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Operating room cost

Katherine Croft, Patricia J Mattingly, Patrick Bosse, R Wendel Naumann
STUDY OBJECTIVE: To determine if educating surgeons about their controllable instrumentation costs by providing cost data for total laparoscopic hysterectomy (LH) would reduce the cost of this procedure. DESIGN: Prospective Cohort Study. DESIGN: Classification: Level III Evidence SETTING: Academic affiliated community hospital. PATIENTS: Patients undergoing LH between April 2014 and March 2015 with surgeons who performed at least 10 LHs in that time period and a second group who had undergone LH with the same cohort of surgeons from July 2015 to September 2015...
October 22, 2016: Journal of Minimally Invasive Gynecology
Heba H El-Maghrabi, Shaimaa M Abdelmaged, Amr A Nada, Fouad Zahran, Saad Abd El-Wahab, Dena Yahea, G M Hussein, M S Atrees
Magnetic graphene based ferberite nanocomposite was tailored by simple, green, low cost and industrial effective method. The microstructure and morphology of the designed nanomaterials were examined via XRD, Raman, FTIR, TEM, EDX and VSM. The prepared nanocomposites were introduced as a novel adsorbent for uranium ions scavenging from aqueous solution. Different operating conditions of time, pH, initial uranium concentration, adsorbent amount and temperature were investigated. The experimental data shows a promising adsorption capacity...
October 21, 2016: Journal of Hazardous Materials
Julia L Monteiro, Paula F Carneiro, Petteri Elsner, Dominique Roberge, Peter G M Wuts, Kathrin Kurjan, Bernhard Gutmann, C Oliver Kappe
Herein, we report an operationally simple and rapid continuous flow radical C─C bond formation under Minisci-type reaction conditions. The transformations are performed at or below room temperature employing hydrogen peroxide (H2O2) and dimethylsulfoxide (DMSO) as reagents in the presence of an Fe(II) catalyst. For electron rich aromatic and heteroaromatic substrates C─C bond formation proceeds satisfactorily with electrophilic radicals including ∙CF3, ∙C4F9, ∙CH2CN and ∙CH2CO2Et. In contrast, electron poor substrates exhibit minimal reactivity...
October 24, 2016: Chemistry: a European Journal
Melissa K James, Sebastian D Schubl, Michael P Francois, Geoffrey K Doughlin, Shi-Wen Lee
STUDY OBJECTIVE: The aim of this study is to determine if the introduction of a pan-scan protocol during the initial assessment for blunt trauma activations would affect missed injuries, incidental findings, treatment times, radiation exposure, and cost. METHODS: A 6-month prospective study was performed on patients with blunt trauma at a level 1 trauma center. During the last 3 months of the study, a pan-scan protocol was introduced to the trauma assessment. Categorical data were analyzed by Fisher exact test and continuous data were analyzed by Mann-Whitney nonparametric test...
September 22, 2016: American Journal of Emergency Medicine
Charles Kaboré, Valéry Ridde, Séni Kouanda, Ludovic Queuille, Paul-André Somé, Isabelle Agier, Alexandre Dumont
BACKGROUND: Since 2006, Burkina Faso has subsidized the cost of caesarean sections to increase their accessibility. Caesareans are performed by obstetricians, general practitioners, and nurses trained in emergency surgery. While the national caesarean rate is still too low (only 2 % in 2010), 12 to 24 % of caesareans performed in hospital are, in fact, not medically indicated. The objective of this study is to evaluate the effectiveness and analyze the implementation of a multi-faceted intervention to lower the rate of non-medically indicated caesareans in Burkina Faso...
October 21, 2016: BMC Pregnancy and Childbirth
Jenny T Chen, Steven J Kempton, Venkat K Rao
: The incidence and cost of nonmelanoma skin cancers are skyrocketing. Five million cases cost $8.1 billion in 2011. The average cost of treatment per patient increased from $1000 in 2006 to $1600 in 2011. We present a study of the economics and costs of skin cancer management in Medicare patients. METHODS: We studied data released by the Centers for Medicare and Medicaid Services in 2014. Treatment modalities for the management of skin cancer were reviewed, and costs of treatment were quantified for a sample of 880,000 providers...
