Preop opioid use linked to increased costs, worse outcomes
Editor's Note Opioid use before major abdominal surgery was independently associated with increased postoperative healthcare utilization and morbidity in this study. Of 2,413 patients analyzed, 502 used opioids preoperatively. After covariate adjustment, opioid users, compared with non-opioid users had: higher costs ($26,604 vs $24,263) longer lengths of stay (5.9 vs…
App helps surgical patients recover faster
Editor's Note To help surgical patients recover faster, Rush University Medical Center in Chicago has started providing them with a computer app that prompts, monitors, and encourages activities that promote healing. The app, called “SeamlessMD,” can be downloaded to a patient’s smartphone, tablet, or computer and is part of Rush’s…
Study: Improving preop throughput
Editor's Note Healthcare managers’ top priority needs to focus on work environment design to improve preoperative throughput and OR first-case on time starts, this study finds. Two main barriers were identified−lack of equipment and availability of equipment in the preoperative area. Four vital sign monitors with wheels were purchased, as were…
CDC publishes cancer screening stats
Editor's Note More adults are getting screening tests for colorectal cancer but not for breast or cervical cancers, according to new data from the Centers Disease Control and Prevention (CDC). From 2000 to 2015, the rate of colorectal cancer screening increased from 33% to 62% in men and from 35%…
Case cancellations reduced by preop patient phone calls
Cancellation of surgical cases, especially prescheduled elective surgeries, is a pervasive problem that reduces OR utilization and hospital revenue. The estimated direct and indirect annual cost of such cancellations across the US is approximately $39 billion per year, with an average OR cost between $20 and $65 per minute. Facilities…
Lean processes improve surgical wait times at VA hospital
Editor's Note Implementation of Lean system redesigns was associated with a significant and sustained wait list reduction from 33.4 days to 12.0 days for patients waiting for elective general surgery procedures at a Veterans Affairs medical center, this study finds. The study covered FY 2012 to 2014. At the same…
ASA updates guidelines for preop fasting, drugs to reduce pulmonary aspiration risk
Editor's Note The American Society of Anesthesiologists (ASA) has published new “Practice guidelines for preoperative fasting and the use of pharmacologic agents to reduce the risk of pulmonary aspiration: Application to health patients undergoing elective procedures.” The document updates its guidelines published in 2011. The guidelines are intended for use…
SSIs fall sharply with team-based protocol changes
Surgical site infections (SSIs) are a major cause of morbidity in surgical patients, leading to increased length of stay and healthcare costs. No single intervention has demonstrated efficacy in reducing SSIs. When SSIs rose to a rate of 16.3% in 2013 at St Elizabeth Boardman Hospital in Boardman, Ohio, perioperative…
Huddles help hospitals move toward the goal
Like a football team gathering to confirm tactical details before a play, surgical staff often form a huddle to ensure readiness of the providers, patient, and equipment for the upcoming procedure. In a twist on the traditional huddle the day before surgery, staff at the Hospital of Central Connecticut (HOCC)…
Prehabilitation program improves preop fitness in colon cancer patients
Editor's Note Engaging colon cancer patients in a prehabilitation program 4 weeks before surgery modified exercise behaviors and improved physical function, which improved postoperative outcomes, finds this study. Researchers randomized 116 patients to either a prehabilitation program (57 patients) or a control group (59 patients). After 4 weeks, compared with…
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