Postop morbidity, discharge in elderly fast-track total joint patients
Editor's Note Fast-track total hip and knee arthroplasties with a median length of stay of 3 days and discharge to home are feasible in most patients 85 years of age or older, this study finds. Of 13,775 procedures included in the analysis: median age was 87 years and median length…
Surgery at critical access hospitals safe, less expensive
Editor's Note In this study, Medicare patients having common surgical procedures at critical access hospitals had no significant difference in 30-day mortality than those at noncritical access hospitals (5.4% vs 5.6%), and they had lower rates of serious complications (6% vs 14%) and lower expenditures ($14,450 vs $15, 845). The…
Rates, risk factors for readmissions after emergency general surgery
Editor's Note Readmission after emergency general surgery procedures is common and varies widely depending on patient factors and diagnosis categories, this study finds. Of 177,500 emergency general surgery patients, the overall 30-day readmission rate was 5.91%. Predictors of readmission included Charlson Comorbidity Index score of 2 or greater, leaving against medical…
Orthopedic service line takes health system to another level
Total joint replacements have grown rapidly in recent years, thanks to an aging population and advances in surgical techniques and pain management. As a result, many healthcare facilities have added joint and spine procedures to their service lines. Others would like to know how to do this. What’s involved in…
Musical preference differs by OR specialty, professional role
Editor's Note Musical preferences and perceptions of the effect of music in the OR differ by professional status and specialty, this study finds. A survey of 282 patients and 390 providers (ie, physicians, residents, and nurses in anesthesiology and surgery), found that: Patients who highly enjoyed music said it alleviated…
Joint Commission: Michigan second state to partner on statewide high reliability effort
Editor's Note The Joint Commission announced on March 9 that the Michigan Health & Hospital Association and its member hospitals have partnered with the Joint Commission Center for Transforming Healthcare on a statewide high reliability organization improvement effort. Michigan is the second state to partner with the Center; South Carolina…
Study doesn’t support capnography for colonoscopy
Editor's Note Capnographic monitoring during outpatient colonoscopy with moderate sedation increased costs significantly and did not improve patient safety or satisfaction, this study finds. The analysis included 966 patients (465 without and 501 with capnography) who underwent colonoscopy at the Beth Israel Deaconess Medical Center, Boston. Patients and nurses reported…
PSH initiative demonstrates measurable impact on quality, costs
Editor's Note The American Society of Anesthesiologists and Premiere on February 9 announced results from the first phase of the Perioperative Surgical Home (PSH) learning collaborative. The collaborative included 44 healthcare organizations that piloted and evaluated the PSH model from July 2014 through November 2015. Many members of the collaborative…
Early postoperative showers appear to be safe for selected patients
Many patients may be able to safely shower 48 hours after surgery without increasing their risk of surgical site complications, and showering may increase patients’ satisfaction and lower the cost of wound care, a new study finds. Showering after surgery is a controversial issue. Traditionally, postoperative wounds are cleaned with…
Effectiveness of patient choice in nonoperative vs surgical management of appendicitis
Editor's Note When an initial nonoperative management strategy was chosen by patients and families, 3 in 4 children with uncomplicated acute appendicitis avoided surgery at 1-year follow-up, this study finds. Nonoperative management was associated with fewer days of disability, lower costs, and no difference in rates of complicated appendicitis or…
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