Today’s Top Story

Study: PRO tool may help identify patients likely to benefit from lumbar spine surgery

A study published online in the journal JAMA Surgery offers evidence to validate a patient-reported outcome (PRO) measure for patients who undergo lumbar spine surgery. The authors surveyed 1,965 adult lumbar surgical candidates at baseline and at least once postoperatively within three years. Demographic and clinical characteristics included in the final prediction models were age, sex, race, insurance status, American Society of Anesthesiologists score, smoking status, diagnoses, prior surgery, prescription opioid use, asthma, and baseline PRO scores. They found that a PRO response prediction tool, informed by population-level data, explained most of the variability in pain reduction and functional improvement following surgery.

Read the complete study…

View the outcomes calculator…

 
 
Other News

Study: Cortisone injection within six months of primary surgery may increase risk of revision rotator cuff repair

Findings presented at the Specialty Day meeting of the American Orthopaedic Society for Sports Medicine suggest that cortisone injections within six months prior to rotator cuff repair may be linked in increased risk of revision surgery. The researchers reviewed data on 4,959 arthroscopic primary rotator cuff repair patients, of whom 553 required reoperation within the following three years and of whom 392 were for a revision rotator cuff repair. They found that patients who received a cortisone injection in the six months before surgery had a significantly increased risk of revision cuff repair, while patients who received a cortisone injection in the period six to 12 months prior to surgery displayed no increased risk compared to those who had no injection.

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NQF offers proposals for implementing an opioid stewardship program

The National Quality Forum (NQF) has released a guidebook for providers to help implement and sustain an opioid stewardship program. The book offers seven steps for healthcare organizations to curb inappropriate opioid usage, and will be distributed to NQF members, including specialty societies. Recommendations include the following:

  • promoting leadership commitment and culture
  • organizational policies to support evidence-based approaches to multimodal pain management
  • improved clinician training in the science of pain, evidence-based pain management strategies, and patient communication techniques
  • enhancing caregiver education and engagement
  • tracking, monitoring, and reporting performance data to identify opportunities for improvement
  • establishing accountability for creating, promoting, and maintaining a culture of opioid stewardship
  • improved collaboration with community leaders and stakeholders

Read more…  (registration may be required)

Read the NQF summary…

 

In related news, a report from CNN identifies a link between payments from pharmaceutical companies and physician prescribing of opioids.

Read more…

 
 
 
Healthcare stakeholders release report card on medical error rates

A report card released by the Institute for Healthcare Improvement, the National Patient Safety Foundation Lucian Leape Institute, and the University of Chicago looks at trends in medical error rates and finds that, despite overall improvement from 2015 to 2017, about 1 in 5 people personally experienced a medical error, and 1 in 3 reported an error in the care of a close relative or friend last year. Of those who experienced an error, 73 percent said it had a long-term or permanent impact on their physical and emotional health, financial well-being, or family relationships.

Read more…  (registration may be required)

 
 
 
Report: Shift to value-based payments may have helped reduce Medicare spending

A report published by The Commonwealth Fund suggests that value-based payment initiatives may help reduce per-beneficiary Medicare spending. Members of the research team compared Medicare Part A and Part B spending for a 5 percent sample of Medicare fee-for-service enrollees age 65 and older, for the periods 2007—2010 and 2011—2014. After adjustment for provider rate changes, they found that the average amount Medicare spent on health services per beneficiary declined by $180 from the first period to the second. The researchers suggest that the decrease may be linked in part to a shift toward value-based payments for healthcare services.

Read the abstract…

 
 
 
CMS enrollees will soon receive new Medicare cards

The U.S. Centers for Medicare & Medicaid Services (CMS) will begin mailing new Medicare cards to all enrollees beginning in April 2018. Cards will be distributed from April through June based on geographic location and other factors. CMS has posted additional information on the new cards for both providers and patients.

Read more…

Read the provider-targeted information…

Learn more about the distribution plan (PDF)…

 
 
Your AAOS

Public comments sought on Management of Hip Fractures in the Elderly Performance Measure

A quality measure developed by the AAOS related to the timing of surgical intervention of hip fractures in the elderly is entering the public commentary stage. Public comments on the guideline will be accepted through Monday, March 26, 2018. For more information, the necessary materials, and to provide comments, please contact Mary DeMars, at:

demars@aaos.org