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Operating room cost

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https://www.readbyqxmd.com/read/28919125/multi-institution-analysis-of-infection-control-practices-identifies-the-subset-associated-with-best-surgical-site-infection-performance-a-texas-alliance-for-surgical-quality-collaborative-project
#1
Catherine H Davis, Lillian S Kao, Jason B Fleming, Thomas A Aloia
BACKGROUND: In an effort to reduce surgical site infection (SSI) rates, a large number of infection control practices (ICPs), including operating room attire policies, have been recommended. However, few have proven benefits and many are costly, time-consuming, and detrimental to provider morale. The goal of this multi-institution study was to determine which ICPs are associated with lower postoperative SSI rates. STUDY DESIGN: Twenty American College of Surgeons NSQIP and Texas Alliance for Surgical Quality-affiliated hospitals completed this Quality Improvement Assessment Board-approved study...
August 16, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28917019/the-trend-toward-minimally-invasive-complex-abdominal-wall-reconstruction-is-it-worth-it
#2
Igor Belyansky, Adam S Weltz, Udai S Sibia, Justin J Turcotte, Haley Taylor, H Reza Zahiri, T Robert Turner, Adrian Park
BACKGROUND: Open abdominal wall reconstruction (AWR) was previously one of the only methods available to treat complex ventral hernias. We set out to identify the impact of laparoscopy and robotics on our AWR program by performing an economic analysis before and after the institution of minimally invasive AWR. METHODS: We retrospectively reviewed inpatient hospital costs and economic factors for a consecutive series of 104 AWR cases that utilized separation of components technique (57 open, 38 laparoscopic, 9 robotic)...
September 15, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28915948/the-economics-of-surgical-simulation
#3
REVIEW
Noel Jabbour, Carl H Snyderman
There are massive hidden costs in the current paradigm of surgical training related to increased operative times for procedures with resident involvement and costs of medical errors. Shifting procedural training outside of the operating room through use of simulation has the potential to improve patient safety, minimize learning time to achieve competency, and increase operative efficiency. Investment in surgical simulation has the potential to reduce costs to health care systems through improved operating room efficiency and reduction of medical errors...
October 2017: Otolaryngologic Clinics of North America
https://www.readbyqxmd.com/read/28913761/radioactive-seed-localization-versus-wire-guided-localization-for-nonpalpable-breast-cancer-a-cost-and-operating-room-efficiency-analysis
#4
Yimeng Zhang, Jean Seely, Erin Cordeiro, Joshua Hefler, Kednapa Thavorn, Mukta Mahajan, Sue Domina, Jon Aro, Andrea Marie Ibrahim, Angel Arnaout, Denis Gravel, Carolyn Nessim
BACKGROUND: This study aimed to compare the cost and resource use between our first-year experience using breast-conserving surgery (BCS) with radioactive seed localization (RSL) and the previous-year standard practice of BCS with wire-guided localization (WGL) for patients with nonpalpable breast cancer at a large Canadian tertiary center. METHODS: For this retrospective cohort study, data for BCS cases with RSL was collected from 1 April 2015 to 31 March 2016 and for BCS cases with WGL from 1 April 2014 to 31 March 2015...
September 14, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28902606/an-evaluation-of-patient-risk-factors-to-determine-eligibility-to-undergo-orthopaedic-surgery-in-a-freestanding-ambulatory-center-a-survey-of-4-242-consecutive-patients
#5
Matthew Siow, Germaine Cuff, Jovan Popovic, Joseph Bosco
INTRODUCTION: The value proposition of surgery at freestanding ambulatory surgery centers (FSASCs) in terms of efficiency, safety, and patient satisfaction is well established and has led to increased FSASC utilization. However, there are comorbid conditions that disqualify certain patients from surgery at FSASCs. Understanding the percentage of patients whose comorbid conditions exclude them from FSASCs is important for the proper planning and utilization of operating room assets. We aim to understand the percentage of excluded patients, and we predict that certain procedures have higher rates of disqualification due to the types of patients who undergo them...
