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Operating room cost

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https://www.readbyqxmd.com/read/29155269/influence-of-time-to-appendectomy-and-operative-duration-on-hospital-cost-in-children-with-uncomplicated-appendicitis
#1
Stephanie K Serres, Dionne A Graham, Charity C Glass, Danielle B Cameron, Seema P Anandalwar, Shawn J Rangel
BACKGROUND: The goal of this study was to examine the influence of time to appendectomy (TTA) and operative duration (OD) on hospital cost as surrogate measures of perioperative efficiency. STUDY DESIGN: Retrospective cohort analysis of 2,116 children undergoing appendectomy for uncomplicated appendicitis at 16 children's hospitals from 1/2013 to 12/2014. TTA (emergency department presentation to incision) and OD were obtained from the NSQIP-Pediatric Appendectomy Pilot Database and merged with cost data from the Pediatric Health Information System Database...
November 16, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/29152748/comparison-of-pediatric-adenoidectomy-techniques
#2
Phayvanh P Sjogren, Andrew J Thomas, Benjamin N Hunter, James Butterfield, Craig Gale, Jeremy D Meier
OBJECTIVES: Evaluate the effects of electrocautery, microdebrider, and coblation techniques on outpatient pediatric adenoidectomy costs and complications. STUDY DESIGN: Observational retrospective cohort study. METHODS: An observational cohort study was performed in a multihospital network using a standardized accounting system. Children < 18 years of age who underwent outpatient adenoidectomy were included from January 2008 to September 2015...
November 20, 2017: Laryngoscope
https://www.readbyqxmd.com/read/29149469/cuffed-versus-uncuffed-endotracheal-tubes-for-general-anaesthesia-in-children-aged-eight-years-and-under
#3
REVIEW
Flavia A De Orange, Rebeca Gac Andrade, Andrea Lemos, Paulo Sgn Borges, José N Figueiroa, Pete G Kovatsis
BACKGROUND: Since the introduction of endotracheal intubation in paediatrics, uncuffed endotracheal tubes (ETTs) have been the standard of care for children under eight years old, based on the presumption that complications, particularly postoperative stridor, are higher with cuffed ETTs. The major disadvantages of uncuffed ETTs cited for this shift in procedure include the difficulty in achieving tidal volumes due to leakage around an uncuffed ETT. To seal the airway adequately, uncuffed tubes may need to be exchanged for another tube with a larger diameter, which sometimes requires several attempts before the appropriate size is found...
November 17, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29132596/air-medical-evacuated-battle-injuries-french-army-2001-to-2014-in-afghanistan
#4
Jimmy Robert, Jean-Pierre Tourtier, Vicky Vitalis, Sébastien Coste, Wanda Gaspard, Cyprien Bourrilhon
OBJECTIVE: The purpose of strategic air medical evacuation (STRAT AE) is to enable the continuity of care and repatriation of wounded soldiers. Between 2001 and 2014, STRAT AEs have been implemented many times over the course of the military engagement in Afghanistan. The purpose of this work was to study the nature of the pathologies and the medicalization of patients most seriously wounded during the PAMIR Operation (Afghanistan). METHODS: This was an epidemiological study conducted retrospectively from January 1, 2001, to December 31, 2014, of the STRAT AEs with the air medical team from the Afghan operating room to France...
November 2017: Air Medical Journal
https://www.readbyqxmd.com/read/29130748/evaluation-of-two-matrices-for-long-term-ambient-storage-of-bacterial-dna
#5
Karen M Miernyk, Carolynn K DeByle, Karen M Rudolph
BACKGROUND: Culture-independent molecular analyses allow researchers to identify diverse microorganisms. This approach requires microbiological DNA repositories. The standard for DNA storage is liquid nitrogen or ultralow freezers. These use large amounts of space, are costly to operate, and could fail. Room temperature DNA storage is a viable alternative. In this study, we investigated storage of bacterial DNA using two ambient storage matrices, Biomatrica DNAstable(®) Plus and GenTegra(®) DNA...
