Category: Perspectives, Opinions and Curiosities

ACS Verification Improves Surgical Quality Metrics

ACS verification enhances safety and effectiveness across multiple surgical outcomes. 61% of outcomes improved with ACS verification; 34% showed no difference. Significant gains in safety (p=0.0024), effectiveness (p<0.0001), equity (p=0.001), and patient-centeredness (p<0.0001). Consider ACS verification as a pivotal strategy for quality improvement, particularly in safety-focused practices. Efficiency and timeliness outcomes were less consistent and […]

New Model Accurately Predicts Postoperative Risk

A new model incorporates complex health data to better predict complications after major surgeries, enhancing surgical decision-making and patient safety. Complication prevalence: 8% ICU admission, 4% mechanical ventilation, 7% acute kidney injury, and 1% in-hospital mortality. Model performance: AUROC scores of 0.93 for ICU admission, 0.94 for mechanical ventilation, 0.92 for acute kidney injury, and […]

Rationalizing Surgical Trays Cuts Costs and Emissions

Rationalizing surgical trays for elective procedures can save money and reduce environmental impact. 39% reduction in tools for rectal procedures, from 53 to 16 items. Open hernia repair trays reduced from 53 to 43 items and from 75 to 60 items. Annual savings estimated at £16,863 and reduced carbon emissions by 42.6 kgCO2. This approach […]

New Insights on DNR Orders in Elderly Surgical Patients

In older adults undergoing surgery, new Do Not Resuscitate (DNR) orders often indicate significant risk factors and timing that can guide surgical decision-making. Only 2.3% of 47,564 cases resulted in new perioperative DNR orders. Key predictors of DNR orders: ASA IV/V (2.6x), disseminated cancer (3.3x), and emergent surgery (3.5x). DNR orders typically occur early post-surgery; […]

Improving Surgeon-Anesthesiologist Collaboration for Safer Care

Surgeons need to enhance teamwork with anesthesiologists to improve patient safety and outcomes in the OR. Interviews with 40 surgeons and anesthesiologists revealed seven barriers to collaboration, including communication issues and professional identity conflicts. Five effective strategies were identified: fostering relationships, improving communication at all surgical phases, and adopting a mindset of respect and trust. […]

High-Markup Hospitals: Higher Risks and Costs in Major Surgery

Surgeons should note that operating in high-markup hospitals significantly raises patient risks and costs for major surgeries. Patients at high-markup hospitals faced 50.3% higher costs and increased odds of in-hospital complications (adjusted odds ratio 1.07). Moderate-markup hospitals showed 24.7% higher costs and elevated mortality risks (adjusted odds ratio 1.07). Surgeons must consider hospital pricing when […]

Improved Outcomes with the Global Budget Revenue Model in Cancer Surgery

Switching to a global budget revenue model can enhance surgical outcomes for cancer procedures. Textbook outcomes improved from 72.8% to 76.1% in GBR hospitals versus a slight change from 70.2% to 70.5% in controls, showing a 2.9 percentage point gain (p=0.02). Complication rates fell by 1.5 percentage points, and prolonged stays decreased by 1.8 percentage […]

Diabetes Status Matters for Surgical Risk Assessment

Elective surgeries may carry different risks based on patients’ glycemic status rather than just diabetes diagnosis. In a study of over 2 million hospitalizations, 9.16% of patients with diabetes and hyperglycemia had major adverse events, compared to 5.31% without diabetes. Patients with diabetes without hyperglycemia had a modest increased risk (5.85%) with a number needed […]

Surgeons Improve Antibiotic Use with Education

Surgeons can significantly enhance antimicrobial prescribing practices through targeted education, tackling the critical issue of antibiotic misuse. Educational interventions led to better antibiotic selection, timing, and duration. Review included 17 studies, primarily from high-income, tertiary hospitals, emphasizing pre-post design effectiveness. These findings underscore the importance of implementing educational strategies to strengthen antimicrobial stewardship in surgical […]

Mentorship Programs Increase Diversity in Surgery

Surgical subspecialties are striving for greater diversity through targeted mentorship for underrepresented minorities. Only 18 of 255 studies highlighted programs for URIM students, mainly at medical school (11) and high school (3) levels. Outreach can effectively boost interest in surgery among URIM individuals, though vascular surgery lacks any dedicated programs. Increasing mentorship initiatives across all […]