Rachel R Kelz

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This study looked at how different groups involved in surgical care—nurses, residents, and faculty—report safety incidents and their attitudes toward the safety culture in their hospital. Researchers interviewed 41 people and found that nurses were the most consistent in using the reporting system, while faculty reported the least, and residents had mixed views. These differences are important because they can help hospitals create a better environment for reporting safety issues, ultimately improving patient care. Who this helps: This helps patients and healthcare workers by improving safety in surgical care.

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This study looked at different ways surgeons in the U.S. are paid and how these payment models impact their work and patient care. Researchers reviewed 39 studies covering various payment methods like salary, productivity-based pay, and hybrid models. They found that while salary models promote teamwork and stability, productivity-based models focus too much on volume and can overlook important factors like patient care quality. Overall, the study highlights the need for clearer and more adaptable pay structures that encourage surgeons to balance patient care with teaching and research. Who this helps: This helps patients and doctors by promoting better care and support for surgeons.

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This study looked at how confident surgical residents feel about writing and securing grants, which are important for their careers. It found that, on average, residents rated their confidence at 6 out of 10, with senior residents feeling more confident (5.5) than junior residents (3.5). Those who had formal training in grant writing were significantly more likely to get their grants funded (43.2%) compared to those without training (7.5%), highlighting the importance of grant writing education early in their careers. Who this helps: This helps surgical residents and their training programs.

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This study looked at how well hospitals perform in treating emergency general surgery patients by comparing two different ways of analyzing data. Researchers assessed outcomes for over 536,000 Medicare patients from July 2015 to June 2018 and found that the two methods gave similar results for hospital rankings, indicating that both are effective for measuring performance. Notably, while many hospitals performed similarly, there were still significant differences in outcomes, particularly between those using surgical versus non-surgical treatments. Who this helps: This benefits patients and doctors by identifying hospitals that provide better quality care for emergency surgeries.

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This study created a machine learning tool to better predict how long surgeries will take, aiming to improve efficiency in operating rooms. The tool was tested on over 55,000 surgeries and was found to be much more accurate than the existing prediction method, reducing errors in estimated surgery times from an average of 91 minutes to just 61 minutes. This improvement means that the tool can help schedule surgeries more effectively, benefiting both patients and healthcare providers. Who this helps: Patients and doctors involved in surgical procedures.

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This study looked at patients with serious gastrointestinal blockages caused by cancers like colorectal, gynecologic, and hepatobiliary cancers. Researchers found that out of nearly 8,700 patients, those who had been hospitalized for cancer before were 7.8% less likely to receive surgery for their blockage. This information is important because it highlights how previous hospital stays can influence treatment options, which can help doctors make better decisions for their patients. Who this helps: This helps patients facing malignant gastrointestinal obstructions and their healthcare providers.

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This study looked at whether certain training assessments for general surgery residents can predict how well they perform once they become independent surgeons. Researchers found that specific assessments, like those measuring patient care skills, correlated with better patient outcomes: for instance, surgeons with lower scores in patient care had significantly worse results. These findings are important because improving how we train and assess future surgeons can lead to better care for patients. Who this helps: This helps patients and healthcare providers by ensuring that surgeons are better prepared to deliver quality care.

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This study looked at how mental health care after surgery affects the chances of patients with serious mental illnesses being readmitted to the hospital. The research found that out of 88,092 patients, those who had a mental health visit within 30 days after discharge had a 40% lower chance of being readmitted if they had surgery, and a 33% lower chance if they were treated without surgery. This matters because connecting patients with serious mental illnesses to mental health care after they leave the hospital can help keep them from needing emergency care again. Who this helps: This benefits patients with serious mental illnesses and their healthcare providers.

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This study looked at how to improve surgical residency education by examining past recommendations and developing new ideas for training. The main findings emphasize moving towards a training approach focused on demonstrating specific skills, using technology to enhance learning, and creating better mentorship programs to help new surgeons transition to independent practice. These improvements aim to ensure that surgical residents are thoroughly prepared to provide high-quality care. Who this helps: This helps surgical residents and ultimately benefits patients receiving surgical care.

