Surgery/Specialties 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…
Editor's Note This study, which examined the relationship between nursing specialty certification and surgical site infections (SSIs), found that only Magnet status was associated with lower SSI rates. Analyzing data from 69 hospitals, 346 units, and 6,585 RNs, along with SSI data on 22,188 patients after colon and abdominal hysterectomy…
Editor's Note The Joint Commission and American Heart Association (AHA) on July 25 announced a new jointly offered hospital cardiovascular certification program. The “Advanced Certification for Heart Failure” program is the first of multiple, jointly offered cardiac certifications that will be available to hospitals. Organizations must meet the following criteria:…
Editor's Note After implementing two presurgery checklists from the American College of Surgeons Strong for Surgery (S4S) program, most diabetic patients met blood sugar control recommendations, and many patients quit smoking before surgery. Use of the checklists along with an Enhanced Recovery After Surgery (ERAS) approach resulted in decreased length…
Editor's Note In high-risk hip fracture patients, an Enhanced Recovery After Surgery (ERAS) program lowers mortality rates, reduces hospital stays, and results in fewer complications, finds this study presented July 23 at the American College of Surgeons 2018 Quality and Safety Conference in Orlando, Florida. Results showed that ERAS: cut…
