Sunil Eappen

Implementing the World Health Organization Surgical Safety Checklist: A Model for Future Perioperative Initiatives

In the fall of 2008, perioperative leaders at Brigham and Womens Hospital, Boston, Massachusetts, conducted a two-week trial of the World Health Organization Surgical Safety Checklist in the main OR. The checklist was incorporated by using a Plan-Do-Study-Act cycle. In 2009, we began a 14-week rollout of the surgical safety checklist to all our ORs. Critical factors that led to the success of this implementation included gaining executive leadership endorsement; recruiting volunteers from each discipline to lead the project; using quality methodologies to ensure a thoughtful, organizing implementation; providing frequent feedback and data; and confirming standardized use of the checklist by creating a policy.

Relationship Between Occurrence of Surgical Complications and Hospital Finances

IMPORTANCE The effect of surgical complications on hospital finances is unclear. OBJECTIVE To determine the relationship between major surgical complications and per-encounter hospital costs and revenues by payer type. DESIGN, SETTING, AND PARTICIPANTS Retrospective analysis of administrative data for all inpatient surgical discharges during 2010 from a nonprofit 12-hospital system in the southern United States. Discharges were categorized by principal procedure and occurrence of 1 or more postsurgical complications, using International Classification of Diseases, Ninth Revision, diagnosis and procedure codes. Nine common surgical procedures and 10 major complications across 4 payer types were analyzed. Hospital costs and revenue at discharge were obtained from hospital accounting systems and classified by payer type. MAIN OUTCOMES AND MEASURES Hospital costs, revenues, and contribution margin (defined as revenue minus variable expenses) were compared for patients with and without surgical complications according to payer type. RESULTS Of 34,256 surgical discharges, 1820 patients (5.3%; 95% CI, 4.4%-6.4%) experienced 1 or more postsurgical complications. Compared with absence of complications, complications were associated with a

Incidence of epidural catheter replacement in parturients: a retrospective chart review

39,017 (95% CI,

Continuous spinal anesthesia with invasive hemodynamic monitoring for surgical repair of the hip in two patients with severe aortic stenosis.

20,069-

Effect of subarachnoid bupivacaine block on anesthetic requirements for thiopental in rats.

50,394; P < .001) higher contribution margin per patient with private insurance (

Introduction of Anesthesia Resident Trainees to the Operating Room Does Not Lead to Changes in Anesthesia- controlled Times for Efficiency Measures

55,953 vs

Phase Ia and Ib study of amitriptyline for ulnar nerve block in humans: Side effects and efficacy

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Doxepin by topical application and intrathecal route in rats.

1749 (95% CI,

Nonpharmacological means of pain relief for labor and delivery.

976-

REGIONAL ANESTHESIA TECHNIQUES FOR PAIN CONTROL IN THE INTENSIVE CARE UNIT

3287; P < .001) higher contribution margin per patient with Medicare (