Surgery/Specialties Editor's Note In this position paper, three global surgery groups advocate for global surgeons based in US academic healthcare centers. Though 30% of all diseases globally require surgical care and expertise, global surgeons based in academic healthcare centers often face institutional barriers that make it difficult to take time to…
The Centers for Medicare & Medicaid Services (CMS) is poised to launch Bundled Payments for Care Improvement (BPCI) Advanced on October 1, 2018, and is continuing its Comprehensive Care for Joint Replacement (CJR) bundled payment model for total hip and knee arthroplasty (THA, TKA). “Orthopedics is the most important service…
Editor's Note A blood management program at Johns Hopkins using a hemoglobin transfusion threshold of 7 g/dl in orthopedic surgical patients reduced blood use by 32.5% and resulted in similar or improved outcomes. Improved outcomes were primarily in patients 65 years of age or older. For this study, researchers evaluated…
Editor's Note The Food & Drug Administration (FDA) on August 17 issued a Safety Alert for SynCardia Systems’ (Tucson, Arizona) Temporary Total Artificial Heart Companion 2 Driver System. Final results from a post-approval study indicate higher mortality and stroke rates for patients initially supported with the C2 Driver System compared…
Editor's Note Led by Martin A. Makary, MD, MPH, a Johns Hopkins panel of experts developed the nation’s first set of opioid prescribing guidelines for 20 common surgical procedures in 8 surgical specialties. The guidelines are based on the premise that opioid prescribing should be based on the surgical procedure…
Editor's Note Increased use of neuraxial anesthesia was associated with lower hospitalization costs for hip and knee replacements, but more studies are needed before considering neuraxial anesthesia as a marker of quality, this study finds. National data on 808,237 total knee and 371,607 total hip replacements were analyzed. Increasing frequency…
Editor's Note In this study, implementation of Lean interventions to redesign the workflow in the preoperative holding area of a large urban medical center was linked to significantly improved rates of elective first case on-time starts. Data from 23,891 surgical procedures performed over 415 days were examined−86 days before, 35…
Editor's Note This study finds that irregularly shaped OR surfaces may require enhanced covering, cleaning, and monitoring protocols, compared to more regularly shaped surfaces. Researchers coupled ATP assays with traditional RODAC plate sampling and mass spectrometry to evaluate cleaning of five types of high-touch surfaces in the OR. Whether surfaces…
Editor's Note A recent Reaction Data survey of 254 physicians found that 21% believed electronic health records (EHRs) were the biggest determinant in burnout, followed by payers/preauthorization, regulatory compliance, and internal bureaucracy, the July 31 Healthcare Informatics reports. All factors had a common theme of consuming time and preventing physicians…
Editor's Note The number of door openings in the OR and duration of procedure were significantly associated with increased colony-forming units (CFUs) in the OR overall and outside of laminar airflow (LAF), this study finds. In LAF conditions, however, only the number of OR personnel was significantly associated with increased…
