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Ambulatory surgical centers

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https://www.readbyqxmd.com/read/28506476/adherence-to-lipid-management-guidelines-is-associated-with-lower-mortality-and-major-adverse-limb-events-in-patients-undergoing-revascularization-for-chronic-limb-threatening-ischemia
#1
Thomas F X O'Donnell, Sarah E Deery, Jeremy D Darling, Katie E Shean, Murray A Mittleman, Gabrielle N Yee, Matthew R Dernbach, Marc L Schermerhorn
OBJECTIVE: The 2013 American College of Cardiology/American Heart Association lipid management guidelines recommend high-intensity statins for all patients ≤75 years old with chronic limb-threatening ischemia (CLTI) and moderate-intensity statins for CLTI patients >75 years old without contraindications or on dialysis, but these recommendations are based primarily on coronary and stroke data. We aimed to validate these guidelines in patients with CLTI and to assess current adherence to these recommendations...
May 12, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28501117/institutional-variation-in-surgical-care-for-early-stage-breast-cancer-at-community-hospitals
#2
Christopher M Dodgion, Stuart R Lipsitz, Marquita R Decker, Yue-Yung Hu, Sudha R Pavuluri Quamme, Anita Karcz, Leonard D'Avolio, Caprice C Greenberg
BACKGROUND: There is significant institutional variation in the surgical care of breast cancer, and this may reflect access to services and resultant physician practice patterns. In previous studies, specialty care has been associated with variation in the operative treatment of breast cancer but has not been evaluated in a community setting. This study investigates these issues in a cohort of 59 community hospitals in the United States. MATERIALS AND METHODS: Data on patients receiving an operation for breast cancer (2006-2009) in a large, geographically diverse cohort of hospitals were obtained...
May 1, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28498074/an-analysis-from-the-quality-outcomes-database-part-1-disability-quality-of-life-and-pain-outcomes-following-lumbar-spine-surgery-predicting-likely-individual-patient-outcomes-for-shared-decision-making
#3
Matthew J McGirt, Mohamad Bydon, Kristin R Archer, Clinton J Devin, Silky Chotai, Scott L Parker, Hui Nian, Frank E Harrell, Theodore Speroff, Robert S Dittus, Sharon E Philips, Christopher I Shaffrey, Kevin T Foley, Anthony L Asher
OBJECTIVE Quality and outcomes registry platforms lie at the center of many emerging evidence-driven reform models. Specifically, clinical registry data are progressively informing health care decision-making. In this analysis, the authors used data from a national prospective outcomes registry (the Quality Outcomes Database) to develop a predictive model for 12-month postoperative pain, disability, and quality of life (QOL) in patients undergoing elective lumbar spine surgery. METHODS Included in this analysis were 7618 patients who had completed 12 months of follow-up...
May 12, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28469457/outcomes-of-surgeries-performed-in-physician-offices-compared-with-ambulatory-surgery-centers-and-hospital-outpatient-departments-in-florida
#4
Robert L Ohsfeldt, Pengxiang Li, John E Schneider, Ivana Stojanovic, Cara M Scheibling
BACKGROUND: The proportion of outpatient surgeries performed in physician offices has been increasing over time, raising concern about the impact on outcomes. OBJECTIVE: To use a private insurance claims database to compare 7-day and 30-day hospitalization rates following relatively complex outpatient surgical procedures across physician offices, freestanding ambulatory surgery centers (ASCs), and hospital outpatient departments (HOPDs). METHODS: A multivariable logistic regression model was used to compare the risk-adjusted probability of hospitalization among patients after any of the 88 study outpatient procedures at physician offices, ASCs, and HOPDs over 2008-2012 in Florida...
2017: Health Services Insights
https://www.readbyqxmd.com/read/28456510/high-acuity-sleeve-gastrectomy-patients-in-a-free-standing-ambulatory-surgical-center
#5
Peter Billing, Josiah Billing, Jedediah Kaufman, Kurt Stewart, Eric Harris, Rob Landerholm
BACKGROUND: Procedures performed in ambulatory surgical centers (ASC) can provide several advantages over hospital-based surgery. Understandably, concerns have been raised regarding "high acuity" cases in the ASC setting. Recently the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) presented protocols for ASCs to follow, requiring them to perform only "low acuity" cases to be compliant with accreditation. OBJECTIVE: Assess the safety and efficacy of outpatient sleeve gastrectomy (SG) on the "high acuity patient" in a free-standing ASC...
