Editor's Note On July 27, PinnacleHealth (Harrisburg, Pennsylvania) announced the opening of its Surgery Optimization Clinic to support orthopedic patients at high risk for surgical complications. Other high-risk surgical patient service lines will be added by the end of the year. The aim of the program is to improve patient…

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Editor's Note These guidelines were developed to provide a more efficient and cost-effective preoperative workup of patients with diagnosed or suspected obstructive sleep apnea (OSA). They examine the existing evidence-base for preoperative screening and preparation of patients with OSA, as well as the perioperative use of CPAP in patients with…

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Editor's Note In this study, researchers developed a question prompt list for older adults considering high-risk surgery. Three decision-making needs were addressed, including clarification of treatment options, setting postoperative expectations, and advance care planning. The list included 11 questions within 3 domains: Should I have surgery? What should I expect…

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Editor's Note Preoperative cognitive screening is feasible in most older elective surgical patients, and results show a substantial prevalence of probable cognitive impairment in this population, this study finds. Because preexisting cognitive impairment is emerging as a predictor of poor postoperative outcomes in seniors, researchers examined whether preoperative cognitive screening…

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Editor's Note A quick, reliable, and cost-effective mobility assessment tool helped to identify older patients at risk for adverse postoperative outcomes in this study. Mobility was assessed with 10 animated video clips of activities. Patients were asked to watch each clip and respond to a series of questions about their…

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Editor's Note Total joint patients benefited from preoperative one-on-one educations sessions provided by a physical therapist and access to a custom web portal, in this study presented February 20 at the annual meeting of the American Physical Therapy Association. Researchers from the Hospital for Special Surgery, New York City, followed…

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Editor's Note Depending on which hospital a patient goes to for a low-risk surgical procedure, he or she may be 2.4 times more or less likely to be sent for preoperative blood work, this study finds. Researchers found that overall, unnecessary preoperative lab tests (eg, complete blood count, blood clotting…

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Is your preanesthesia testing area providing measurable value, and is it positioned to drive surgery toward a new paradigm of care? As government payers shift toward value-based care with the required bundled payment for total joints starting in 800 hospitals and 75 markets (as part of the Comprehensive Care for…

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Editor's Note A few calming words from an anesthesiologist are as effective as medication in relaxing patients before anesthesia and surgery, finds research presented at the Anesthesiology 2015 annual meeting. Researchers compared conversational hypnosis (ie, talking quietly and positively and focusing the patient’s attention on something other than the upcoming…

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Editor's Note A significant percentage of two common preoperative tests—prothrombin time (PT) and activated partial thromboplastin time (aPTT)—are unnecessary, this study finds. PT was ordered unnecessarily in 94.3% of patients and aPPT in 99.9% of patients. PT evaluates the patient’s blood clotting ability, and aPPT determines if heparin therapy is…

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