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ORTHOPEDICS: 30-day readmission rates for total hip and total knee replacement

The readmission rate for total hip replacement and total knee replacement procedures performed recently on patients in California, Florida and Massachusetts was studied.  Here are the findings for the percent of these patients readmitted within 30 days:

  • 4.29 percent (California during the period 2009 to 2011)
  • 4.7 percent (Florida during the period 2009 to 2013)
  • 3.92 percent (Massachusetts during the period 2009 to 2012)

The authors analyzed the role of infection in these 30-day readmissions, finding that in about one-third of the total hip and total knee arthroplasty patients, infection was listed as the primary or secondary reason for readmission.

Source: A retrospective study. Medicine, 96(38). Click here for free full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5617700/pdf/medi-96-e7961.pdf  Posted by AHA Resource Center (312) 422-2050, rc@aha.org

PERIOPERATIVE: Enhanced recovery after surgery

Enhanced recovery after surgery (ERAS) refers to redesigned perioperative care, sometimes also referred to as fast-track recovery after surgery.  Among the objectives are to reduce readmissions and avoid opioid abuse.  Changes include early ambulation, multi-modal analgesia and careful attention to nutrition.  The Cleveland Clinic includes ERAS in a list of the top 10 medical innovations for 2018.  The Gramlich article describes how the ERAS guidelines for colorectal surgery were implemented in six Canadian hospitals by the Alberta Health Services.  More information can also be obtained from the ERAS Society.

Sources:

Cleveland Clinic. Top 10 medical innovations.  Click here: http://innovations.clevelandclinic.org/Summit/Top-10-Medical-Innovations.aspx

Gramlich, L.M., and others. (2017). Implementation of enhanced recovery after surgery: A strategy to transform surgical care across a health system. Implementation Science. 12(67). Click here:  https://implementationscience.biomedcentral.com/track/pdf/10.1186/s13012-017-0597-5?site=implementationscience.biomedcentral.com

ERAS Society. Click here: http://erassociety.org/   Posted by AHA Resource Center (312) 422-2050, rc@aha.org

POPULATION HEALTH: Kaiser Permanente innovative model

Kaiser Permanente Oakland Medical Center is collaborating with the UC Berkeley School of Public Health in offering a population-health focused residency program.  The program is small – there are two degrees being offered and only two residents matched into each of the programs each year.  Two residents are in an Internal Medicine-Masters in Public Health (MPH) track and the other two are in a Pediatrics MPH track.  There have been a total of 16 program graduates so far.

Source: Lo, J.C., and others. (2017). Innovative partnerships to advance public health training in community-based academic residency programs. Advances in Medical Education and Practice. 8, 703-706. Click here for full text: https://www.dovepress.com/innovative-partnerships-to-advance-public-health-training-in-community-peer-reviewed-article-AMEP  Posted by AHA Resource Center, (312) 422-2003 rc@aha.org

SAFETY: falls and pressure ulcers by type of hospital unit

Development of a hospital quality improvement measure that evaluates patient falls and pressure ulcers was the focus of this study based on 2013 data from the National Database of Nursing Quality Indicators.  Table 2 has interesting unit-level data for different types of hospital patient care units based on statistics supplied by 857 hospitals.  The different types of patient care units compared included: critical care, step-down, medical, surgical, med-surg, rehab and critical access.  The group of hospitals in this study is said to under-represent small hospitals.

Highest and Lowest Rates by Type of Hospital Unit

  • 6.09 total falls / 1000 patient days in rehab units – critical care units had the lowest falls rate (1.13 per 1000)
  • 6.42 percent of patients in critical care units had hospital acquired pressure ulcers – critical access hospitals had the lowest occurrence – at 1.52 percent
  • 17.36 percent of patients in critical care units had restraints – critical access hospitals had the lowest rate at 0).

Source: Boyle, D.K., and others. (2017). A pressure ulcer and fall rate quality composite index for acute care units: A measure development study. International Journal of Nursing Studies. 63, 73-81.  Click here: http://www.journalofnursingstudies.com/article/S0020-7489(16)30146-8/pdf  Posted by AHA Resource Center (312) 422-2050, rc@aha.org

SURGERY: How much vascular surgery is done?

This is an analysis of over 3 million adult inpatient admissions in the state of Maryland during the years 2009 to 2013.

  • 3,157,499 adult admissions to Maryland hospitals 2009-2013
    •    154,004 (5 percent) of the total admissions involved a vascular procedure
      • 54 percent of the vascular procedures were emergent
      • 13 percent of the vascular procedures were urgent
      • 33 percent of the vascular procedures were elective

Patients who were in the emergent or urgent groups were found to have higher mortality rates and hospital resource utilization.

Source: Harris, D.G., and others. (2017, November). Defining the burden, scope, and future of vascular acute care surgery. Journal of Vascular Surgery, 66(5), 1511-1517.  Click here for access to the publisher’s website: http://www.jvascsurg.org/article/S0741-5214(17)31354-X/pdf  Posted by AHA Resource Center (312) 422-2050, rc@aha.org

OBSTETRICS: C-section rate expected to be 27 to 30 percent

The rate of cesarean deliveries is currently around one-third of all deliveries in the U.S. and is expected to remain in the range of 27 to 30 percent for the near term.  In about 15 years, the rate may drop to 20 to 25 percent.  Factors responsible for the continued “upward pressure” on the C-section rate include maternal age, obesity and diabetes.

Source: Clapp, M.A., and Barth, W.H., Jr. (2017, December). The future of cesarean delivery rates in the United States. Clinical Obstetrics & Gynecology, 60(4), 829-839.  Click here for publisher’s website: http://journals.lww.com/clinicalobgyn/Abstract/2017/12000/The_Future_of_Cesarean_Delivery_Rates_in_the.17.aspx  Posted by AHA Resource Center (312) 422-2050, rc@aha.org

2018 Calendar of Health Observances and Recognition Days

Want to find out when Healthy Weight Week is? Brain Injury Awareness Month? Medical Laboratory Professionals Week or International Orthopaedic Nurses Day?

You can find the answers for these and hundreds of other health observances or professional recognition days throughout the year. For each calendar listing, descriptive information is provided with sponsor contact information for more details.

Source: 2018 Health observances & recognition days. Society for Healthcare Strategy & Market Development of the American Hospital Association, 2017. https://www.surveymonkey.com/r/HEALTHCAL2018 [free registration required to view/download]

Posted by AHA Resource Center (312) 422-2050, rc@aha.org