Change in Policy Allowing Overlapping Surgery Decreases Length of Stay in an Academic, Safety-net Hospital
A presentation at the 2018 American Association of Neurological Surgeons Annual Scientific Meeting
26-Apr-2018 1:05 PM EDT
Newswise — Winner of the Robert Florin Award, Anthony DiGiorgio, DO, MHA, presented his research, Change in Policy Allowing Overlapping Surgery Decreases Length of Stay in an Academic, Safety-net Hospital, during the 2018 American Association of Neurological Surgeons (AANS) Annual Scientific Meeting.
As the practice of surgeons performing overlapping surgery has recently come under scrutiny, this research sought to examine the impact of hospital policy that allows overlapping rooms on surgery wait time and length of stay in patients admitted to a tertiary care, safety-net hospital for urgent neurosurgical procedures.
The neurosurgery service at the hospital being studied transitioned from routinely allowing one room per day (period one) to overlapping rooms (period two), with the second room being staffed by the same attending surgeon. Patients undergoing neurosurgical intervention in each period were retrospectively compared. Case urgency, patient demographics, case type, indication, length of stay and time from admission to surgery were tracked.
Per study results, allowing overlapping rooms significantly reduced length of stay, complication rate and increased the rate of discharges to home. This was in a vulnerable population, comprised mostly of Medicare, Medicaid and uninsured patients who were in need of urgent surgery at a single safety-net academic institution.
There were 452 total cases reviewed (201 in period one, 251 in period two), covering seven months in each period. There were 122 cases classified as “urgent” (59 in period one, 63 in period two). In these patients, length of stay was significantly decreased in period two (13.09 days vs. 19.52) and the time from admission to surgery for urgent cases trended towards a shorter time (5.12 vs. 7.00). Insurance status of these patients was 26.2 percent uninsured, 39.3 percent Medicaid, 18.9 percent Medicare, 9 percent commercial and the remainder workers compensation, liability or prisoner care. Wait time significantly correlated with length of stay.
Author Block: Praveen Mummaneni, MD; Jonathan Fisher, BS; Adam Podet, MD; Michael Virk, MD, PhD; Clifford Crutcher, MD; Jason Wilson, MD; Gabriel Tender, MD
Disclosure: The author reported no conflicts of interest.
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About the 2018 AANS Annual Scientific Meeting: Attended by neurosurgeons, neurosurgical residents, medical students, neuroscience nurses, clinical specialists, physician assistants, allied health professionals and other medical professionals, the AANS Annual Scientific Meeting is the largest gathering of neurosurgeons in the nation, with an emphasis on the field’s latest research and technological advances. The scientific presentations accepted for the 2018 event will represent cutting-edge examples of the incredible developments taking place within the field of neurosurgery. Find additional information about the 2018 AANS Annual Scientific Meeting and the meeting program here.
Founded in 1931 as the Harvey Cushing Society, the American Association of Neurological Surgeons (AANS) is a scientific and educational association with more than 11,000 members worldwide. The AANS is dedicated to advancing the specialty of neurological surgery in order to provide the highest quality of neurosurgical care to the public. Fellows of the AANS are board-certified by the American Board of Neurological Surgery, the Royal College of Physicians and Surgeons of Canada or the Mexican Council of Neurological Surgery, A.C. Neurosurgery is the medical specialty concerned with the prevention, diagnosis, treatment and rehabilitation of disorders that affect the spinal column, spinal cord, brain, nervous system and peripheral nerves.
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