Implementation of Enhanced Recovery After Surgery (ERAS) at Virginia Commonwealth University (VCU) Health System in Richmond has been achieved through project and change management tools that transform the current state to the desired future state. To hardwire ERAS protocols in the OR as well as the ambulatory and acute care…

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Editor's Note In this study from the University of Virginia, new geriatric-specific characteristics were found to raise the risk of elderly surgical patients having unplanned readmissions within a month of leaving the hospital. The four geriatric-specific risk factors for readmission include: cognitive impairment requiring another person to sign the patient’s…

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Editor's Note Increased adherence to an Enhanced Recovery After Surgery (ERAS) protocol after total hip arthroplasty (THA) and total knee arthroplasty (TKA) was associated with a decrease in postoperative complications in this study from Spain. However, only a few interventions were linked to decreased complications In this analysis of 6,146…

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Editor's Note The implementation of an aviation-style computerized surgical safety checklist displayed on a large, centrally located screen and operated by the anesthesia provider improved checklist performance in this study. A total of 671 cases were observed before and 547 cases after implementation of the computerized checklist system. The proportion…

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Editor's Note In this Canadian study, older patients with frailty were significantly more likely to die or experience a new disability within 90 days after surgery. This prospective multicenter study included 702 patients, 65 years or older, having elective noncardiac surgery; 645 patients completed follow up. Frailty status was determined…

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Editor's Note In this study, an outpatient fracture pathway greatly improved the efficiency and timeliness of care, and it reduced costs. A total of 187 patients during the preintervention period and 308 patients during the intervention period were eligible for the ambulatory pathway. Those managed as outpatients increased from 1.6%…

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At Virginia Commonwealth University (VCU) Health System in Richmond, implementation of Enhanced Recovery After Surgery (ERAS) incorporates principles of Lean thinking, a management methodology that emphasizes “…maximize[ing] customer value while minimizing waste. Simply, lean means creating more value for customers with fewer resources,” according to the Lean Enterprise Institute.1 Several…

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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 Though patient and personnel factors affect the order of case induction, induction time is most dependent on patient factors, this study finds. Of 15,823 cases analyzed, predictors of later patient induction included add-on case, ASA class 3 or more, neuraxial anesthesia, and CRNA staffing. In 11,093 (70.1%) cases,…

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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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