Embrace specialized teams, comanagement to improve surgery

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After the results of a data-sharing project found wide variations for knee surgery readmissions, length of stay and operating times, several U.S. health systems are adjusting clinical processes, reported the Associated Press. For example, Dartmouth-Hitchcock Medical Center in New Hampshire now is looking to implement a specialized operating room team and a comanagement model, among other identified best practices.

The Health Affairs report has demonstrated that the one institution consistently matching surgeons with the same specialized team of technicians and nurses had the shortest surgery times. With longer operative times linked to more inpatient complications, Dartmouth-Hitchcock is embracing the team-based approach for total knee replacement surgeries going forward, the article noted.

The medical center also decreased length of stay by almost half a day after telling patients what to expect before, during and after surgery, Ivan Tomek, a Dartmouth-Hitchcock surgeon, told the AP.

The health system with the lowest in-hospital complication rate identified coordinated management of medically complex patients as another best practice, according to the report. So Dartmouth-Hitchcock has started to get the anesthesia, internal medicine, and orthopedic surgery departments all involved in managing patients with additional medical issues that could affect surgery, according to the article.

Meanwhile, research last week suggested hospitals use checklists before discharging surgical patients to avoid infections or moving surgical patients to units with empty beds rather than sending them home prematurely.

To learn more:
- read the AP article
- here's the research announcement  and full report

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