May 2017: Bulletin of the Hospital for Joint Diseases
https://www.readbyqxmd.com/read/28899592/the-american-college-of-surgeons-national-surgical-quality-improvement-program-surgical-risk-calculator-has-a-role-in-predicting-discharge-to-post-acute-care-in-total-joint-arthroplasty
#6
Daniel E Goltz, Billy T Baumgartner, Cary S Politzer, Marcus DiLallo, Michael P Bolognesi, Thorsten M Seyler
BACKGROUND: Patient demand and increasing cost awareness have led to the creation of surgical risk calculators that attempt to predict the likelihood of adverse events and to facilitate risk mitigation. The American College of Surgeons National Surgical Quality Improvement Program Surgical Risk Calculator is an online tool available for a wide variety of surgical procedures, and has not yet been fully evaluated in total joint arthroplasty. METHODS: A single-center, retrospective review was performed on 909 patients receiving a unilateral primary total knee (496) or hip (413) arthroplasty between January 2012 and December 2014...
August 18, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28899588/costs-associated-with-single-use-and-conventional-sets-for-distal-radius-plating
#7
Bryce Fugarino, Mary Patricia Fox, Cristina Terhoeve, Nicholas Pappas
PURPOSE: Volar plating of distal radius fractures is an increasingly common procedure. Presterilized, single-use volar plate fixation sets have been purported to increase operating room efficiency and decrease cost. The purpose of this study was to compare the actual cost of using a conventional set compared with the projected cost of using its single-use counterpart. METHODS: We retrospectively analyzed 30 consecutive cases of volar plate fixation in which conventional instrument sets were used...
September 9, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28893445/cost-benefit-analysis-of-different-air-change-rates-in-an-operating-room-environment
#8
Thomas Gormley, Troy A Markel, Howard Jones, Damon Greeley, John Ostojic, James H Clarke, Mark Abkowitz, Jennifer Wagner
BACKGROUND: Hospitals face growing pressure to meet the dual but often competing goals of providing a safe environment while controlling operating costs. Evidence-based data are needed to provide insight for facility management practices to support these goals. METHODS: The quality of the air in 3 operating rooms was measured at different ventilation rates. The energy cost to provide the heating, ventilation, and air conditioning to the rooms was estimated to provide a cost-benefit comparison of the effectiveness of different ventilation rates currently used in the health care industry...
September 8, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28890650/economic-impact-of-laparoscopic-conversion-to-open-in-left-colon-resections
#9
Katherine Etter, Brad Davis, Sanjoy Roy, Iftekhar Kalsekar, Andrew Yoo
BACKGROUND AND OBJECTIVES: Studies have shown economic and clinical advantages of laparoscopic left-colon resections. Laparoscopic conversion to open is an important surgical outcome. We estimated conversion incidence, identified risk factors, and measured the clinical and economic impact. METHODS: In this retrospective study, we used the Premier Perspective database to analyze left-sided colectomies from 2009 to 2014. Operating room time (ORT), length of stay (LOS), total hospital cost (2014 U...
July 2017: JSLS: Journal of the Society of Laparoendoscopic Surgeons
https://www.readbyqxmd.com/read/28889824/differences-in-clinical-outcomes-and-cost-between-complex-and-simple-arterial-switches
#10
Eric R Griffiths, Nelangi M Pinto, Aaron W Eckhauser, Ragheed Al-Dulaimi, Angela P Presson, David K Bailly, Phillip T Burch
BACKGROUND: This study evaluates the morbidity, mortality, and cost differences between patients who underwent either a simple or a complex arterial switch operation. METHODS: A retrospective study of patients undergoing an arterial switch operation at a single institution was performed. Simple cases were defined as patients with d-transposition of the great arteries with usual coronary anatomy or circumflex artery originating from the right with either intact ventricular septum or ventricular septal defect...
September 11, 2017: Cardiology in the Young
https://www.readbyqxmd.com/read/28876611/construction-and-validation-of-low-cost-laparoscopic-simulator-using-android-smartphone-and-pop-cast-and-a-laptop
#11
A Vyas, G Goel
Minimal invasive surgery training requires a lot of practice and for this purpose innovative tools are needed to develop methods for practice and training skills outside the operating room. Commercially available devices are readily available but cost effectiveness and availability are major limiting factors in resource limited setting. We present an innovative and cost effective laparoscopic simulator which can be easily manufactured and used for practice of laparoscopic surgery. Using a free android application, such as IP webcam we can relay video to laptop without the use of any cables and uniquely we use the flash of a camera as the light source and a selfie stick for movement of the camera...
