Implementation science for the adductor canal block: A new and adaptable methodology process.

Background: Following the successful Perioperative Surgical Home (PSH) practice for total knee arthroplasty (TKA) at our institution, the need for continuous improvement was realized, including the deimplementation of antiquated PSH elements and introduction of new practices.

Aim: To investigate the transition from femoral nerve blocks (FNB) to adductor canal nerve blocks (ACB) during TKA.

Methods: Our 13-month study from June 2016 to 2017 was divided into four periods: a three-month baseline (103 patients), a one-month pilot (47 patients), a three-month implementation and hardwiring period (100 patients), and a six-month evaluation period (185 patients).

Respiratory Volume Monitoring in the Perioperative Setting Across Multiple Centers.

Background: The prevalence of nuisance (technical) alarms is the leading cause of alarm fatigue resulting in decreased awareness and a reduction in effective care. The Joint Commission identified in their National Patient Safety goals alarm fatigue as a major safety issue. The introduction of noninvasive respiratory volume monitoring (RVM) has implications for effective perioperative respiratory status management.

Impact of Anesthesia on Hospital Mortality and Morbidities in Geriatric Patients Following Emergency Hip Fracture Surgery.

Objectives: To determine the impact of anesthesia type on in-hospital mortality and morbidity for geriatric fragility hip fracture surgery.

Design: Retrospective cohort study.

Setting: Integrates health care delivery system across 38 facilities in the United States.

An Ambulatory Surgery Perioperative Surgical Home in Kaiser Permanente Settings: Practice and Outcomes.

Background: The aim of this study is to describe the design, implementation, and associated outcome changes of a Perioperative Surgical Home (PSH) for patients undergoing ambulatory laparoscopic cholecystectomy in a Kaiser Permanente practice model.

Methods: A multidisciplinary planning committee of 15 individuals developed and implemented a new PSH program. A total of 878 subjects were included in the preimplementation period (T-fast), and 1082 patients were included in the postimplementation period (PSH) based on the date of their surgery.

Practice and Outcomes of the Perioperative Surgical Home in a California Integrated Delivery System.

Background: In this article, we report on the implementation and impact of a Perioperative Surgical Home (PSH) model for the total knee arthroplasty at an integrated delivery system (Kaiser Permanente).

Methods: A multidisciplinary committee developed and implemented a series of PSH protocols that included the entire continuum of care from the decision for surgery until 30 days after surgery. Five hundred forty-six subjects were included in the preimplementation phase (Fast Track [T-fast]), and 518 patients were included in the postimplementation phase (PSH).