVID-19 patients, 48 of them in ICU and 20 receiving care in a hospital unit, along with 13 disease free…
Enhanced Recovery After Surgery (ERAS) is arguably the greatest advancement in surgery in the last 20 years. But even healthcare leaders who support the use of ERAS to achieve better outcomes can find it daunting to implement the protocols throughout their hospital systems. Standardizing practices across areas that have historically…
Editor's Note The American College of Surgeons (ACS) on April 17 announced that the ACS, AORN, American Society of Anesthesiologists (ASA), and American Hospital Association (AHA) together developed a roadmap to guide readiness, prioritization, and scheduling for safely resuming elective surgery. Highlights of the roadmap include: Implementing a policy for…
Editor' Note The American College of Surgeons (ACS) on April 17 released a new document, “Local Resumption of Elective Surgery Guidance,” to help healthcare facilities prepare to resume elective surgery once COVID-19 has peaked in their area. The document includes four categories: COVID Awareness—addresses the community’s COVID-19 numbers, including prevalence,…
Over the last 5 years, the perioperative surgical home (PSH) model has attracted increasing interest from OR directors, anesthesiologists, and surgeons. This team-based, patient-centered approach coordinates all phases of surgical care, from preoperative assessment through intraoperative care and postdischarge recovery. According to the American Society of Anesthesiologists, PSH initiatives have…
Virginia Commonwealth University Health System (VCU Health) in Richmond is a Magnet facility, and as such we continually examine innovative ideas to improve the quality, safety, and care of our patients. Evidence has linked Enhanced Recovery After Surgery (ERAS) with better outcomes, and ERAS has become a focal point at…
Editor's Note This study of Medicare patients at 340 teaching hospitals and matched patient controls at 2,444 nonteaching hospitals found that as risk of mortality increased, the mortality benefit of treatment at teaching hospitals also increased, though with marginally higher costs. Included in the analysis were 86,751 pairs of general,…
Editor's Note A system-wide, multipronged pain management and opioid reduction program significantly reduced postoperative opioid discharge prescriptions written for more than 5 days, this study finds. Surgeon education, monitoring, and incentives lead to a shift from longer-term to shorter-term prescriptions for patients after surgery, reducing postoperative opioid prescriptions of more…
Healthcare technology can be a great thing, but nurses at Abington—Jefferson Health, in Abington, Pennsylvania, have discovered that sometimes stepping back from it is the best way to make progress. Going low-tech was the key that unlocked patient flow gridlock that had plagued the postanesthesia care unit (PACU). Before 2017,…
Implementation of Enhanced Recovery After Surgery (ERAS) at Virginia Commonwealth University (VCU) Health System in Richmond has been achieved through project and change management tools that transform the current state to the desired future state. To hardwire ERAS protocols in the OR as well as the ambulatory and acute care…