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Ambulatory surgical centers

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https://www.readbyqxmd.com/read/28691385/injectable-loop-recorder-implantation-in-an-ambulatory-setting-by-advanced-practice-providers-analysis-of-outcomes
#1
Ryan Kipp, Natasha Young, Anne Barnett, Douglas Kopp, Miguel A Leal, Lee L Eckhardt, Thomas Teelin, Kurt S Hoffmayer, Jennifer Wright, Michael Field
INTRODUCTION: Implantable loop recorder (ILR) insertion has historically been performed in a surgical environment such as the electrophysiology (EP) lab. The newest generation loop recorder (Medtronic Reveal LINQ™) is injectable with potential for implantation in a non-EP lab setting by advanced practice providers (APPs) facilitating improved workflow and resource utilization. We report the safety and efficacy of injectable ILR placement in the ambulatory care setting by APPs. METHODS: A retrospective review was performed including all patients referred for injectable ILR placement from March 2014 to November 2015...
July 10, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/28683239/comparison-of-efficacy-and-safety-of-glargine-and-detemir-insulin-in-the-management-of-inpatient-hyperglycemia-and-diabetes
#2
Rodolfo J Galindo, Georgia M Davis, Maya Fayfman, David Reyes-Umpierrez, David Alfa, Limin Peng, Ronald Tamler, Francisco J Pasquel, Guillermo E Umpierrez
OBJECTIVE: Glargine and detemir insulin are the two most commonly prescribed basal insulin analogs for the ambulatory and inpatient management of diabetes. The efficacy and safety of basal insulin analogs in the hospital setting has not been established. METHODS: This observational study compared differences in glycemic control and outcomes in non-ICU patients with blood glucose (BG) >140 mg/dl who were treated with glargine or detemir, between 01/01/2012 and 09/30/2015 in two academic centers...
July 6, 2017: Endocrine Practice
https://www.readbyqxmd.com/read/28632541/hospital-based-acute-care-within-7-days-of-discharge-after-outpatient-arthroscopic-shoulder-surgery
#3
Jiabin Liu, David N Flynn, Wai-Man Liu, Lee A Fleisher, Nabil M Elkassabany
BACKGROUND: The rate of hospital-based acute care (defined as hospital transfer at discharge, emergency department [ED] visit, or subsequent inpatient hospital [IP] admission) after outpatient procedure is gaining momentum as a quality metric for ambulatory surgery. However, the incidence and reasons for hospital-based acute care after arthroscopic shoulder surgery are poorly understood. METHODS: We studied adult patients who underwent outpatient arthroscopic shoulder procedures in New York State between 2011 and 2013 using the Healthcare Cost and Utilization Project database...
June 16, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28624052/association-between-surgical-patient-satisfaction-and-nonmodifiable-factors
#4
Luke Martin, Angela P Presson, Chong Zhang, David Ray, Samuel Finlayson, Robert Glasgow
BACKGROUND: Patient satisfaction surveys are an important tool in measuring physician performance. We hypothesized that nonmodifiable factors would be associated with surgical outpatient satisfaction scores. METHODS: Press Ganey Consumer Assessment of Health Providers and Systems outpatient satisfaction scores from completed surveys (18,373) at an academic department of surgery were reviewed. Data were collected on patient factors, provider specialty, practice setting, and first visit status...
June 15, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28604548/pediatric-lower-extremity-lawn-mower-injuries-and-reconstruction-retrospective-10-year-review-at-a-level-1-trauma-center
#5
Leslie G Branch, John C Crantford, James T Thompson, Shruti C Tannan
INTRODUCTION: From 2004 to 2013, there were 9341 lawn mower injuries in children under 20 years old. The incidence of lawn mower injuries in children has not decreased since 1990 despite implementation of various different prevention strategies. In this report, the authors review the results of pediatric lawn mower-related lower-extremity injuries treated at a tertiary care referral center as well as review the overall literature. METHODS: A retrospective review was performed at a level 1 trauma center over a 10-year period (2005-2015)...
June 9, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28593406/laparoscopic-liver-surgery-towards-a-day-case-management
#6
Hadrien Tranchart, David Fuks, Panagiotis Lainas, Martin Gaillard, Ibrahim Dagher, Brice Gayet
BACKGROUND: Ambulatory surgery (AS) is a contemporary subject of interest. The feasibility and safety of AS for solid abdominal organs are still dubious. In the present study, we aimed at defining potential surgical criteria for AS by analyzing a large database of patients who underwent laparoscopic liver surgery (LLS) in two French expert centers. METHODS: This study was performed using prospectively filled databases including patients that underwent pure LLS between 1998 and 2015...
June 7, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28579291/successful-use-of-partial-aneurysmectomy-and-repair-approach-for-managing-complications-of-arteriovenous-fistulas-and-grafts
#7
Shouwen Wang, Michele S Wang
OBJECTIVE: Arteriovenous fistulas and grafts may often be associated with localized complications related to aneurysms/pseudoaneurysms, buttonholes, or structural defects that require proper management to ensure continued access functionality for hemodialysis. Partial aneurysmectomy and repair (PAR) is a targeted surgical approach specifically designed for managing these complications. The basic concepts of PAR include resecting unhealthy or excessive tissue over an access, reconstructing the vascular access lumen using in situ vascular wall or tissue when possible, and closing overlying skin with healthy margins to promote reliable healing...
May 31, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28549511/infection-prevention-outside-of-the-acute-care-setting-results-from-the-megasurvey-of-infection-preventionists
#8
Monika Pogorzelska-Maziarz, Ericka L Kalp
BACKGROUND: In recent years, there has been a significant shift of health care delivery to nonacute care settings. However, research on staffing and resources dedicated to infection prevention and control (IPC) in these settings is lacking. METHODS: The data for this analysis come from the 2015 APIC MegaSurvey. Descriptive statistics were computed to describe infection preventionists (IPs) employed in nonacute care settings. Bivariate analyses were conducted to examine differences in facility and demographic characteristics by type of nonacute care setting...
June 1, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28528356/operating-room-fires-in-periocular-surgery
#9
Michael A Connor, Anne M Menke, Ivan Vrcek, John W Shore
AIM: A survey of ophthalmic plastic and reconstructive surgeons as well as seven-year data regarding claims made to the Ophthalmic Mutual Insurance Company (OMIC) is used to discuss operating room fires in periocular surgery. METHODS: A retrospective review of all closed claim operating room fires submitted to OMIC was performed. A survey soliciting personal experiences with operating room fires was distributed to all American Society of Oculoplastic and Reconstructive Surgeons...
May 20, 2017: International Ophthalmology
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
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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...
June 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
#20
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
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