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This study looked at how often people go to the emergency department (ED) for abdominal pain between 2007 and 2019 and how they were diagnosed using imaging tests like CT scans and X-rays. The number of ED visits for abdominal pain rose significantly, especially among younger adults (from 9.4% to 11.6%) and older adults (from 6.0% to 6.5%). While the use of CT scans increased from 26.2% to 42.6%, particularly among older adults, many older patients still received less effective X-rays instead of more suitable scans, and overall diagnosis rates improved from 17.2% to 22.9%. Who this helps: This research benefits doctors and healthcare providers by highlighting trends in diagnosing abdominal pain, which can improve patient care in the emergency setting.

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The CIRCE Project aimed to create a comprehensive and reliable dataset from electronic health records (EHRs) of patients at six hospitals within the University of Pennsylvania Health System. They collected data on 740,035 patients, who had a total of 1,629,920 hospital visits since 2017, with the majority being emergency visits. This project matters because it improves the availability of high-quality healthcare data for clinical research, allowing for better findings and informed decisions that ultimately enhance patient care. Who this helps: This benefits patients, healthcare researchers, and medical professionals.

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This study looked at how surgeons obtain advice from colleagues when facing complicated emergency surgeries. The research involved 48 surgeons, and it found that 23% of the time, they sought a second opinion, especially in more complex cases. However, the biggest challenge to getting that help was the time of day or night. Improving access to trusted surgeons around the clock could enhance patient care and outcome. Who this helps: This benefits patients undergoing emergency surgeries.

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This study examined the best treatment methods for older patients with multiple health issues who are hospitalized for acute cholecystitis, a painful gallbladder condition. Researchers found that among nearly 33,000 patients, those who had surgery (cholecystectomy) had a 3% lower risk of dying within 30 days and a 4% lower risk within 90 days compared to those who did not have surgery. Additionally, surgery led to fewer readmissions and emergency department visits after treatment, and while it was more expensive initially, it resulted in lower overall costs after 90 days. Who this helps: This benefits older patients with multiple health conditions and their doctors when making treatment decisions.

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This study looked at how a new program that pairs medical students and volunteers with underinsured patients can help them navigate the challenges of getting surgery. Researchers interviewed 22 navigators and found major barriers such as language differences and lack of patient engagement, alongside helpful factors like support from hospital leaders and clear procedures for navigators. These insights can lead to better support systems that help ensure all patients have access to the surgical care they need. Who this helps: This benefits underinsured patients needing surgery, as well as healthcare providers working to improve patient care.

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This study looked at how treatment for colorectal cancer affects the quality of life for older adults on Medicare. Researchers found that patients currently undergoing treatment had lower physical and mental health scores, with a decrease of over 3 points in physical health and over 1 point in mental health compared to when they were not in treatment. In contrast, patients who completed their treatment showed stable quality of life scores over time. This research is important because it highlights the need for better support for cancer patients to help them manage long-term health impacts after treatment. Who this helps: This helps patients undergoing colorectal cancer treatment and their healthcare providers.

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This study looked at how well hospitals provide language services for surgery patients who speak little or no English. Out of 230 patients who had gallbladder surgery, only 62% used interpreter services, and just 30% had medical documents in their native language. The researchers found that using these services didn't significantly affect hospital stay length or follow-up visits, indicating that many patients still aren't getting the language help they need. Who this helps: This helps patients with limited English proficiency who need better communication during their medical care.

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This study looked at how surgeons feel about using risk calculators in emergency general surgery, which involves making quick, important treatment decisions. Researchers interviewed 20 surgeons and found that while some were skeptical about the accuracy of these calculators, many recognized their potential benefits, such as improving communication with patients and aiding in informed consent. The ideal risk calculator would be easy to use and provide clear, relevant information to help guide treatment choices. Who this helps: This benefits surgeons and their patients by enhancing decision-making during critical situations.

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This study examined how often older Black and White adults received imaging tests like CT scans and ultrasounds when they went to the emergency room with abdominal pain. Researchers found that White patients were 26.8% more likely to receive these imaging tests compared to Black patients, with 67% of White patients getting them versus only 40.2% of Black patients. This difference in treatment is concerning because it points to inequalities in healthcare that need to be addressed to ensure all patients receive appropriate care. Who this helps: This helps older patients, particularly those from racial and ethnic minority groups, by highlighting the need for equal access to medical testing.

