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A Survey of Overlapping Surgery Policies at U.S. Hospitals

Published online by Cambridge University Press:  21 April 2021

Margaret B. Mitchell ,
Catherine M. Hammack-Aviran ,
Ellen W. Clayton  and
Alexander Langerman
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Abstract

The authors surveyed hospitals across the country on their policies regarding overlapping surgery, and found large variation between hospitals in how this practice is regulated. Specifically, institutions chose to define “critical portions” in a variety of ways, ultimately affecting not only surgical efficiency but also the autonomy of surgical trainees and patient experiences at these different hospitals.

Keywords

Overlapping SurgeryConcurrent SurgeryCritical PortionsImmediately AvailableInformed Consent
Type
Independent Articles
Information
Journal of Law, Medicine & Ethics , Volume 49 , Issue 1: Public Sector and Non-Profit Contributions to Drug Development: Historical Scope, Opportunities, and Challenges , Spring 2021 , pp. 64 - 73
Copyright
© 2021 The Author(s)

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References

Abelson, J., Saltzman, J., and Kowalczyk, L., “Clash in the Name of Care: A Boston Globe Spotlight Team Report,” The Boston Globe, 2015.Google Scholar
Mello, M. and Livingston, E., “Managing the Risks of Concurrent Surgeries,” JAMA 315, no. 15 (2016): 1563–1564, doi:10.1001/jama.2016.2305.CrossRefGoogle Scholar
Guan, J., Karsy, M., Brock, A.A., et al., “Impact of a More Restrictive Overlapping Surgery Policy: An Analysis of Pre- and Postimplemental Complication Rates, Resident Involvement, and Surgical Wait Times at a High-Volume Neurosurgical Department,” Journal of Neurosurgery 129, no. 2 (2018): 515–523, doi: 10.3171/2017.5.JNS17183; A. Langerman, “Careful, Compassionate, Concurrent Surgery,” Boston Globe, January 10, 2016, <https://www.bostonglobe.com/ideas/2016/01/10/careful-compassionate-concurrent-surgery/YBNewe5HE6y-gL05N27UIxJ/story.html> (January 14, 2021); G.M. Beasley, T.N. Pappas, and A.D. Kirk, “Procedure Delegation by Attending Surgeons Performing Concurrent Operations in Academic Medical Centers: Balancing Safety and Efficiency,” Annals of Surgery 261, no. 6 (2015): 1044-1045.CrossRefGoogle Scholar
CMS, Medicare Claims Processing Manual, Chapter 12-Phy-sicians/Nonphysician Practitioners.Google Scholar
American College of Surgeons Statement on Principles, Section D-The Operation-Intraoperative Responsibility of the Primary Surgeon, available at <https://www.facs.org/about-acs/statements/stonprin> (last visited January 14, 2021).+(last+visited+January+14,+2021).>Google Scholar
Concurrent and Overlapping Surgeries: A Senate Finance Committee Staff Report, Finance.senate.gov, (2016) available at <https://www.finance.senate.gov/imo/media/doc/Concurrent%20Surgeries%20Report%20FINAL%20.pdf> (last visited January 14, 2021).+(last+visited+January+14,+2021).>Google Scholar
See American College of Surgeons, supra note 5.Google Scholar
See Senate Finance Committee, supra note 6.Google Scholar
“Best Hospitals 2017-2018,” US News and World Report, available at <https://health.usnews.com/best-hospitals/rankings> (last visited January 14, 2021).+(last+visited+January+14,+2021).>Google Scholar
Harris, P.A., Taylor, R., Thielke, R., et al., “Research Electronic Data Capture (REDCap) — A Metadata-Driven Methodology and Workflow Process for Providing Translational Research Informatics Support,” Journal of Biomedical Informatics 42, no. 2 (2009): 377–381.CrossRefGoogle Scholar
See American College of Surgeons, supra note 5.Google Scholar
See CMS, supra note 4.Google Scholar
See American College of Surgeons, supra note 5.Google Scholar
See Senate Finance Committee, supra note 6.Google Scholar
Sun, E., Mello, M.M., Rishel, C.A., et al., “Association of Overlapping Surgery With Perioperative Outcomes,” JAMA 321, no. 8 (2019):762–772, doi:10.1001/jama.2019.0711.CrossRefGoogle Scholar
See Senate Finance Committee, supra note 6.Google Scholar
Id.Google Scholar
See Sun, supra note 15; A. Morris, J. Sanford, E. Damrose, et al., “Overlapping Surgery: A Case Study in Operating Room Throughout and Efficiency,” Anesthesiology Clinics 36, no. 2 (2018): 161-176; B. Howard, C. Holland, and C. Mehta, “Association of Overlapping Surgery with Patient Outcomes in a Large Series of Neurosurgical Cases,” JAMA Surgery 153, no. 4 (2018): 313-321, doi:10.1001/jamasurg.2017.4502; C.J. Dy, D.A. Osei, T.G. Maak, et al., “Safety of Overlapping Inpatient Orthopaedic Surgery: A Multicenter Study,” The Journal of Bone and Joint Surgery 100, no. 22 (2018): 1902-1911.Google Scholar
See Morris, supra note 17; J. Liu, J. Berian, K. Ban, et al., “Outcomes of Concurrent Operations: Results from the American College of Surgeons’ National Surgical Quality Improvement Program,” Annals of Surgery 266, no. 3 (2017): 411-420.CrossRefGoogle Scholar
See Morris, supra note 17.Google Scholar
Ponce, B., Wills, B., Hudson, P., et al., “Outcomes with Overlapping Surgery at a Large Academic Medical Center,” Annals of Surgery 269, no. 3 (2019): 465–470; C. Zygourakis, S. Sizdah-kani, M. Keefe, et al., “Comparison of Patient Outcomes and Cost of Overlapping versus Nonoverlapping Spine Surgery,” World Neurosurgery 100 (2017): 658-664.CrossRefGoogle Scholar
See Morris, supra note 17.Google Scholar
See Morris, supra note 17.Google Scholar
See Liu, supra note 18.Google Scholar
See Morris, supra note 17.Google Scholar
See Morris and Howard, supra note 17.Google Scholar