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Smaller hospitals can provide safe and high-quality surgical care comparable to larger counterparts
Date:7/27/2010

ry will last longer than two hours, such as measuring core temperature, monitoring blood glucose level and a clear decision about continuing beta blocker drugs postoperatively if they have been used preoperatively."

The availability of blood for transfusion in a surgery and any special instruments needed also were helpful to include on the checklist, Galandiuk said.

The studies looked at how quickly the smaller hospitals four in Kentucky and one in Indiana adopted quality improvement measures, as evidenced by the implementation of surgical time-out; whether surgical specialists were committed to accepting the quality and safety parameters outlined in the expanded surgical time-out checklist; and how the payment structure may affect quality and safety measures.

Major surgeries examined included hip and knee replacements, hysterectomy, colon resections, and hernia repairs. In all, 2,300 surgeries were examined. The researchers found that all specialties had extremely high rates of adherence to timely administration of prophylactic antibiotics within the recommended one hour before surgery.

"We also found that, although almost one quarter to one third of patients were awake during the surgical time-out, surgical time-out was implemented in more than 97 percent of all cases among the different subspecialties," Polk said.

The researchers also found that all specialties successfully avoided hypothermia in most cases, and gynecologists, especially, made appropriate choices regarding antibiotics in a majority of cases.

"Our research showed that clinicians in these rural hospitals showed an extremely high standard of care to their patients, equal to that given at urban and tertiary counterparts," Polk said. "The hospitals' willingness to commit to participating in these studies with the goal of better patient care should be commended as well."

Approximately 40 percent of Americans get their surgical care in ce
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Contact: Lauren Williams
lauren.williams@louisville.edu
502-852-7461
University of Louisville
Source:Eurekalert

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