A study identifies critical contextual factors for effective implementation of enhanced recovery programs (ERPs) in hospitals. Out of 86 hospitals, 30.2% achieved high ERP adherence. Success scenarios included low-socioeconomic status hospitals eager for change lacking team cohesion, low surgical volume hospitals with strong staff buy-in, and high-volume hospitals needing leadership support while ensuring appropriate workload. […]
Category: Perspectives, Opinions and Curiosities
Effective Implementation Strategies for Shared Decision-Making Identified
The systematic review reveals that implementing shared decision-making (SDM) in gastrointestinal cancer care faces challenges despite its importance for patient autonomy. Researchers synthesized data from 37 qualitative studies, identifying nine influencing factors categorized into two subthemes. Key strategies include enhancing medical staff’s understanding of patients’ needs and improving communication skills to facilitate SDM. These findings […]
Increased VTE rates identified in postoperative COVID-19 patients
A meta-analysis of 17 studies involving over 3 million patients reveals heightened venous thromboembolism (VTE) rates among postoperative individuals who were COVID-19 positive. Notably, those undergoing total joint arthroplasty, other orthopedic surgery, and emergency general surgery experienced significantly elevated VTE rates compared to their COVID-19 negative counterparts. No substantial differences were found between pre-pandemic and […]
Surgical complications linked to surgeon age and volume
A systematic review analyzing 2.3 million procedures from 72,000 surgeons reveals a U-shaped relationship between surgeon age and surgical complications. High-volume surgeons maintained stable outcomes up to age 70, while low-volume surgeons faced significant complications after age 55. Complex procedures showed more pronounced age effects compared to minimally invasive ones. The findings advocate for personalized […]
Comprehensive geriatric approaches reduce readmission risks post-surgery
A comprehensive geriatric assessment combined with individualized prehabilitation programs may significantly reduce unplanned hospital readmissions in older adults after digestive surgery. The study emphasizes the importance of addressing underlying frailty, comorbidities, and postoperative complications. By coordinating efforts between surgical teams and geriatric specialists, improved perioperative care can be achieved, consequently minimizing the adverse effects of […]
Worsening frailty scores predict postoperative mortality risk.
Preoperative frailty, measured by the modified frailty index (MFI), significantly predicts postoperative mortality. Patients who experienced in-hospital mortality exhibited higher preoperative MFI scores (0.178) compared to those discharged alive (0.115). This difference persisted on postoperative day 1 (0.240 vs. 0.143) and along the entire hospitalization trajectory. Notably, the increase in MFI scores was substantial for […]
CPOE prompts lead to reduced use of extended-spectrum antibiotics
Implementing computerized provider order entry (CPOE) prompts significantly reduced the use of empiric extended-spectrum antibiotics for non-critically ill patients with abdominal infection. In a trial involving 198,480 patients across 92 hospitals, a 35% relative reduction in antibiotic days was observed with CPOE intervention compared to routine care, while hospital length of stay and ICU transfer […]
Checklist interventions enhance hospital ward rounds and patient outcomes
A systematic review of 84 studies revealed that checklist interventions significantly reduced ICU length of stay and improved documentation without extending ward round duration. In contrast, structured interventions did not impact patient length of stay or 30-day readmission rates. This evidence synthesis, which included over 43,000 patients across 18 countries and 23 specialties, presents the […]
Millions of Americans Lack Access to Quality Surgical Care
Access to surgical care poses significant challenges for roughly 100 million Americans, representing one in three individuals who face inadequate healthcare options. This disparity incurs a staggering $1 billion annually in preventable healthcare costs and contributes to higher morbidity and mortality rates. Key barriers include rural geography, hospital closures, and systemic issues affecting marginalized communities. […]
Enhanced recovery compliance significantly reduces postoperative venous thromboembolism
Enhanced Recovery After Surgery (ERAS) guidelines significantly lower postoperative venous thromboembolism (VTE) rates across various surgical specialties. Among 8,118 patients, those adhering to higher ERAS compliance scored a 23% reduced incidence of VTE. Notably, 11% of patients with VTE had low compliance compared to only 5.6% without VTE, indicating a strong trend. Logistic regression confirmed […]