Tag: Discharge Planning

Outcomes, costs of Medicare patients having surgery at teaching vs nonteaching hospitals

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,…

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By: Judy Mathias
March 9, 2020
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Surgeons reduce opioid prescriptions using new multipronged strategy

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…

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By: Judy Mathias
March 4, 2020
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Back to basics: How collaboration can improve PACU patient flow

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,…

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By: Catherine Spader, RN
February 21, 2020
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Using project management principles to hardwire ERAS protocols

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…

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By: OR Manager
February 21, 2020
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Using smartphones to capture patient differences in postop physical recovery

Editor's Note Metrics derived from smartphone accelerometer data can capture differences in postoperative physical recovery in surgical patients, this study finds. In this analysis of 62 patients, smartphone accelerometer data showed decreases in daily exertional activity in 17 who experienced a postoperative event (eg, complication, reoperation) up to 6 weeks…

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By: Judy Mathias
February 20, 2020
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Association of geriatric-specific characteristics with postop readmissions

Editor's Note In this study from the University of Virginia, new geriatric-specific characteristics were found to raise the risk of elderly surgical patients having unplanned readmissions within a month of leaving the hospital. The four geriatric-specific risk factors for readmission include: cognitive impairment requiring another person to sign the patient’s…

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By: Judy Mathias
February 19, 2020
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Association between ERAS and postop complications after total hips and knees

Editor's Note Increased adherence to an Enhanced Recovery After Surgery (ERAS) protocol after total hip arthroplasty (THA) and total knee arthroplasty (TKA) was associated with a decrease in postoperative complications in this study from Spain. However, only a few interventions were linked to decreased complications In this analysis of 6,146…

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By: Judy Mathias
February 13, 2020
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Standardized pathway for outpatient ambulatory fracture surgery

Editor's Note In this study, an outpatient fracture pathway greatly improved the efficiency and timeliness of care, and it reduced costs. A total of 187 patients during the preintervention period and 308 patients during the intervention period were eligible for the ambulatory pathway. Those managed as outpatients increased from 1.6%…

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By: Judy Mathias
February 3, 2020
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Medicare may overpay for postop care

Editor's Note Medicare may be overpaying surgeons for postoperative care they provide to patients, according to a new Rand Corporation analysis in the January 23 New England Journal of Medicine. The authors of the analysis suggest that federal officials should incorporate ways to more objectively measure the amount of postoperative…

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By: Judy Mathias
January 23, 2020
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Virtual physical therapy rehab vs traditional care after TKA

Editor's Note A virtual system for in-home physical therapy (PT) provided similar patient outcomes after total knee arthroplasty (TKA), with lower costs than traditional in-person PT, finds this study. A total of 306 TKA patients were randomly assigned to have traditional PT, either at home or at clinic visits, or…

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By: Judy Mathias
January 16, 2020
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