September 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/28859720/sleep-overnight-monitoring-for-apnea-in-patients-hospitalized-with-heart-failure-soma-hf-study
#12
Sunil Sharma, Paul J Mather, Anindita Chowdhury, Suchita Gupta, Umer Mukhtar, Leslee Willes, David J Whellan, Atul Malhotra, Stuart F Quan
INTRODUCTION: Sleep-disordered breathing (SDB) is highly prevalent in hospitalized patients with congestive heart failure (CHF) and the condition is diagnosed and treated in only a minority of these patients. Portable monitoring (PM) is a screening option, but due to costs and the expertise required, many hospitals may find it impractical to implement. We sought to test the utility of an alternative approach for screening hospitalized CHF patients for SDB, high-resolution pulse oximetry (HRPO)...
August 29, 2017: Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine
https://www.readbyqxmd.com/read/28852356/detection-of-retained-foreign-objects-in-upper-extremity-surgical-procedures-with-incisions-of-two-centimeters-or-smaller
#13
Josef N Tofte, Lindsey S Caldwell
BACKGROUND: While the true incidence of retained foreign bodies after surgery is unknown, it has been approximated at 1:5,500 operations overall, with substantially less frequency in hand and upper extremity procedures. Despite the rarity of foreign body retention in hand and upper extremity surgery, universal radiofrequency scanning for electronically-tagged sponges and automatic radiographic evaluation for incorrect sponge counts are employed for all surgical procedures at our institution...
2017: Iowa Orthopaedic Journal
https://www.readbyqxmd.com/read/28841568/extended-device-profiles-and-testing-procedures-for-the-approval-process-of-integrated-medical-devices-using-the-ieee-11073-communication-standard
#14
Armin Janß, Johannes Thorn, Malte Schmitz, Alexander Mildner, Jasmin Dell'Anna-Pudlik, Martin Leucker, Klaus Radermacher
Nowadays, only closed and proprietary integrated operating room systems (IORS) from big manufacturers are available on the market. Hence, the interconnection of components from third-party vendors is only possible with increased time and costs. In the context of the German Federal Ministry of Education and Research (BMBF)-funded project OR.NET (2012-2016), the open integration of medical devices from different manufacturers was addressed. An integrated operating theater based on the open communication standard IEEE 11073 shall give clinical operators the opportunity to choose medical devices independently of the manufacturer...
August 25, 2017: Biomedizinische Technik. Biomedical Engineering
https://www.readbyqxmd.com/read/28830223/defining-the-costs-of-reusable-flexible-ureteroscope-reprocessing-using-time-driven-activity-based-costing-tdabc
#15
Dylan Isaacson, Tessnim Ahmad, Ian Metzler, David T Tzou, Kazumi Taguchi, Manint Usawachintachit, Samuel Zetumer, Benjamin Sherer, Marshall Stoller, Thomas Chi
Purpose Careful decontamination and sterilization of reusable flexible ureteroscopes used in ureterorenoscopy cases prevents the spread of infectious pathogens to patients and technicians. However, inefficient reprocessing and unavailability of scopes sent out for repair can contribute to expensive operating room delays. Time-driven activity-based costing (TDABC) was applied to describe the time and costs involved in reprocessing. Materials and Methods Direct observation and timing was performed for all steps in reprocessing of reusable flexible ureteroscopes following operative procedures...
August 22, 2017: Journal of Endourology
https://www.readbyqxmd.com/read/28818287/application-of-flexible-endoscopy-based-biopsy-in-the-diagnosis-of-tumour-pathologies-in-otorhinolaryngology
#16
Carlos Saga, Manuel Olalde, Ekhiñe Larruskain, Leire Álvarez, Xabier Altuna
INTRODUCTION AND OBJECTIVES: Interventional endoscopy allows us to act on the pathology of the patient with minimal discomfort, low costs and high efficiency. We assessed the validity of flexible endoscopic biopsies in our hospital, in lesions suspected of malignancy in the rhino-pharyngo-laryngeal space. SUBJECTS AND METHODS: Retrospective study of patients with a pathology suspected of malignancy assessed between 2006-2016 in our centre. We evaluated the effectiveness, the tolerance and the number of complications...
