Handoffs and transitions of care: A systematic review, meta-analysis, and practice management guideline from the Eastern Association for the Surgery of Trauma.

Background: The Joint Commission reports that at least half of communication breakdowns occur during handovers or transitions of care. There is no consensus on how best to approach the transfer of care within acute care surgery (ACS). We conduct a systematic review and meta-analysis of the current data on handoffs and transitions of care in ACS patients and evaluate the impact of standardization and formalized communication processes.

Contemporary management and outcomes of penetrating colon injuries: Validation of the 2020 AAST Colon Organ Injury Scale.

Introduction: The American Association for the Surgery of Trauma Colon Organ Injury Scale (OIS) was updated in 2020 to include a separate OIS for penetrating colon injuries and included imaging criteria. In this multicenter study, we describe the contemporary management and outcomes of penetrating colon injuries and hypothesize that the 2020 OIS system correlates with operative management, complications, and outcomes.

Methods: This was a retrospective study of patients presenting to 12 Level 1 trauma centers between 2016 and 2020 with penetrating colon injuries and Abbreviated Injury Scale score of <3 in other body regions.

Stop Flying the Patients! Evaluation of the Overutilization of Helicopter Transport of Trauma Patients.

Introduction: Helicopter transport is a resource intensive and expensive method for transportation of patients by helicopter. The primary objective of this study was to evaluate the appropriateness of helicopter transport determined by procedural care within 1-h of transfer at an urban level I trauma center.

Methods: All trauma patients transported by helicopter from January 2015-December 2017 to an urban level I trauma center from referring hospitals or the scene were retrospectively analyzed.

Continuous Cardiac Monitoring Policy Implementation: Three-year Sustained Decrease of Hospital Resource Utilization.

Inappropriate cardiac monitoring leads to increased hospital resource utilization and alarm fatigue, which is ultimately detrimental to patient safety. Our institution implemented a continuous cardiac monitoring (CCM) policy that focused on selective monitoring for patients based on the American Heart Association (AHA) guidelines. The primary goal of this study was to perform a three-year median follow-up review on the longitudinal impact of a selective CCM policy on usage rates, length of stay (LOS), and mortality rates across the medical center.

Radioactive seed vs wire localization for nonpalpable breast lesions: A single institution review.

The aim of this study was to compare wire localization (WL) and radioactive seed localization (RSL) for nonpalpable breast lesions with regard to margin status, re-excision rate, procedure length, and complications related to localization. A retrospective review of the electronic health records at a single institution was performed. There was no difference in re-excision rate, margin positivity, volume of tissue removed, and complication rate for RSL vs WL (P = 0.

Long-Term Results After Lung Volume Reduction Surgery: A Single Institution's Experience.

Background: The National Emphysema Treatment Trial (NETT) showed a clear survival and quality of life benefit for patients selected for lung volume reduction surgery (LVRS). However, long-term outcomes after LVRS are still lacking. The aim of this study was to evaluate overall mortality and functional durability in this single-institution cohort of patients undergoing LVRS.

Improving the mortality index by capturing patient acuity through interprofessional real-time documentation improvement in a single hospital system.

Background: The observed to expected mortality ratio is a standardized way for reporting inpatient mortality and is used as a measure for hospital quality rankings and Centers for Medicare & Medicaid Services value-based payments. The goal of this study is to describe a single institution's mortality index improvement initiative through improved documentation of patient severity.

Methods: Data were prospectively collected October 2016 through May 2017 on patients discharged from the acute care surgery, open heart surgery, neurosurgery, and University Hospital East.

A qualitative analysis of clinical decompensation in the surgical patient: Perceptions of nurses and physicians.

Background: There is little knowledge on how health care providers individually interpret and communicate early warning signs to other providers. The aim of the study described here was to qualitatively assess the similarities and differences in how nurses and physicians perceive early warning signs that potentially predict clinical decompensation, changes in clinical acuity in surgical patients, and need for escalation of care.

Methods: Ethnographic interviews were conducted with nurses, surgical residents, and attending surgeons on an acute care medical-surgical unit.