Enhanced Recovery After Surgery The implementation of Enhanced Recovery After Surgery (ERAS) is based on the concept of organizing care around the patient, addressing medical condition needs to optimize readiness for surgery and reducing the likelihood of postoperative complications. Efficacy is measured by how well we perform according to these…

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Editor's Note Despite high rates of patients discharged with cardioprotective medications, the long-term burden of postoperative myocardial infarction (MI) after major vascular surgery is substantial, with a high mortality rate in the following year, this study finds. Of 26,231 vascular surgery patients analyzed, factors linked to an increased risk of postoperative…

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Editor's Note Care coordination strategies were found to be associated with high overall hospital quality star ratings from the Centers for Medicare & Medicaid Services (CMS) in this study. A total of 710 general acute care noncritical access hospitals that received star ratings and responded to the 2015 American Hospital…

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At Virginia Commonwealth University System (VCU Health) in Richmond, we are using quality standards to establish operational definitions for elements of Enhanced Recovery After Surgery (ERAS). This article describes what those standards are and how they are implemented. Previous articles in this series appeared in the October 2019 and November…

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Editor's Note In this study, a new machine learning Complexity Score algorithm outperformed three commonly used risk scores in predicting postoperative morbidity, 30-day readmission, 90-day readmission, and postoperative surper-use. Study patients underwent colectomy, abdominal aortic aneurysm repair, coronary artery bypass grafting, total hip or knee replacement, or lung resection. The…

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Editor's Note A state-mandated policy restricting opioid prescriptions in Vermont greatly reduced opioid prescribing and use by surgical patients at the University of Vermont Medical Center without affecting patient satisfaction with their postoperative pain management, finds this study presented October 29 at the American College of Surgeons Clinical Congress 2019…

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Editor's Note In this study, machine learning algorithms accurately identified cancer patients who were at risk of 6-month mortality. Of 26,525 cancer patients analyzed, machine learning models based on structured electronic health record data accurately predicted short-term mortality risk with good discrimination and positive predictive value. When the gradient boosting…

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Editor's Note An Enhanced Recovery Pathway (ERP) created by the Mayo Clinic’s colorectal surgery service a decade ago has now been adopted by other surgical services in seven medical centers that are members of the Mayo Clinic Care Network, the October 15 Harvard Business Review reports. The ability of each…

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The US has been on a journey for the last several years to reduce the cost of healthcare. In 2017, the percent of gross domestic product attributed to healthcare goods and services was at 17.9%. This is expected to reach as much as 19.4% by the year 2027.1 Factors contributing…

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Editor's Note This study found that opioid prescribing can be decreased by more than 50% and not adversely affect patients’ satisfaction scores with their surgeons. Of 996 patients surveyed on their satisfaction with their surgeons before (period A) and after (period B) an educational intervention that resulted in decreased opioid…

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