September 2016: Plastic and Reconstructive Surgery. Global Open
Joseph E Cruz, Zachariah Thomas, David Lee, David M Moskowitz, Jeff Nemeth
BACKGROUND: Generic price inflation has resulted in rising acquisition costs for sodium nitroprusside (SNP), an agent historically described as the drug of choice for the treatment of perioperative hypertension in cardiac surgery. PURPOSE: To describe the implementation and cost avoidance achieved by utilizing clevidipine as an alternative to SNP in cardiac surgery patients at a 520-bed community teaching hospital that performs more than 300 cardiac surgeries each year...
October 2016: P & T: a Peer-reviewed Journal for Formulary Management
Sooyeon Kim, Sage P Kramer, Adam J Dugan, David J Minion, John C Gurley, Daniel L Davenport, Victor A Ferraris, Sibu P Saha
BACKGROUND: Iliac arterial stenting is performed both in the operating room (OR) and the catheterization lab (CL). To date, no analysis has compared resource utilization between these locations. METHODS: Consecutive patients (n = 105) treated at a single center were retrospectively analyzed. Patients included adults with chronic, symptomatic iliac artery stenosis with a minimum Rutherford classification (RC) of 3, treated with stents. Exclusion criteria were prior stenting, acute ischemia, or major concomitant procedures...
October 12, 2016: International Journal of Surgery
Allen Gabriel, G Patrick Maxwell, Leah Griffin, Manish C Champaneria, Mousam Parekh, David Macarios
BACKGROUND: Centrifugation (Cf) is a common method of fat processing but may be time consuming, especially when processing large volumes. OBJECTIVES: To determine the effects on fat grafting time, volume efficiency, reoperations, and complication rates of Cf vs an autologous fat processing system (Rv) that incorporates fat harvesting and processing in a single unit. METHODS: We performed a retrospective cohort study of consecutive patients who underwent autologous fat grafting during reconstructive breast surgery with Rv or Cf...
October 11, 2016: Aesthetic Surgery Journal
Emilio Trignano, Nefer Fallico, Gino Zingone, Luca Andrea Dessy, Gian Vittorio Campus
Background Microsurgery is very challenging, requiring a high degree of dexterity and manual skills that should be fully trained outside of the operating room. Common microsurgery courses usually follow a stepwise training approach beginning practice on nonliving models and proceeding with live rats. However, training on live rats raises certain issues, including ethical concerns as well as the associated costs. As such, there is an increasing drive toward alternative models. The current article describes a three-step training approach (latex glove-endovascular prosthesis-human placenta), which aims to prepare trainees for the clinical direct application...
October 12, 2016: Journal of Reconstructive Microsurgery
Martijn G M Schotanus, Daphne A L Schoenmakers, Rob Sollie, Nanne P Kort
PURPOSE: Patients-specific instruments (PSI) for implantation of total knee arthroplasty (TKA) can be used to predict the implant size for both the femur and the tibia component. This study aims to determine the impact of approval of the PSI planning for TKA on the frequency of, and reason for intraoperative changes of implant sizes. METHODS: The clinical records of 293 patients operated with MRI- (90.4 %) and CT-based (9.6 %) PSI were reviewed for actual used implant size...
October 5, 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Benjamin L Olesnicky, Catherine Traill, Frank B Marroquin-Harris
BACKGROUND: Postoperative residual curarisationf is a preventable cause of postoperative morbidity. Although sugammadex has been shown to reduce the risk of residual curarisation, it has not yet been shown if this directly translates to a reduction in morbidity. We aimed to demonstrate whether the introduction of unrestricted sugammadex for routine reversal changed the incidence of post-operative respiratory diagnoses and the rate of airway and respiratory complications in the post-operative care unit...
October 5, 2016: Minerva Anestesiologica
C Barone, F Lang, C Mauro, G Landi, J Rappich, N H Nickel, B Rech, S Pagano, H C Neitzert
The hybrid perovskite methylammonium lead iodide CH3NH3PbI3 recently revealed its potential for the manufacturing of low-cost and efficient photovoltaic cells. However, many questions remain unanswered regarding the physics of the charge carrier conduction. In this respect, it is known that two structural phase transitions, occurring at temperatures near 160 and 310 K, could profoundly change the electronic properties of the photovoltaic material, but, up to now, a clear experimental evidence has not been reported...
October 5, 2016: Scientific Reports
Yangyang R Yu, Paulette I Abbas, Carolyn M Smith, Kathleen E Carberry, Hui Ren, Binita Patel, Jed G Nuchtern, Monica E Lopez
PURPOSE: As reimbursement programs shift to value-based payment models emphasizing quality and efficient healthcare delivery, there exists a need to better understand process management to unearth true costs of patient care. We sought to identify cost-reduction opportunities in simple appendicitis management by applying a time-driven activity-based costing (TDABC) methodology to this high-volume surgical condition. METHODS: Process maps were created using medical record time stamps...
