Cost Drivers of Elective Colon and Rectal Surgery: A Retrospective Cohort Analysis.

Background: Colorectal surgery is expensive. Few studies have evaluated complications as an economic cost driver, and there is little evidence comparing multiple cost drivers of colorectal surgery to determine the most effective means of reducing total cost.

Objective: This study aimed to determine the effects of surgical techniques, use of enhanced recovery protocols, and presence or absence of complications on the total cost of hospitalization for elective colorectal surgery.

Defining Risk and Risk Factors for Unplanned ICU Admission of Trauma Patients.

Background: Unplanned ICU admissions (up-ICUad) are associated with poor outcomes. It is difficult to identify who is at risk for up-ICUad in trauma patients. This study aimed to identify injury patterns and comorbidities associated with up-ICUad and develop a predictive tool for who is at risk.

Using performance frontiers to differentiate elective and capacity-based surgical services.

Background: Acute care surgery (ACS) model of care delivery has many benefits. However, since the ACS surgeon has limited control over the volume, timing, and complexity of cases, traditional metrics of operating room (OR) efficiency almost always measure ACS service as "inefficient." The current study examines an alternative method-performance fronts-of evaluating changes in efficiency and tests the following hypotheses: (1) in an institution with a robust ACS service, performance front methodology is superior to traditional metrics in evaluating OR throughput/efficiency, and (2) introduction of an ACS service with block time allocation will improve OR throughput/efficiency.

Delay in ICU transfer is protective against ICU readmission in trauma patients: a naturally controlled experiment.

Background: Unplanned intensive care unit (ICU) readmission-ICU bounce back (ICUbb)-is associated with worse outcomes. Patients not requiring organ system support or intensive nursing are deemed 'ICU discharge ready' and transfer orders are placed. However, actual transfer only occurs when an appropriate, non-ICU bed is available.

Maximizing Learning in the Operating Room: Residents' Perspectives.

Background: Few studies examine how residents can optimize their educational experience in the OR on their terms. This study aimed to examine residents' perceptions of how learners can maximize their education in the OR.

Method: Using constructivist grounded theory methodology, the authors conducted focus groups with general surgery residents, PGY1-5, followed by semi-structured interviews with attending surgeons from a single, academic medical center.