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Otolaryngologic Clinics of North America

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https://www.readbyqxmd.com/read/30390737/patient-engagement-in-otolaryngology
#1
REVIEW
Marisa A Ryan, Emily F Boss
Patient engagement, which involves incorporating the patient and family as partners in their care, is a growing focus in otolaryngology and surgery. Attention to patient and family centeredness, shared decision making, and patient experience together improves the overall tenor of patient engagement. Patient engagement promotes safety through improving quality of electronic health record data, error detection, and treatment decisions and adherence. In this article, we review specific areas of importance for patient engagement in otolaryngology as well as areas needing more research and development...
February 2019: Otolaryngologic Clinics of North America
https://www.readbyqxmd.com/read/30390736/clinical-indices-to-drive-quality-improvement-in-otolaryngology
#2
REVIEW
Christine L Barron, Charles A Elmaraghy, Stephanie Lemle, Wallace Crandall, Richard J Brilli, Kris R Jatana
A Pediatric Tracheostomy Care Index (PTCI) was developed by the authors to standardize care and drive quality improvement efforts at their institution. The PTCI comprises 9 elements deemed essential for safe care of children with a tracheostomy tube. Based on the PTCI scores, the number of missed opportunities per patient was tracked, and interventions through a "Plan-Do-Study-Act" approach were performed. The establishment of the PTCI has been successful at standardizing, quantifying, and monitoring the consistency and documentation of care provided at the authors' institution...
February 2019: Otolaryngologic Clinics of North America
https://www.readbyqxmd.com/read/30309675/button-battery-safety-industry-and-academic-partnerships-to-drive-change
#3
REVIEW
Kris R Jatana, Silas Chao, Ian N Jacobs, Toby Litovitz
The pediatric button battery (BB) hazard has been recognized for several decades. In 2012, the National Button Battery Task Force was established, and most manufacturers have improved warning labels, more secure packaging, and made BB compartments in products are more secure. Tissue neutralization before BB removal (ie, honey or sucralfate/Carafate®) is an effective way to reduce the rate of BB injury. In absence of visible perforation, 0.25% sterile acetic acid esophageal tissue irrigation at time of BB removal is recommended as a neutralization strategy to mitigate injury progression...
February 2019: Otolaryngologic Clinics of North America
https://www.readbyqxmd.com/read/30297183/multidisciplinary-tracheostomy-care-how-collaboratives-drive-quality-improvement
#4
REVIEW
Joshua R Bedwell, Vinciya Pandian, David W Roberson, Brendan A McGrath, Tanis S Cameron, Michael J Brenner
There have been reports of successful quality-improvement initiatives surrounding tracheostomy care for more than a decade, but widespread adoption of best practices has not been universal. Five key drivers have been found to improve the quality of care for tracheostomy patients: multidisciplinary synchronous ward rounds, standardization of care protocols, appropriate interdisciplinary education and staff allocation, patient and family involvement, and use of data to drive improvement. The Global Tracheostomy Collaborative is a quality-improvement collaborative dedicated to improving the care of tracheostomy patients worldwide through communication, dissemination, and implementation of proven strategies based on these 5 key drivers...
February 2019: Otolaryngologic Clinics of North America
https://www.readbyqxmd.com/read/30297182/rethinking-morbidity-and-mortality-conference
#5
REVIEW
Brian Nussenbaum, Richard A Chole
This article will discuss the importance of an effective morbidity and mortality (M&M) conference toward supporting a proactive and preventative approach to patient safety and quality improvement (PSQI). Key characteristics will be discussed that enhance this process for being a mechanism for driving positive PSQI culture change that permeates the department. The focus of this article will be on how to approach the structure and process of this conference for maximal benefit.
February 2019: Otolaryngologic Clinics of North America
https://www.readbyqxmd.com/read/30297181/delivering-otolaryngologic-care-safely-and-successfully
#6
EDITORIAL
Sujana S Chandrasekhar
No abstract text is available yet for this article.
February 2019: Otolaryngologic Clinics of North America
https://www.readbyqxmd.com/read/30297180/publicly-available-databases-in-otolaryngology-quality-improvement
#7
REVIEW
Alexander L Schneider, Jennifer M Lavin
The historical context for quality improvement is provided. Important differences are described between the two overarching types of databases: clinical registries and administrative databases. The pros and cons of each are provided as are examples of their utilization in otolaryngology-head and neck surgery.
February 2019: Otolaryngologic Clinics of North America
https://www.readbyqxmd.com/read/30287065/patient-safety-in-audiology
#8
REVIEW
Tommie L Robinson, Tracey Ambrose, Lyuba Gitman, Lemmietta G McNeilly
There is a need to educate audiologists, physicians, and other clinicians about patient safety in audiology. This article addresses the many aspects of patient safety and the applicability to the practice of audiology in health care. Clinical examples of strategies to build a culture of patient safety are provided.
February 2019: Otolaryngologic Clinics of North America
https://www.readbyqxmd.com/read/30274800/patient-safety-and-quality-improvement-driving-to-new-frontiers
#9
EDITORIAL
Rahul K Shah
No abstract text is available yet for this article.
