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Objective: The primary objective of this study was to review the complication rate of percutaneous tracheostomies performed by a single surgeon in a community teaching hospital. Methods: This retrospective study reviewed the patients who underwent percutaneous tracheostomy with bronchoscopic guidance in a community hospital setting between 2009 and 2017. Patients older than the age of 18 requiring percutaneous tracheostomy were chosen for this retrospective study. Patients who were medically unstable, had no palpable neck landmarks, and inadequate neck extension were excluded. Indications for percutaneous tracheostomy included patients who had failed to wean from mechanical ventilation, required pulmonary toileting, or in whom airway protection was required. Results: Of the 600 patients who received percutaneous tracheostomy, 589 patients were included in the study. Intraoperative complication (2.6%) and postoperative complication rates (11.4%) compared similarly to literature reported rates. The most common intraoperative complications were bleeding, technical difficulties, and accidental extubation. Bleeding, tube obstruction, and infection were the most common postoperative complications. Overall burden of comorbidity, defined by Charlson Comorbidity Index, and coagulopathy were also found to be associated with higher complication rates. The decannulation rate at discharge was 46.3%. Conclusion: Percutaneous tracheostomy is a safe alternative to open tracheostomies in the community setting for appropriately selected patients. [ABSTRACT FROM AUTHOR]

Abstract Background The debate of whether to centralize hepato-pancreato-biliary surgery has been ongoing. The principal objective was to compare outcomes of a community pancreatic surgical program with those of high-volume academic centers. Methods The current pancreatic surgical study occurred in an environment where (1) a certified abdominal transplant surgeon performed all surgeries; (2) complementary quality enhancement programs had been developed; (3) the hospital’s trauma center had been verified; and (4) the hospital’s surgical training had been accredited. Pancreatic surgical outcomes at high-volume academic centers were obtained through PubMed literature searches. Articles were selected if they described diverse surgical procedures. Two-tailed Fisher exact and mid-P tests were used to perform 2 × 2 contingency analyses. Results The study patients consisted of 64 consecutive pancreatic surgical patients. The study patients had a similar pancreaticoduodenectomy proportion (59.4%) when compared to literature patients (66.8%; P = 0.227). The study patients also had a similar distal pancreatectomy proportion (25.0%) when compared to literature patients (31.9%; P = 0.276). The study patients had a significantly higher American Society of Anesthesiologists physical status ≥ 3 proportion (100%) than literature patients (28.1%; P

Background: The debate of whether to centralize hepato-pancreato-biliary surgery has been ongoing. The principal objective was to compare outcomes of a community pancreatic surgical program with those of high-volume academic centers. Methods: The current pancreatic surgical study occurred in an environment where (1) a certified abdominal transplant surgeon performed all surgeries; (2) complementary quality enhancement programs had been developed; (3) the hospital's trauma center had been verified; and (4) the hospital's surgical training had been accredited. Pancreatic surgical outcomes at high-volume academic centers were obtained through PubMed literature searches. Articles were selected if they described diverse surgical procedures. Two-tailed Fisher exact and mid-P tests were used to perform 2 × 2 contingency analyses. Results: The study patients consisted of 64 consecutive pancreatic surgical patients. The study patients had a similar pancreaticoduodenectomy proportion (59.4%) when compared to literature patients (66.8%; P = 0.227). The study patients also had a similar distal pancreatectomy proportion (25.0%) when compared to literature patients (31.9%; P = 0.276). The study patients had a significantly higher American Society of Anesthesiologists physical status ≥ 3 proportion (100%) than literature patients (28.1%; P < 0.001). The 90-day study mortality proportion (0%) was similar to the literature proportion (2.3%; P = 0.397). The study postoperative pancreatic fistula proportion was lower (3.2%), when compared to the literature proportion (18.4%; P < 0.001; risk ratio = 5.8). The study patients had a lower reoperation proportion (3.1%) than the literature proportion (8.7%; mid-P = 0.051; risk ratio = 2.8). The study patients had a lower surgical site infection proportion (3.1%) than those in the literature (21.1%; P < 0.001; risk ratio = 6.8). The study patients had equivalent delayed gastric emptying (15.6%) when compared to literature patients (10.6%; P = 0.216). The study patients had decreased Clavien–Dindo grades III–IV complications (10.9%) compared to the literature patients (21.8%; mid-P = 0.018). Lastly, the study patients had a similar readmission proportion (20.3%) compared to literature patients (18.4%; P = 0.732). Conclusion: Despite pancreatic surgical patients having greater preoperative medical comorbidities, the current community study outcomes were comparable to or better than high-volume academic center results. [ABSTRACT FROM AUTHOR]

Introduction The Meds to Beds (MTB) program aims to enhance medication adherence and reduce hospital readmissions by delivering prescribed medications directly to patients' bedsides before discharge. This study evaluated the effectiveness of the MTB program in reducing 90-day readmission rates in a community teaching hospital. Methods This prospective study was conducted at a 159-bed community teaching hospital in Boston, MA. The study included 63 patients discharged from emergency, medical, or surgical units with at least one newly prescribed medication. Patients served as their own controls, with readmission rates compared to 90 days before and after the MTB intervention. Data were collected from electronic medical records, and paired t-tests were used to assess statistical significance, with a p-value <0.05 was used to determine statistical significance. Principal findings The study included 63 patients who received their medications before discharge. The mean number of admissions significantly decreased from 1.52 pre-intervention to 0.47 post-intervention (p < 0.001). Key interventions included prescription retrieval, addressing medication access barriers, and bedside delivery with personalized counseling. Conclusions The implementation of the MTB program significantly reduced hospital readmissions, improved medication adherence, and enhanced patient satisfaction. Addressing barriers such as transportation, high copays, and pharmacy accessibility empowered patients to adhere to prescribed regimens. This study highlights the potential benefits of expanding the MTB program to other healthcare settings to enhance care quality and reduce readmission rates., Competing Interests: Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. Steward IRB issued approval N/A. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2025, Kamel et al.)

The Medical Library and the Department of Research of the Staten Island University Hospital developed a collaborative project aimed at improving research and scholarly productivity in the community teaching hospital setting to meet teaching program accreditation requirements. The project opens a new venue for hospital librarians seeking new and innovative roles within their institutions while helping to strengthen the library’s position and demonstrate the value of library services to health professionals. [ABSTRACT FROM PUBLISHER]

Abstract: Background: There has been increased national attention on methicillin-resistant Staphylococcus aureus (MRSA) and surgical site infections (SSIs) highlighted by the media, the public, and federal agencies. It was therefore considered important to analyze the trends and incidence of inpatient detected SSIs and associated resistant organisms at our own institution. Methods: The analysis reflects the cultures and sensitivities of SSI on the surgical services at Monmouth Medical Center, a 527-bed community teaching hospital, from January 2003 through December 2007. The SSIs included in the study were those detected in hospitalized patients. Results: There were 312 surgical patients who developed SSIs. Contrary to observed national trends, our study demonstrated a statistically significant decrease in the incidence of MRSA among all the surgical services. We also noted a statistically significant decrease trend of SSIs in orthopedic surgery. The 312 patients'' cultures yielded 399 bacterial strains. The most common strains varied with the service. Overall, the most common isolate identified was Staphylococcus species, numbering 143% or 35.8% of all isolates. MRSA was identified in 46 SSIs and 8 SSIs were positive for vancomycin-resistant enterococci (VRE). Conclusions: Only a hospital-specific SSI analysis can help focus improvement with clinical impact. The scrutiny of SSI analysis has highlighted SSI problems in the pediatric and orthopedic surgery services that have been addressed. [Copyright &y& Elsevier]