title: Reductions in unwanted complications and lengths of inpatient stay by use of "dynamic guidelines".
abstract: A literature survey was used to identify pre-operative risks that commonly result in unwanted post-operative complications in the elderly. By adapting these risk conditions into a pre-operative survey, seniors who might have these complications were identified. Practitioners were notified of these risk factors. Elective surgery was postponed, when necessary, to have patients stop smoking and to gain training in pulmonary toilet. When in the inpatient setting, the patients were followed by both the surgeon and the appropriate specialist to reduce complications rates. By developing and employing this approach, a 25 percent decrease in unwanted complications was experienced, mostly due to reduction in pulmonary events. This resulted in an associated 58 percent drop in unwanted length-of-stay days in the hospital per 1,000 senior patients. Outcomes were improved, while inpatient utilization was reduced.
authors.affiliation: QualMed/HSI, Albuquerque, NM, USA.
authors.forename: R M
authors.initials: RM
authors.lastname: Burton
mesh_terms: D000368:Aged; D015897:Comorbidity; D017558:Elective Surgical Procedures / Q000009:adverse effects*; D006279:Health Maintenance Organizations / Q000592:standards* / Q000706:statistics & numerical data; D006801:Humans; D007902:Length of Stay; D009516:New Mexico; D011183:Postoperative Complications / Q000517:prevention & control*; D017410:Practice Guidelines as Topic; D012307:Risk Factors