September 15, 2016: Journal of Pediatric Surgery
Aaron Heller, John Dollerschell, Joshua Burk, Hailey Haines, Jonathan Kozinn
BACKGROUND: In the past decade, the rate and utilization of veno-venous extracorporeal membrane oxygenation (VV-ECMO) has increased dramatically. A single catheter technique has recently come into favour for providing VV-ECMO. Although it has been shown that intensivists can safely place these catheters, the safety of decannulation by intensivists has not been reported. OBJECTIVE: We describe a technique for safely decannulating the Avalon Elite VV-ECMO catheter at the bedside and assess the safety of this technique, as compared with the standard technique of decannulation in the operating room by a surgeon...
September 30, 2016: Anaesthesiology Intensive Therapy
Eliana Montanari, Richard Schwameis, Marisa Louridas, Christian Göbl, Lorenz Kuessel, Stephan Polterauer, Heinrich Husslein
BACKGROUND: The aim of the study was to assess whether an inexpensive tablet-based box trainer (TBT) is at least equally effective compared with a standard box trainer (SBT) to learn basic laparoscopic skills (BLS). BLS training outside the operating room has been shown to be beneficial for surgical residency. However, simulation trainers are expensive and are not consistently available in all training centers. Therefore, TBT and other homemade box trainers were developed. METHODS: Medical students were randomized to either a TBT or an SBT and trained 4 fundamentals of laparoscopic surgery (FLS) tasks for 1 hour twice a week for 4 weeks...
September 2016: Medicine (Baltimore)
Gaurav Aman Luther, Praveen Murthy, Philip E Blazar
PURPOSE: As health care costs continue to rise, providers must increasingly identify and implement cost-effective practice measures without sacrificing quality of care. Corticosteroid injections are an established treatment for trigger finger; however, numerous clinical trials have documented the limited efficacy of these injections in the diabetic population. Furthermore, the most cost-effective treatment strategy for diabetic trigger finger has not been determined. The purpose of this study was to perform a decision analysis to identify the least costly strategy for effective treatment of diabetic trigger finger using existing evidence in the literature...
September 23, 2016: Journal of Hand Surgery
Michel Taylor, Wilma Hopman, Jeff Yach
BACKGROUND: In September 2011, Kingston General Hospital (KGH) opened a dedicated orthopedic weekend trauma room. Previously, 1 weekend operating room (OR) was used by all surgical services. We assessed the impact this dedicated weekend trauma room had on hospital length of stay (LOS), time to surgery and 30-day mortality for patients with hip fractures. METHODS: Patients admitted between Oct. 1, 2009, and Sept. 30, 2012, were identified through our trauma registry, representing the 2 years before and 1 year after the opening of the orthopedic weekend trauma room...
September 2016: Canadian Journal of Surgery. Journal Canadien de Chirurgie
Audra Clark, Alan P Dackiw, Wendy D White, Fiemu E Nwariaku, Shelby A Holt, Jennifer L Rabaglia, Sarah C Oltmann
BACKGROUND: Preincision operating room (OR) preparation varies greatly. Cases requiring exacting preoperative setup may be more sensitive to inconsistent team members and trainees. Leadership and oversight by the surgeon may facilitate a timely start. The study hypothesized that early attending presence in the OR expedites surgery start time, improving efficiency, and decreasing cost. METHODS: Prospective data collection of endocrine surgery cases at an urban teaching hospital was performed...
October 2016: Journal of Surgical Research
Seth A Cohen, Zaid Chaudhry, Janine L Oliver, Evgeniy I Kreydin, My-Linh T Nguyen, Steven A Mills, A Lenore Ackerman, Ja-Hong Kim, Christopher M Tarnay, Shlomo Raz
INTRODUCTION AND OBJECTIVE: There is currently a national shortage of indigo carmine. In efforts to identify the most efficient aide for visualizing ureteral efflux intra-operatively, we wanted to investigate the time to excretion of phenazopyridine versus a newly identified alternative, sodium fluorescein. METHODS: We analyzed prospectively collected data from a cohort of women who underwent pelvic reconstructive surgery in 2015. Per provider preference patterns, a number of patients were administered 200 mg phenazopyridine orally with a sip of water, 1 hour prior to start of operative time...
September 21, 2016: Journal of Urology
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