March 27, 2017: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/28453349/chronic-exertional-compartment-syndrome-of-the-hand-case-report-and-literature-review
#6
C Liam Dwyer, Maximillian C Soong, N George Kasparyan
BACKGROUND: Chronic exertional compartment syndrome (CECS) is characterized by activity-induced pain, swelling, and decreased muscle function due to increased pressure and decreased circulation within a confined muscle compartment. Although well-known to occur in the leg, involvement of the hand has rarely been reported in the literature. METHODS: We present a 44 year old male with CECS involving bilateral thenar and hypothenar compartments. Symptoms were reproduced on exam by driving screws into wood with a screwdriver...
May 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28375491/anticipated-changes-in-spine-practice-with-advancing-center-for-medicare-and-medicaid-services-required-changes
#7
Karin R Swartz, Joseph S Cheng
In providing spinal care to neurosurgical patients, cost and quality metrics are areas of interest to many. The federal government has legislated changes mandated for Centers for Medicare and Medicaid Services-enrolled patient care. The ever-changing administrative and patient-care challenges and opportunities are explored in this article, highlighting the Medicare Access and CHIP (Children's Health Insurance Program) Reauthorization Act of 2015 (MACRA), in the context of the Affordable Care Act. Trends in contemporary spinal care, addressing bundling, patient satisfaction, and ambulatory surgical centers are featured...
April 1, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28368986/trend-of-spine-surgeries-in-the-outpatient-hospital-setting-vs-ambulatory-surgical-center
#8
Olumuyiwa A Idowu, Haroutioun H Boyajian, Edwin Ramos, Lewis L Shi, Michael J Lee
STUDY DESIGN: Retrospective Database Review OBJECTIVE.: The aim of this study was to examine how often spine surgery is being performed in an outpatient hospital setting vs. a more "true" ambulatory setting, specifically ambulatory surgery centers (ASCs) where admission and discharge are required on the same calendar day. SUMMARY OF BACKGROUND DATA: Recent studies have assessed the safety, satisfactory clinical outcomes, and increasing utilization of both cervical and lumbar spinal surgeries performed in the outpatient setting...
March 31, 2017: Spine
https://www.readbyqxmd.com/read/28347178/current-evidence-regarding-routine-antibiotic-prophylaxis-in-hand-surgery
#9
John C Dunn, Austin B Fares, Nicholas Kusnezov, Miguel Pirela-Cruz, Gilberto Gonzalez, Justin D Orr, Mark Pallis
BACKGROUND: Although routine antibiotic prophylaxis immediately preceding an orthopedic surgery has become the standard of care in most cases, this practice is poorly defined in hand surgery. The purpose of this analysis is to review the most current literature of antibiotic use in hand surgery. METHODS: A careful review of the literature regarding routine antibiotic prophylaxis in hand surgery was made. Current relevant resources were used in the construction of this review...
March 1, 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28343240/childhood-angular-kyphosis-a-plea-for-involvement-of-the-pediatric-neurosurgeon
#10
E Cornips, S Koudijs, J Vles, L van Rhijn
INTRODUCTION: Childhood angular kyphosis is rare, as most children are affected by a mixed kyphotic and scoliotic deformity. Published series involving a mix of kyphosis and kyphoscoliosis, pediatric and adult, congenital and acquired cases are almost exclusively authored by orthopedic surgeons, suggesting that (pediatric) neurosurgeons are not involved. CASE SERIES: We present five cases that illustrate the spectrum of angular kyphosis, and these were treated by a multidisciplinary team including child neurologist, orthopedic surgeon, and pediatric neurosurgeon as complementary partners...