November 13, 2017: Biopreservation and Biobanking
https://www.readbyqxmd.com/read/29129336/-cost-of-teaching-cataract-surgery-in-a-public-hospital
#6
R Benzekri, J Marie-Louise, S Chahed
INTRODUCTION: The gold standard of cataract surgery, phacoemulsification is the most commonly performed surgical procedure in France. Surgical instruction often takes place in the operating room where residents and fellows perform real surgery, supervised by an experienced surgeon. The goals of this study were double: evaluate surgical times according to the person performing the surgery, in order to quantitate the cost incurred by teaching and compare complication rate between surgeons...
November 9, 2017: Journal Français D'ophtalmologie
https://www.readbyqxmd.com/read/29122625/comparison-of-intraoperative-and-early-postoperative-outcomes-of-caudal-versus-dorsal-penile-nerve-blocks-for-outpatient-penile-surgeries
#7
Katherine H Chan, Aali Shah, Elizabeth A Moser, Konrad Szymanski, Benjamin M Whittam, Rosalia Misseri, Martin Kaefer, Richard Rink, Mark P Cain
OBJECTIVE: To compare intraoperative and 1-hour postoperative outcomes in caudal versus dorsal penile nerve block (DPNB) patients undergoing penile surgeries. MATERIAL AND METHODS: We performed a retrospective cohort study of males <10 years old undergoing penile procedures (2013-2015) using the Pediatric Regional Anesthesia Network, Pediatric Health Information System databases and our medical records. The primary outcome was a maximum Faces Limbs Activity Crying Consolability pain score > 3...
November 6, 2017: Urology
https://www.readbyqxmd.com/read/29122621/simple-operating-room-bundle-reduces-superficial-surgical-site-infections-after-major-urologic-surgery
#8
Sarah C Vij, Ganesh Kartha, Venkatesh Krishnamurthi, Michelle Ponziano, Howard B Goldman
OBJECTIVE: To reduce our superficial surgical site infection rate (sSSI) following major urologic surgery by implementing a simple operating room bundle. METHODS: A simple operating room bundle was applied to all major urologic cases (cystectomy, nephrectomy and prostatectomy) at a single tertiary referral center. The bundle included allowing skin prep to dry appropriately, changing gloves prior to skin closure, irrigating the wound prior to skin closure and using a new separate sterile closing instrument set for skin closure...
November 6, 2017: Urology
https://www.readbyqxmd.com/read/29122421/evaluating-strategies-for-reducing-scattered-radiation-in-fixed-imaging-hybrid-operating-suites
#9
Claire Miller, Daniel Kendrick, Andrew Shevitz, Ann Kim, Henry Baele, David Jordan, Vikram S Kashyap
OBJECTIVE: High-resolution fixed C-arm fluoroscopic systems allow high-quality endovascular imaging but come at a cost of greater scatter radiation generation and increased occupational exposure for surgeons. The purpose of this study was to evaluate the efficacy of two methods in reducing scattered radiation exposure. METHODS: There were 164 endovascular cases analyzed in three phases. In phase 1 (P1), baseline radiation exposure was calculated. In phase 2 (P2), staff used real-time radiation dose monitoring (dosimetry badges [RaySafe; Unfors, Hopkinton, Mass])...
November 6, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29120003/a-novel-method-of-patient-positioning-using-shoulder-arthroscopy-equipment-for-elbow-arthroscopy
#10
Julianne M Kowalski, James T Monica
Indications for elbow arthroscopy are expanding; however, it is uncommon compared with shoulder arthroscopy. Elbow arthroscopy can be complicated by positioning, including the need to obtain specific arm holders required by most operating rooms. Surgery can be performed in the supine, prone, or lateral position. Arm traction allows for distraction of the joint space, full insufflation, and therefore visualization of intra-articular anatomy. This article outlines a new technique using previously available shoulder arthroscopy equipment to avoid increased cost incurred by procuring new, elbow-specific equipment...
