Variation in patient-reported outcomes after surgery
Editor's Note Patient factors explain a large proportion of hospital variation in postoperative patient-reported outcomes, underscoring the importance of risk adjustment, this study finds. Some variation across hospitals remained unexplained, however, suggesting that patient-reported outcomes may be a viable indicator of hospital performance, the authors conclude. There is a growing…
Achieving quality improvement depends on the local culture
The key to sustaining quality outcomes is promoting confidence and engagement of surgical teams, says Clifford Ko, MD, MS, MSHS, FACS, director of the National Surgical Quality Improvement Program and Division of Research and Optimal Patient Care, at the American College of Surgeons in Chicago. Dr Ko gave the keynote…
Evaluation of anesthesia preinduction checklist
Editor's Note In this study, the use of a preinduction checklist significantly improved information exchange, knowledge of critical information, and perception of safety in anesthesia teams. A total of 105 teams using the checklist were compared with 100 control teams. The outcome scores for the checklist group vs the controls…
Anesthesia enhanced recovery pathway improves outcomes
Editor's Note Development of an anesthesia enhanced recovery pathway (ERP) at Johns Hopkins Hospital, Baltimore, resulted in a 45% reduction in length of stay in colorectal surgery patients. In addition, patient satisfaction scores improved from the 37th percentile to the 97th percentile. The goals of the ERP were achieving superior…
Implementation of integrated recovery pathway quickly improves outcomes
Editor's Note A trust-based accountability model that included senior hospital leadership and frontline providers provided an enabling structure to rapidly implement an integrated recovery pathway and quickly improve outcomes, value, and experience of colorectal surgical patients, in this study. The pathway included preoperative education, mechanical bowel preparation with oral antibiotics,…
Quality of supervision provided by anesthesiologists not linked to clinical productivity
Editor's Note When anesthesiologists supervise anesthesia residents and nurse anesthetists, the amount of clinical work (total weekly hours) they perform does not positively correlate with the quality of the supervision they provide, this study finds. The results suggest that anesthesiology department managers should be monitoring (and perhaps reporting) the quality…
Effect of music on OR performance
Editor's Note When surgeons listen to their preferred music, they’re more efficient at closing incisions, and their technique improves, this study finds. Researchers asked 15 plastic surgery residents at the University of Texas to perform layered closures on pigs’ feet. Half the resident worked in a silent OR and half…
UTIs reduced by focusing on catheter use in the OR
Editor's Note Surgical teams at Northwesterm Memorial Hospital in Chicago are decreasing the rate of urinary tract infections by focusing on the use of catheters before and immediately after surgical procedures. A process improvement program reduced the number of UTIs associated with catheters placed in patients in the OR from…
Integrate systems to sustain gains from process change
Many organizations have reaped the benefits of adopting Lean concepts, such as greater workflow efficiency, staff engagement, and cost savings. After initial improvements are made, however, it can be hard to sustain the process changes over time. That was the case at Nemours A. I. duPont Hospital for Children in…
Adaptive Design makes patient-centered care a part of every day
Providing ideal patient care is the fundamental purpose behind Adaptive Design, an innovative systems approach that engages frontline staff in problem solving and focuses on improving patient care as part of everyone’s daily work. “More access to better care at a continually lower cost is the promise of doing Adaptive…
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