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This study looked at the use of outpatient right colectomy (a type of surgery for the right side of the colon) in the U.S. from 2016 to 2021. Researchers found that the number of these surgeries performed as outpatient procedures rose significantly— from 3.9% of all right colectomies in 2016 to more overall—but there was no change in the rate of patients needing to go back to the hospital within 30 days after surgery. However, the overall costs for outpatient procedures increased from about $9,447 in 2016 to $14,544 in 2021, indicating that more resources were needed for patient care after surgery. Who this helps: This information is useful for patients and doctors considering outpatient surgery options.

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This study looked at how much surgical residents feel they belong to their community during their training. Out of 10,747 residents, 6,166 responded, giving an average belonging score of 47 out of 55. The researchers found that feeling a sense of belonging was linked to training in one's hometown, being in the fifth year of residency, and lower stress levels, while those identified as non-White reported feeling less belonging. Understanding these factors is important because improving a sense of belonging can enhance residents' academic success and mental health. Who this helps: This helps surgical residents, especially those from diverse backgrounds.

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This study focused on creating a report card to evaluate the quality of surgical care in hospitals by comparing the outcomes of surgeries performed on Medicare patients across different hospitals. The researchers found that among the 20 largest hospitals in Pennsylvania, five had higher mortality rates than expected, while two had lower mortality rates, highlighting significant differences in surgical quality. This information is important because it helps hospitals identify areas where they can improve their surgical care and better serve their patients. Who this helps: This helps patients and hospitals by providing clear insights into surgical quality and outcomes.

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This study looked at how often different surgeons decide to perform surgery on patients with emergency conditions. It found that for common issues like complicated diverticulitis, surgeons operated on only 44% of patients, while for cholecystitis, they went with surgery 74% of the time. The results show that the choice to operate varies significantly depending on which surgeon is in charge, impacting how patients are treated in emergencies. Who this helps: Patients facing emergency surgeries benefit from understanding these variations in care.

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This study looked at patients with kidney failure who had surgery to remove parathyroid glands, specifically focusing on whether they had the surgery as inpatients (staying in the hospital) or outpatients (going home the same day). The researchers found that 19% of all patients returned to the hospital within 30 days, but those admitted as inpatients had a higher readmission rate of 22% compared to 15% for outpatients. Importantly, outpatient surgery costs less, averaging $6,357 compared to $9,615 for inpatient care, making outpatient surgery a safer and more economical option for suitable patients. Who this helps: This benefits patients with kidney failure and their healthcare providers by offering a less expensive and effective treatment option.

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This study looked at how the surgery to remove parathyroid glands (parathyroidectomy) has been performed over the years, specifically focusing on whether patients stay overnight or go home the same day. From 2013 to 2019, researchers found that 67.3% of these surgeries were done as same-day procedures, and the overall number of same-day surgeries increased while overnight stays decreased, particularly for conditions like primary hyperparathyroidism. This is important because it shows that more patients can safely have this surgery without needing to stay in the hospital, which can lead to less recovery time and lower healthcare costs. Who this helps: Patients needing parathyroidectomy, especially those with primary hyperparathyroidism.

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This study looked at how many patients had adrenal surgery done as outpatient procedures from 2016 to 2020. Researchers found that the percentage of these surgeries performed on an outpatient basis increased from 44.1% in 2016 to 59.2% in 2020, with similar costs and readmission rates regardless of whether patients stayed overnight or were discharged the same day. This is important because it shows that more patients can go home the same day without compromising their safety or increasing costs. Who this helps: This helps patients who may prefer to recover at home rather than in a hospital.

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Researchers studied whether a simple blood test during parathyroid surgery—measuring how much a hormone called PTH drops during the operation—could predict whether the surgery would successfully cure a specific type of parathyroid disease and avoid a dangerous drop in calcium levels afterward. They tested this prediction method in over 1,000 patients from multiple hospitals and confirmed that a 50-65% drop in PTH during surgery reliably indicates the operation will work and help doctors avoid dangerously low calcium levels after surgery. This matters because doctors can now use this quick, real-time measurement during surgery to know whether they've removed the right amount of diseased tissue, without having to wait for results afterward.