November 8, 2017: Orthopedics
https://www.readbyqxmd.com/read/29114284/intraoperative-magnetic-resonance-imaging-for-cranial-and-spinal-cases-using-preexisting-c-shaped-three-side-open-0-2-tesla-magnetic-resonance-imaging
#11
Vinod Kumar Tewari, Ravindra Tripathi, Subodh Aggarwal, Mazhar Hussain, Hari Kishan Das Gupta
Background: The existing Intraoperative MRI (IMRI) of developed countries is too costly to be affordable in any developing country and out of the reach of common and poor people of developing country at remote areas. We have used the pre-existing (refurbished) 3 side open "C" shaped 0.2 Tesla MRI for IMRI in a very remote area. Materials and Methods: In this technique the 0.2 Tesla MRI and the operating theatre were merged. MRI table was used as an operation table...
October 2017: Asian Journal of Neurosurgery
https://www.readbyqxmd.com/read/29112512/causal-analysis-of-world-health-organization-s-surgical-safety-checklist-implementation-quality-and-impact-on-care-processes-and-patient-outcomes-secondary-analysis-from-a-large-stepped-wedge-cluster-randomized-controlled-trial-in-norway
#12
Arvid Steinar Haugen, Hilde Valen Wæhle, Stian Kreken Almeland, Stig Harthug, Nick Sevdalis, Geir Egil Eide, Monica Wammen Nortvedt, Ingrid Smith, Eirik Søfteland
OBJECTIVE: We hypothesize that high-quality implementation of the World Health Organization's Surgical Safety Checklist (SSC) will lead to improved care processes and subsequently reduction of peri- and postoperative complications. BACKGROUND: Implementation of the SSC was associated with robust reduction in morbidity and length of in-hospital stay in a stepped wedge cluster randomized controlled trial conducted in 2 Norwegian hospitals. Further investigation of precisely how the SSC improves care processes and subsequently patient outcomes is needed to understand the causal mechanisms of improvement...
November 6, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/29108485/minimising-the-risk-of-mycobacterium-chimaera-infection-during-cardiopulmonary-bypass-by-the-removal-of-heater-cooler-units-from-the-operating-room
#13
Thomas A Barker, Uday Dandekar, Nina Fraser, Lincoln Dawkin, Paul Sweeney, Fraser Heron, Jacqui Simmons, Jitendra Parmar
INTRODUCTION: Mycobacterium chimaera ( M. chimaera) is a recently characterised bacterium that can cause life-threatening infections in small numbers of patients who undergo cardiopulmonary bypass during cardiac surgery. The likely mode of transmission is thought to occur through aerosolisation from contaminated water reservoirs. The airborne bacteria then contaminate the surgical field, leading to an infection months or even years later. The preferred practical solution to disrupt the transmission of these airborne bacteria to the patient is to remove the heater-cooler units (HCUs) from the operating room (OR)...
November 1, 2017: Perfusion
https://www.readbyqxmd.com/read/29107431/office-stent-placement-under-local-anesthesia-is-a-safe-and-efficient-procedure-for-the-management-of-multiple-ureteral-disorders
#14
A Carrion, M D'Anna, M Costa-Grau, P Luque, E García-Cruz, A Franco, A Alcaraz
OBJECTIVE: To assess the outcomes of ureteral stent placement under local anesthesia for the management of multiple ureteral disorders. METHODS: Retrospective study of 45 consecutive ureteral stents placed under local anesthesia from January 2015 to July 2016. Inclusion criteria were hemodynamically stable patients with urinary obstruction, urinary fistula or for prophylactic ureteral localization during surgery. Five minutes before the procedure, 10ml of lidocaine gel and 50ml of lidocaine solution were instilled in the bladder...
October 26, 2017: Actas Urologicas Españolas
https://www.readbyqxmd.com/read/29101960/market-evaluation-finances-bundled-payments-and-accountable-care-organizations
#15
REVIEW
Shazia Mehmood Siddique, Shivan J Mehta
To control costs and improve quality, changes in health care delivery and financing have emerged, resulting in shifting of financial risk to providers for the quality and cost of care, including emergence of accountable care organizations and bundled payment models. This article discusses health care financing and delivery models in the context of procedures and surgeries that happen outside of the operating room. It describes the history of health insurance, trends in ambulatory surgery centers, and new payment models that have emerged from the Affordable Care Act and the Medicare Access and Children's Health Insurance Program Reauthorization Act...