March 25, 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28336027/reducing-surgery-cancellations-at-a-pediatric-ambulatory-surgery-center
#11
Chelsea M Lee, Cheryl Rodgers, Albert K Oh, Virginia C Muckler
Surgery cancellations are costly and can be frustrating for patients, their families, and the surgical team. Because of the inherent nature of an ambulatory surgery center, which only performs scheduled elective procedures, surgical cancellations typically result in wasted time and resources. Pediatric surgery cancellations can be mitigated with proper preoperative screening and communication between nurses and patients' guardians. To reduce the rate of cancellation at our pediatric ambulatory surgery center, we implemented a Nurse-Patient Preoperative Call Log...
April 2017: AORN Journal
https://www.readbyqxmd.com/read/28256998/ambulatory-surgery-data-from-hospitals-and-ambulatory-surgery-centers-united-states-2010
#12
Margaret J Hall, Alexander Schwartzman, Jin Zhang, Xiang Liu
Objectives-This report presents national estimates of surgical and nonsurgical ambulatory procedures performed in hospitals and ambulatory surgery centers (ASCs) in the United States during 2010. Patient characteristics, including age, sex, expected payment source, duration of surgery, and discharge disposition are presented, as well as the number and types of procedures performed in these settings. Methods-Estimates in this report are based on ambulatory surgery data collected in the 2010 National Hospital Ambulatory Medical Care Survey (NHAMCS)...
February 2017: National Health Statistics Reports
https://www.readbyqxmd.com/read/28243022/immediate-postoperative-intraocular-pressure-adjustment-reduces-risk-of-cystoid-macular-edema-after-uncomplicated-micro-incision-coaxial-phacoemulsification-cataract-surgery
#13
RANDOMIZED CONTROLLED TRIAL
John S Jarstad, Allison R Jarstad, Gary W Chung, Robert A Tester, Linda E Day
PURPOSE: To determine the accuracy of visual estimation of immediate postoperative intraocular pressure (IOP) following microincision cataract surgery (MICS) and the effect of immediate postoperative IOP adjustment on prevention of cystoid macular edema (CME). SETTING: Ambulatory surgical center. METHODS: Prospective, randomized analysis of 170 eyes in 135 patients with MICS, performed in a Medicare approved outpatient ambulatory surgery center...
February 2017: Korean Journal of Ophthalmology: KJO
https://www.readbyqxmd.com/read/28215733/frozen-sections-in-patients-undergoing-breast-conserving-surgery-at-a-single-ambulatory-surgical-center-5-year-experience
#14
J M Jorns, S Daignault, M S Sabel, J L Myers, A J Wu
OBJECTIVES: To evaluate outcomes of our breast frozen section (FS) practice in its first 5 years, including our specialized FS of margins (FSM) procedure for breast conserving therapy (BCT) patients. METHODS: One thousand two hundred and forty eight patients undergoing 1303 breast FSM and/or sentinel lymph node (SLN) FS were included. Clinicopathologic features were assessed by chart review. RESULTS: Use of SLN FS declined, from 43.5% of FS cases before to 19...
February 6, 2017: European Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28210917/adjuvant-agents-in-regional-anesthesia-in-the-ambulatory-setting
#15
REVIEW
Veerandra Koyyalamudi, Sudipta Sen, Shilpadevi Patil, Justin B Creel, Elyse M Cornett, Charles J Fox, Alan D Kaye
PURPOSE OF REVIEW: A majority of surgical practice has involved ambulatory centers with the number of outpatient operations in the USA doubling to 26.8 million per year. Local anesthesia delivery provides numerous benefits, including increased satisfaction, earlier discharge, and reduction in unplanned hospital admission. Further, with the epidemic of opioid mediated overdoses, local anesthesia can be a key tool in providing an opportunity to reduce the need for other analgesics postoperatively...
January 2017: Current Pain and Headache Reports
https://www.readbyqxmd.com/read/28210648/utilization-of-platelet-rich-plasma-for-musculoskeletal-injuries-an-analysis-of-current-treatment-trends-in-the-united-states
#16
Joanne Y Zhang, Peter D Fabricant, Chad R Ishmael, Jeffrey C Wang, Frank A Petrigliano, Kristofer J Jones
BACKGROUND: Platelet-rich plasma (PRP) has emerged as a popular biologic treatment for musculoskeletal injuries and conditions. Despite numerous investigations on the efficacy of PRP therapy, current utilization of this treatment within the United States is not widely known. PURPOSE: To investigate the national utilization of PRP, including the incidence and conditions for which it is used in the clinical setting, and to determine the current charges associated with this treatment...