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This study looked at older patients admitted to hospitals to see if being treated at a "flagship hospital" or one of its affiliate hospitals led to better survival rates compared to other hospitals in the area. It found that patients in flagship hospitals had a 1.02% lower chance of dying within 30 days compared to those at non-flagship hospitals, while patients at affiliate hospitals had a 0.43% lower chance. This matters because it highlights that patients in flagship hospital systems generally experience better outcomes, particularly if they are treated at the main flagship hospital. Who this helps: Patients receiving care for serious medical conditions.

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This study looked at how patients fare after surgery at different types of hospitals, specifically comparing flagship hospitals (the main hospitals in a hospital system), their affiliates, and hospitals not part of those systems. The researchers found that patients who had surgery at flagship system hospitals had a 3.79% chance of dying within 30 days after surgery, compared to 4.36% for similar patients at non-affiliated hospitals, indicating that flagship hospitals generally offer better outcomes. However, there was no significant difference in mortality for patients at flagship hospital affiliates compared to non-affiliated hospitals. Who this helps: This information benefits patients and doctors by highlighting the importance of choosing hospitals with strong surgical performance.

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This study looked at how speaking a non-English language affects outcomes for patients who have a stroke after surgery. Out of 3,078 patients, 6.2% spoke a non-English language, and while most outcomes were similar between groups, non-English speakers were nearly twice as likely (about 95% more) to need a feeding tube after their stroke. These findings are important because they highlight potential communication issues between doctors and patients who don’t speak English. Who this helps: Doctors and healthcare providers working with diverse patient populations.

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This study examined how Medicare Advantage (MA) and Fee-for-Service (FFS) beneficiaries experience minimally invasive surgery for colorectal cancer. Researchers found that MA patients were less likely to have advanced disease, such as lymph node or distant metastases, and had a higher chance (12% more) of receiving laparoscopic surgery than FFS patients. Additionally, MA beneficiaries had fewer complications, such as hospital readmissions (24% less likely), highlighting that MA plans may offer better outcomes for elderly patients needing colorectal cancer surgery. Who this helps: This benefits elderly patients undergoing colorectal cancer treatment.

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This study looked at a new program created to help surgical interns who work night shifts feel more connected and improve their learning experiences. The program included weekly sessions led by senior residents, and the interns reported feeling 85% more familiar with each other and 92% more familiar with senior residents. By the end of the quarter, interns who were part of the program showed improved decision-making skills and a greater sense of belonging compared to those who didn’t participate. Who this helps: This program benefits surgical interns and helps them feel more supported and connected during their challenging night shifts.

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This study looked at how telemedicine affects access to elective gallbladder surgery for socially vulnerable adults, who often struggle to get surgical care. Out of 60 participants, only 60% who used telemedicine completed their surgical consultations, compared to 76% who had in-person visits. However, those who received help with scheduling had better outcomes, with 76.7% completing consultations compared to just 46.9% without scheduling help. Who this helps: This benefits socially vulnerable patients who need surgery but face barriers to care.

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This study looked at thyroid nodule biopsies in patients who may not need them because they have a limited life expectancy, focusing on those who died within two years of their biopsy. Out of 2,565 biopsies performed, only 37 patients died within two years, and 78% of these had a different type of cancer. This is important because it shows that many of these biopsies might not be necessary, potentially saving over $98,000 in healthcare costs and helping doctors make better decisions for patients with serious health issues. Who this helps: Patients with limited life expectancy and their doctors.

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Researchers studied trends in primary hyperparathyroidism (PHPT), a condition where the body produces too much parathyroid hormone, affecting calcium levels. They examined over 1,000 patients who had surgery to remove the parathyroid glands between 2002 and 2019 and found that patients were showing milder symptoms and lower hormone and calcium levels. Despite these milder cases, the surgery successfully cured 93.7% of patients, indicating that even those with less severe disease can benefit from surgical intervention. Who this helps: This helps patients with primary hyperparathyroidism and their doctors by expanding treatment options.

