Improved Survival in Critically Ill Patients after Implementing a Visual Clinical Decision Support System
Publication Description: Research indicates that there is an association between physician leadership and hospital performance.1Hospitals led by physicians have higher US News and World Report (USNWR) quality scores, reduced complication rates, better bed-usage rates, higher physician-satisfaction scores, and financial performance scores that equal those of nonphysician managers.2-4 These findings in the health care sector are in line with new management thinking that organizations led by core-business experts (ie, participants or practitioners in their respective fields) tend to demonstrate better performance.5 A recent article6 suggests that management-led organizations may be lagging because they have not embraced physician input and leadership, thus resulting in resistance to change. Access the Full Article.
The aim of this study was to determine whether preoperative nutritional counseling and exercise (prehabilitation) in obese patients with ventral hernia repair (VHR) results in more hernia-free and complication-free patients. Obesity and poor fitness are associated with complications following VHR. These issues are prevalent in low socioeconomic status patients. This was a blinded, randomized controlled trial at a safety-net academic institution. Obese patients (BMI 30 to 40) seeking VHR were randomized to prehabilitation versus standard counseling. VHR was performed once preoperative requirements were met: 7% total body weight loss or 6 months of counseling and no weight gain. Primary outcome was the proportion of hernia-free and complication-free patients. Secondary outcomes were wound complications at 1 month postoperative and weight loss measures. Univariate analysis was performed. Access Full Article.
Variation in use of postacute care (PAC), including skilled nursing facilities and inpatient rehabilitation, accounts for 73% of regional variation in Medicare spending. Studies of hospital variation in PAC use have typically focused on nonsurgical patients or have been limited to Medicare data. Consequently, there is no nationally representative data on how rates of postoperative discharge to PAC differ between hospitals. The purpose of this study was to explore hospital-level variation in PAC utilization after cardiovascular and abdominal surgery. Access Full Article.