December 2017: Anesthesiology Clinics
https://www.readbyqxmd.com/read/29089495/fully-inkjet-printed-two-dimensional-material-field-effect-heterojunctions-for-wearable-and-textile-electronics
#16
Tian Carey, Stefania Cacovich, Giorgio Divitini, Jiesheng Ren, Aida Mansouri, Jong M Kim, Chaoxia Wang, Caterina Ducati, Roman Sordan, Felice Torrisi
Fully printed wearable electronics based on two-dimensional (2D) material heterojunction structures also known as heterostructures, such as field-effect transistors, require robust and reproducible printed multi-layer stacks consisting of active channel, dielectric and conductive contact layers. Solution processing of graphite and other layered materials provides low-cost inks enabling printed electronic devices, for example by inkjet printing. However, the limited quality of the 2D-material inks, the complexity of the layered arrangement, and the lack of a dielectric 2D-material ink able to operate at room temperature, under strain and after several washing cycles has impeded the fabrication of electronic devices on textile with fully printed 2D heterostructures...
October 31, 2017: Nature Communications
https://www.readbyqxmd.com/read/29084129/analysis-of-incidents-of-violence-in-a-large-italian-hospital
#17
Dimitri Sossai, Francesco Stefano Molina, Mario Amore, Giovanna Ferrandes, Elena Sarcletti, Gabriella Biffa, Simone Accorsi, Martino Belvederi Murri, Marzia Jole Tomellini, Francesco Copello
INTRODUCTION: An increase in the rate of non-fatal violence events, from 20.65/10,000 in 2012 to 22.81/10,000 in 2014, was observed at the IRCCS Ospedale Policlinico San Martino in Genoa. OBJECTIVES: To analyze the incidence and outcome of the phenomenon of violence, by identifying the type of aggressive event and the ward in which it occurred, assuming that the occurrence is evenly distributed and not only limited to the psychiatric or to the emergency department...
October 27, 2017: La Medicina del Lavoro
https://www.readbyqxmd.com/read/29078885/improving-on-time-surgical-starts-the-impact-of%C3%A2-implementing-pre-or-timeouts-and-performance%C3%A2-pay
#18
Luke Martin, John Langell
BACKGROUND: Operating room (OR) time is expensive. Underutilized OR time negatively impacts efficiency and is an unnecessary cost for hospitals. The purpose of this study was to evaluate the impact of a pre-OR timeout and performance pay incentive on the frequency of on-time, first surgical starts. METHODS: At a single Veterans Affairs Medical Center, we implemented a pre-OR timeout in the form of a safety-briefing checklist and a modest performance pay incentive for on-time starts (>90% compliance) for attending surgeons...
November 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/29078641/robotic-assisted-lobectomy-for-locally-advanced-lung-cancer
#19
REVIEW
Giulia Veronesi, Pierluigi Novellis, Orazio Difrancesco, Mark Dylewski
Some series report the use of video-assisted thoracic surgery (VATS) in patients with locally advanced non-small cell lung cancer (NSCLC) but, few studies describe the use of the robotic approach specifically for locally advanced disease. One potential advantage of the robotic approach over traditional VATS is the increased radicality. While the benefit of the robotic approach over open thoracotomy is directly related to reduced surgical trauma and the improved tolerability in fragile patients that have received induction treatment...
2017: J Vis Surg
https://www.readbyqxmd.com/read/29068966/dermal-regenerative-template-as-a-cost-effective-alternative-for-complex-scalp-reconstruction
#20
Nneamaka B Agochukwu, Lesley Wong, James Y Liau
BACKGROUND: Use of dermal regeneration template (DRT) is well documented in the literature for complex wounds ranging from the scalp, trunk, and lower extremity. METHODS: A retrospective cohort study was performed of the use of dermal regeneration template and skin grafting. A literature review was performed of all studies where DRT was used for scalp reconstruction. RESULTS: Patients in the DRT cohort had an average age of 70, with wounds averaging 108 cm in size...
October 24, 2017: Journal of Craniofacial Surgery
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