August 14, 2017: Acta Otorrinolaringológica Española
https://www.readbyqxmd.com/read/28815459/a-roadmap-for-reducing-cardiac-device-infections-a-review-of-epidemiology-pathogenesis-and-actionable-risk-factors-to-guide-the-development-of-an-infection-prevention-program-for-the-electrophysiology-laboratory
#17
REVIEW
Westyn Branch-Elliman
PURPOSE OF REVIEW: Cardiovascular implantable electronic device (CIED) infections are highly morbid, common, and costly, and rates are increasing (Sohail et al. Arch Intern Med 171(20):1821-8 2011; Voigt et al. J Am Coll Cardiol 48(3):590-1 2006). Factors that contribute to the development of CIED infections include patient factors (comorbid conditions, self-care, microbiome), procedural details (repeat procedure, contamination during procedure, appropriate pre-procedural prep, and antimicrobial use), environmental and organizational factors (patient safety culture, facility barriers, such as lack of space to store essential supplies, quality of environmental cleaning), and microbial factors (type of organism, virulence of organism)...
August 16, 2017: Current Infectious Disease Reports
https://www.readbyqxmd.com/read/28808847/evaluation-of-hyoscine-n-butyl-bromide-efficacy-on-the-prevention-of-catheter-related-bladder-discomfort-after-transurethral-resection-of-prostate-a-randomized-double-blind-control-trial
#18
Golnar Sabetian, Farid Zand, Elham Asadpour, Mohammad Ghorbani, Pourya Adibi, Mohammad Mehdi Hosseini, Shahryar Zeyghami, Farzaneh Masihi
BACKGROUND: Transurethral resection of prostate (TURP) is the most common treatment for benign prostatic hyperplasia (BPH). Urinary tract catheter is inserted post-operatively which results in catheter-related bladder discomfort (CRBD) in many patients. The purpose of this study was to assess the preventive effect of hyoscine N-butyl bromide on CRBD caused by a urinary tract catheter after TURP surgery in patients with BPH. METHODS: Twenty-four and twenty-six patients in the treatment and control groups were enrolled, respectively...
August 14, 2017: International Urology and Nephrology
https://www.readbyqxmd.com/read/28808622/radiation-exposure-and-reduction-in-the-operating-room-perspectives-and-future-directions-in-spine-surgery
#19
REVIEW
Ankur S Narain, Fady Y Hijji, Kelly H Yom, Krishna T Kudaravalli, Brittany E Haws, Kern Singh
Intraoperative imaging is vital for accurate placement of instrumentation in spine surgery. However, the use of biplanar fluoroscopy and other intraoperative imaging modalities is associated with the risk of significant radiation exposure in the patient, surgeon, and surgical staff. Radiation exposure in the form of ionizing radiation can lead to cellular damage via the induction of DNA lesions and the production of reactive oxygen species. These effects often result in cell death or genomic instability, leading to various radiation-associated pathologies including an increased risk of malignancy...
July 18, 2017: World Journal of Orthopedics
https://www.readbyqxmd.com/read/28794870/cost-and-morbidity-analysis-of-chest-port-insertion-in-adults-outpatient-clinic-versus-operating-room-placement
#20
Claudio F Feo, Giorgio C Ginesu, Alessandro Bellini, Giuseppe Cherchi, Antonio M Scanu, Maria Laura Cossu, Alessandro Fancellu, Alberto Porcu
BACKGROUND: Totally implantable venous access devices (TIVADs) represent a convenient way for the administration of medications or nutrients. Traditionally, chest ports have been positioned by surgeons in the operating room, however there has been a transition over the years to port insertion by interventional radiologists in the radiology suite. The optimal method for chest port placement is still under debate. MATERIALS AND METHODS: Data on all adult patients undergoing isolated chest port placement at our institution in a 12-year period were retrospectively reviewed...
September 2017: Annals of Medicine and Surgery
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