Tag Archive for ‘quality improvement’

Profiles in surgical research: Kamal M.F. Itani, MD, FACS

Kamal M.F. Itani, MD, FACS—chief of surgery, Veterans Affairs Boston Health Care System and a leader in health services research—is the latest physician to be profiled in this ongoing series.

Using the palliative performance scale to increase goals of care conversations

The results of a quality improvement initiative at Rutgers New Jersey University Hospital, Newark, focused on increasing goals of care conversations in older patients with low pre-injury palliative performance scale scores.

 

Reducing duration of postoperative prophylactic antibiotics in neonatal surgery

The results of a quality improvement initiative in the intensive care unit at the Hospital for Sick Children, Toronto, ON, focused on reducing inappropriate prophylactic antibiotic use in neonatal patients.

Reducing returns to the operating room

Technology has continued to drive advances in surgery toward more minimally invasive, cost-conscious, patient-centric procedures. At the same time, the battle to prevent surgical complications has taken center stage as a means to improve patient outcomes and reduce overall health care costs for both patients and hospitals. Complications and their associated costs after surgical intervention […]

Australian hospital calls in the COPS to improve care of older patients

As the world’s population ages, older people are increasingly presenting to the hospital with surgical problems that require assessment and management. Older patients face different challenges than their younger counterparts, including an increased risk of complications, death, and functional decline.1,2 The presence of frailty, cognitive impairment, and multiple comorbidities also contributes to poorer postoperative outcomes […]

Hospital aims to stop the clot in neurosurgery

Venous thromboembolism (VTE) occurrences are defined by a deep vein thrombosis (DVT), pulmonary embolism (PE), or both. VTE affects nearly one in 1,000 people and contributes to 60,000–100,000 deaths annually.* Risk factors for VTE can be both hereditary and acquired. We have come to understand that patients who require surgery are at a higher risk […]

Pediatric surgeons and gastroenterologists collaborate with outpatient community services to streamline outpatient gastrostomy tube placement

Gastrostomy tube (G-tube) placement is often a crucial component in a medically complex child’s care and one of the more common procedures performed at children’s hospitals; however, approaches to patient counseling and postoperative management for this procedure varies. Families often agonize over the decision and worry about their ability to care for their child after […]

Managing postoperative pain while limiting opioid prescriptions

Opioid abuse has come to the forefront of medical issues in recent years. What began in the 1990s with an increase in opioid prescriptions, fueled by a desire to better treat pain and reassurances from pharmaceutical companies on safety, developed into a crisis affecting nearly 1.7 million individuals by 2017, according to the National Institute […]

I COUGH provides blueprint for sustainable quality improvement

The I COUGH program, which seeks to prevent non-ventilator-associated postoperative pulmonary complications, is a model for other sustainable quality improvement initiatives.

ACS Quality and Case Studies

Virtual acute care for older patients reduces hospital length of stay

A quality improvement initiative implemented by the University of Alabama at Birmingham improved patient mobility and decreased hospital length of stay for an older surgical patient population.

ACS Quality and Case Studies

Keep calm and stay out of the ICU: A comprehensive approach to reducing unplanned ICU admissions

The results of a quality improvement initiative to decrease unplanned intensive care unit admissions at Geisinger-CMC, Scranton, PA, are summarized.

ACS Quality and Case Studies

Postoperative pain and nausea protocols decrease LOS without increasing readmissions after laparoscopic gastric bypass

Analgesic and nausea protocols deployed across four phases of operative care in patients at The University of Maryland Medical Center, Baltimore, resulted in a reduced length of stay without increasing readmissions.

Hospital-based preoperative clinic applies ERAS and Strong for Surgery guidelines to optimize patients for surgery

Hospital-based preoperative clinic applies ERAS and Strong for Surgery guidelines to optimize patients for surgery

The results of an ERAS initiative and a Strong for Surgery checklist applied to colorectal surgery patients at CHRISTUS St. Michael Health System, Texarkana, TX, are summarized.

The Joint Commission

Revisiting To Err Is Human 20 years later

This month’s column examines the seminal report To Err Is Human, published two decades ago by the National Academy of Medicine, within the context of modern day, quality-related challenges.

ERAS leads to reduced length of stay for geriatric joint replacement patients

The results of a quality improvement initiative to reduce length of stay for arthroplasty patients at the Kaiser Westside Medical Center (KWMC), Hillsboro, OR, are summarized.

ACS NSQIP recognizes 88 hospitals for meritorious outcomes for surgical patient care

ACS NSQIP recognizes 88 hospitals for meritorious outcomes for surgical patient care

ACS NSQIP recognized 88 hospitals for meritorious outcomes in surgical patient care in 2018.

Figure 1. Outcomes comparison, pre-ERAS vs. ERAS

ERAS program improves outcomes in patients undergoing cytoreductive surgery and heated intraperitoneal chemotherapy

The Mayo Clinic in Arizona, Phoenix, implemented an enhanced recovery after surgery program for patients undergoing hyperthermic intraperitoneal chemotherapy, and the results and lessons learned are described.

NSQIP Case Studies

New protocol leads to improved trauma decannulation rate

This column outlines the results of a new tracheostomy decannulation protocol and lessons learned in developing the quality initiative at Christiana Hospital, Newark, DE.

Figure 1. Incidence of postoperative UTI before and after discontinuation of routine IUC placement by year

Routine Foley catheter placement affects postoperative UTIs in bariatric surgery patients

This column outlines the results of a new protocol at Stony Brook University Hospital, Long Island, NY, designed to reduce catheter-associated urinary tract infection rates.

NSQIP Case Studies

Enhanced recovery program benefits frail colon and rectal surgery patients

This column describes the implementation of an enhanced recovery program for colon and rectal surgery patients at a not-for-profit, urban, tertiary care, Level I trauma center.

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