December 2016: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/28169943/bedside-glucose-monitoring-is-it-safe-a-new-regulatory-compliant-risk-assessment-evaluation-protocol-in-critically-ill-patient-care-settings
#17
Jeffrey Anton DuBois, Robbert Jan Slingerland, Marion Fokkert, Alain Roman, Nam Khoa Tran, William Clarke, David Alan Sartori, Tina Louise Palmieri, Andrei Malic, Martha Elizabeth Lyon, Andrew William Lyon
OBJECTIVES: New data have emerged from ambulatory and acute care settings about adverse patient events, including death, attributable to erroneous blood glucose meter measurements and leading to questions over their use in critically ill patients. The U.S. Food and Drug Administration published new, more stringent guidelines for glucose meter manufacturers to evaluate the performance of blood glucose meters in critically ill patient settings. The primary objective of this international, multicenter, multidisciplinary clinical study was to develop and apply a rigorous clinical accuracy assessment algorithm, using four distinct statistical tools, to evaluate the clinical accuracy of a blood glucose monitoring system in critically ill patients...
April 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28157426/comparison-of-healthcare-costs-among-commercially-insured-women-in-the-united-states-who-underwent-hysteroscopic-sterilization-versus-laparoscopic-bilateral-tubal-ligation-sterilization
#18
Patricia I Carney, Jianying Yao, Jay Lin, Amy Law
BACKGROUND: This study evaluated healthcare costs of index procedures and during a 6-month follow-up of women who had hysteroscopic sterilization (HS) versus laparoscopic bilateral tubal ligation (LBTL). MATERIALS AND METHODS: Women (18-49 years) with claims for HS and LBTL procedures were identified from the MarketScan commercial claims database (January 1, 2010, to December 31, 2012) and placed into separate cohorts. Demographics, characteristics, index procedure costs, and 6-month total healthcare costs and sterilization procedure-related costs were compared...
February 3, 2017: Journal of Women's Health
https://www.readbyqxmd.com/read/28149220/factors-affecting-hand-surgeon-operating-room-turnover-time
#19
Michael B Gottschalk, Richard M Hinds, Raghuveer C Muppavarapu, Kenneth Brock, Anthony Sapienza, Nader Paksima, John T Capo, S Steven Yang
Background: The purpose of this study was to determine the factors that affect hand surgeon operating room (OR) turnover time. We hypothesized that surgeon presence in the OR, decreased American Society of Anesthesiologists (ASA) class, smaller case type, and earlier case time, as well as other factors, decreased OR turnover time. Methods: A total of 685 hand surgery cases performed by 5 attending hand surgeons between September 2013 and December 2014 were identified. Turnover time, patient comorbidities (ASA class), surgeon, prior OR surgical procedure, current OR surgical procedure, location of the surgery (ambulatory surgical center [ASC] vs orthopedic specialty hospital [OSH]), time of surgery, and order of OR cases were recorded...
December 2016: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28141817/comparing-the-quality-of-ambulatory-surgical-care-for-skin-cancer-in-a-veterans-affairs-clinic-and-a-fee-for-service-practice-using-clinical-and-patient-reported-measures
#20
Matthew P Dizon, Eleni Linos, Sarah T Arron, Nancy K Hills, Mary-Margaret Chren
The Institute of Medicine has identified serious deficiencies in the measurement of cancer care quality, including the effects on quality of life and patient experience. Moreover, comparisons of quality in Veterans Affairs Medical Centers (VA) and other sites are timely now that many Veterans can choose where to seek care. To compare quality of ambulatory surgical care for keratinocyte carcinoma (KC) between a VA and fee-for-service (FFS) practice, we used unique clinical and patient-reported data from a comparative effectiveness study...
2017: PloS One
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