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This study examined the differences in certain microRNAs (miRNAs) between postmenopausal women with Primary Hyperparathyroidism (PHPT) and those without the condition. Researchers found that 9 specific miRNAs were present in different amounts in women with PHPT, and these levels were linked to parathyroid hormone and calcium in the blood. This is important because it helps identify a unique biochemical signature for PHPT, which could improve diagnosis and treatment options for patients with this condition. Who this helps: This helps patients with Primary Hyperparathyroidism.

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This study looked at how well hospitals perform in surgeries for younger and older patients and found significant differences in outcomes. Among older adults, the death rate after surgery was 3.6%, compared to just 0.7% for younger adults. Hospitals with high death rates tended to have more complications and worse outcomes in both age groups, especially in older adults where failure-to-rescue rates were significantly higher. Who this helps: This research benefits patients and doctors by highlighting the need for improved surgical care, especially for older adults.

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This study looked at how surgical care is provided in healthcare systems that use a "hub and spoke" model, where complex surgeries are done at larger hospitals (hubs) and simpler procedures at smaller ones (spokes). Researchers examined data from nearly 123,000 patients across 43 hospital systems in 13 states and found that while hub hospitals had a lower chance of patients experiencing death or serious complications from complex surgeries (about 20% less likely), they had a higher chance of patients staying longer in the hospital after common surgeries (19% more likely). This highlights a chance to make healthcare delivery more efficient and better for patients. Who this helps: This helps patients undergoing surgical procedures, healthcare systems, and hospital administrators looking to improve care delivery.

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This study developed and tested a new tool to measure how connected surgical residents feel to their community, which is important for their well-being and performance. They found that out of 114 survey responses, Black and Asian residents felt less connected compared to their White peers, and those who graduated with their original class felt more connected. This matters because understanding belonging can lead to better support for surgical trainees and improve their overall performance and mental health. Who this helps: This helps surgical residents and the programs that train them.

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This study looked at how men and women, as well as different racial and ethnic groups, experience and are treated for medullary thyroid cancer (MTC). They found that out of 6,154 patients, 68% received recommended surgery. Men and Hispanic patients tended to have larger tumors, while Black and Hispanic patients often had more advanced cancer and waited longer for surgery; Black patients were also less likely to receive the recommended surgical treatment. Who this helps: This research benefits patients with medullary thyroid cancer, particularly those who are men or from non-White backgrounds, by highlighting disparities in treatment and outcomes.

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This study looked at how necessary in-person health check-ups are before surgeries and whether they could be done online instead. Researchers found that most updates (60.8%) involved changes to patient histories, but only a few (11.6%) affected surgical plans. Patients spent about 7,000 hours traveling and waiting for these visits in 2019, suggesting these check-ups could be less burdensome if done through telehealth. Who this helps: This helps patients by reducing travel and wait times for pre-surgery appointments.

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This study examined how negative patient outcomes affect surgeons and surgical trainees, focusing on their emotional reactions and support needs. Out of 216 trainees surveyed, 82.8% reported being involved in at least one adverse event, with many feeling embarrassed (84.8%), ruminating on the experience (82.1%), and fearing future procedures (65.4%); notably, 35.9% even considered quitting their training. The findings reveal a substantial emotional toll on these medical professionals and highlight the importance of offering support, like debriefing sessions with experienced doctors, to help them cope, especially for female trainees and those from diverse backgrounds. Who this helps: This supports surgical trainees and faculty members facing emotional challenges after adverse events.

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This study looked at how the size of tumors affects survival in patients with well-differentiated thyroid cancer. Researchers found that patients with tumors larger than 4 cm had a 63% higher risk of dying compared to those with smaller tumors, but when combined with other high-risk features, the risk increased even more. Notably, the biggest drops in survival were seen when tumors grew beyond 2 cm and again at 5 cm, suggesting that the 4 cm mark isn't as critical as previously thought. Who this helps: This helps doctors make better treatment decisions for patients with thyroid cancer.