AORN Acquires Outpatient Surgery Magazine
Outpatient Surgery Joins AORN

Two of surgery's most respected voices are joining forces to create a powerhouse with unmatched reach and influence. The Association of periOperative Registered Nurses (AORN) has acquired Outpatient Surgery Magazine and the OR Excellence Conference from Herrin Publishing Partners.

AORN says the acquisition, effective March 31, reinforces the world's largest professional association for perioperative nurses commitment to ambulatory surgery safe practice and strengthens the lines of communication to and from surgical team members in all settings.

"AORN views this acquisition as both a growth opportunity for the association and a significant complement to the news and resources that our Ambulatory Surgery Division provides our members," says AORN's Executive Director/CEO Linda Groah, MSN, RN, CNOR, NEA-BC FAAN. "We expect this move will make a positive difference to all surgical team members in every specialty and OR setting."

Outpatient Surgery will continue its work from its home office in Pennsylvania.

In the near future, subscriptions to Outpatient Surgery's digital edition will be complimentary for AORN's 42,000 members, including 10,000 who work in ambulatory surgery centers. Members may receive the print edition for a reduced annual subscription fee and can subscribe for free to Outpatient Surgery's daily news service to stay informed about current events in the ambulatory surgery setting.

"We were humbled and thrilled to be invited to join one of the world's most successful, dynamic, entrepreneurial professional associations," says Stan Herrin, founder and president of Herrin Publishing Partners. "With the power of AORN's resources, reputation and vision behind us, we feel we are in a great position to continue serving the surgical community through the rest of this century and beyond."

Dan O'Connor

What's the Cost of an OR Minute?
Burning Time TIME IS MONEY In California, 1 minute of operating room time costs an average of $36 to $37.

You already know that the OR minute is the most expensive unit of time in health care. But do you know exactly how expensive? Using financial statements from 302 California hospitals, researchers found that operating room time costs an average of $36 to $37 a minute. Do the math next time a last-minute cancellation leaves the OR unexpectedly idle until you can assign another case.

Researchers went a step further by breaking down the cost of an OR minute. Of the $36 to $37 per OR minute, $20 to $21 are direct costs while wages account for $13 to $14. Unbilled supplies like gloves and sutures account for the remaining $2.50 to $3.50 in expenses, according to a JAMA study .

"These numbers are the first standardized estimates of operating room cost," write the authors. "Understanding the composition of costs will allow those interested in value improvement to identify high-yield targets."

Using financial statements from 302 California short-term general and specialty care hospitals from 2005 to 2014, researchers found the proportion of the total spent on direct costs increased while unbilled supplies and salaries fell over time. The study authors believe that the cost of unbilled supplies can be further reduced.

Richard Abowitz

"As Surgery Centers Boom, Patients Are Paying With Their Lives"
Risky Business RISKY BUSINESS Some surgical centers may be skimping on training and equipment, according to an investigation.

An ambulatory surgery center is the place to go for simple procedures — and tragic results — according to an investigative report in USA Today and Kaiser Health News (KHN) that claims more than 260 ASC patients have died as a result of surgical complications in the last 5 years.

ASCs call 911 thousands of times each year due to a range of patient complications, according to the investigation in which reporters combed through autopsy records, legal fillings, and state and Medicare inspection records to determine how many patients died after complications from outpatient procedures.

The report, which calls into question the safety of the estimated 5,600 U.S. surgery centers, uncovered some risky practices like performing more complicated surgeries to increase profits, being located too far from the local hospital when emergencies arise, taking in patients with high-risk health problems that experts say should only be handled in hospitals, and skimping on training or equipment needed in an emergency.

The Ambulatory Surgery Center Association (ASCA) was quick to dismiss the article for its "sensationalism and misrepresentation" of safety and quality in ASCs.

"By focusing their story on a relatively small number of tragic errors, while ignoring the overwhelming beneficial outcomes found in ASCs, they have created a false and misleading narrative about the safety and efficacy of outpatient surgery," says William Prentice, chief executive officer of ASCA in an emailed press release.

More than 200 million outpatient procedures have been safely completed during the time span mentioned in the report, says ASCA. However, "it's important to realize that surgery centers are not hospitals," says anesthesiologist and safe surgery expert Kenneth Rothfield, MD, board member of the Physician-Patient Alliance for Health and Safety in the article. "They have different resources, different equipment."

JoEllen McBride

InstaPoll: Are Toasters and Toaster Ovens Banned in the Staff Lounge?

A toaster oven inside the break room of a New Jersey hospital sparked a fire recently. That got us thinking: Do you allow toasters and toaster ovens in your staff lounge? Tell us in this week's InstaPoll how many you read each month.

The 249 respondents to last week's poll are rather selective when it comes to reading the many nursing and surgical publications available to them. The results:

How many surgical publications do you read each month?

  • none 2%
  • 1-2 41%
  • 3-5 42%
  • 6-8 10%
  • more than 8 5%

Dan O'Connor

News & Notes
  • Total hip arthroplasty may add years to lifePatients in Sweden that underwent a total hip arthroplasty between 1999 and 2012 had a better survival rate than the general population, a study in Clinical Orthopaedics and Related Research showed. The increased survival rate (3% at 5 years after surgery) was only significant for patients with primary osteoarthritis. Patients with other diagnoses such as osteonecrosis, inflammatory arthritis and secondary osteoarthritis actually had a lower survival rate than the general population.
  • Multimodal pain management improves total joint outcomes A study in the journal Anesthesiology shows that total hip and knee replacement patients who receive 2 or more different analgesics — including COX-2 inhibitors, NSAIDs and peripheral nerve blocks — require fewer opioids, have fewer respiratory and GI complications, and are ready for discharge sooner after surgery. The researchers based the findings on a review of more than 500,000 hip replacements and about 1,000,000 knee replacements performed between 2006 and 2016.
  • Knee surgery unnecessary in elderly patients Arthroscopic partial knee meniscectomy, which removes damaged cartilage from the joint, provides no clinical benefit to patients 65 years of age and older, according to a study in JAMA Surgery. However, the procedure still accounted for about two-thirds of all knee arthroscopy surgeries performed on older patients in 2016. Sparing patients from the unnecessary operation would reduce the healthcare burden for rehabilitation and for treating post-op complications, including opioid-related issues, says study author Martin Makary, MD, MPH, a professor of surgery at the Johns Hopkins University School of Medicine in Baltimore, Md.