February 2019: Otolaryngologic Clinics of North America
https://www.readbyqxmd.com/read/30262168/reprocessing-standards-for-medical-devices-and-equipment-in-otolaryngology-safe-practices-for-scopes-speculums-and-single-use-devices
#10
REVIEW
C W David Chang, Michael J Brenner, Emily K Shuman, Mimi S Kokoska
Stringent regulatory standards for reprocessing medical devices and equipment have proliferated in response to patient safety incidents in which improperly disinfected or contaminated endoscopes lead to large-scale disease transmission or outbreaks. This article details best practices in reprocessing reusable and single-use devices in otolaryngology, with particular attention to flexible fiberoptic endoscopes/nasophyarngoscopes, nasal speculums, and other clinic and operating room instruments. High-risk devices require sterilization, whereas lower risk devices may be reprocessed using various disinfection procedures...
February 2019: Otolaryngologic Clinics of North America
https://www.readbyqxmd.com/read/30262167/leadership-driving-safety-and-quality
#11
REVIEW
Erin L McKean, Carl H Snyderman
Leaders in health care play a large role in successful achievement of quality and safety goals through an overt commitment to both quality and safety, fostering a culture of quality improvement and clear and consistent communication of goals and plans. Specific training for frontline providers, managers, and staff is critical in developing skilled leaders with a quality and safety orientation. Many models exist for organizational leadership development, and exemplars of quality and safety leadership have openly shared the keys to their successes for others to raise the bar...
February 2019: Otolaryngologic Clinics of North America
https://www.readbyqxmd.com/read/30249446/simulation-saves-the-day-and-patient
#12
REVIEW
Ellen S Deutsch, Mary D Patterson
Surgeons can use simulation to improve the safety of the systems they work within, around, because of, and despite. Health care is a complex adaptive system that can never be completely knowable; simulation can expose aspects of patient care delivery that are not necessarily evident prospectively, during planning, or retrospectively, during investigations or audits. The constraints of patient care processes and adaptive capacity of health care providers may become most evident during simulations conducted "in situ" using real teams and real equipment, in actual patient care locations...
February 2019: Otolaryngologic Clinics of North America
https://www.readbyqxmd.com/read/30249445/patient-safety-and-quality-for-office-based-procedures-in-otolaryngology
#13
REVIEW
Prerak D Shah
Office-based procedures have increased in frequency with the recent changes in the current health care climate prioritizing improved efficiency and greater value in the care that is delivered. This article focuses on patient safety and quality issues that are specific to procedures in the office setting of an Otolaryngologist. Specific topics are categorized into preprocedure planning, procedural execution, and postprocedure follow-up. Several best practice recommendations are included to promote and simplify the integration of these quality and safety measures into every office setting...
February 2019: Otolaryngologic Clinics of North America
https://www.readbyqxmd.com/read/30249444/anesthesia-safety-in-otolaryngology
#14
REVIEW
Andrew T Waberski, Alexandra G Espinel, Srijaya K Reddy
This article highlights the important relationship between the otolaryngologist and anesthesiologist, focusing on intraoperative patient safety for otolaryngologic surgery. In addition, consideration of preoperative history, physical examination, and potential postoperative complications helps guide the otolaryngologist and anesthesiologist in formulating an appropriate and collaborative management strategy.
February 2019: Otolaryngologic Clinics of North America
https://www.readbyqxmd.com/read/30245040/the-impact-of-cognitive-and-implicit-bias-on-patient-safety-and-quality
#15
REVIEW
Karthik Balakrishnan, Ellis M Arjmand
Humans use cognitive shortcuts, or heuristics, to quickly assess and respond to situations and data. When applied inappropriately, heuristics have the potential to redirect analysis of available information in consistent ways, creating systematic biases resulting in decision errors. Heuristics have greater effect in high-pressure, high-stakes decisions, particularly when dealing with incomplete information, in other words, daily medical and surgical practice. This article discusses 2 major categories: cognitive biases, which affect how we perceive and interpret clinical data; and implicit biases, which affect how we perceive and respond to other individuals, and also discusses approaches to recognize and alleviate bias effects...
February 2019: Otolaryngologic Clinics of North America
https://www.readbyqxmd.com/read/30245039/device-safety
#16
REVIEW
Vinay K Rathi, Stacey T Gray
Medical devices are essential in the diagnosis and treatment of otolaryngologic disease. The US Food and Drug Administration (FDA) is tasked with assuring the safety and effectiveness of these devices. Otolaryngologists, in turn, are often responsible for helping patients understand risks, benefits, and alternatives when deciding whether to rely on devices in their care. To best counsel patients, otolaryngologists should be aware of the strengths and limitations of device regulation by the FDA. This article reviews the FDA regulatory framework for medical devices, premarket evidentiary standards for marketing devices, and postmarket methods of safety surveillance...
February 2019: Otolaryngologic Clinics of North America
https://www.readbyqxmd.com/read/30245038/systems-science-a-primer-on-high-reliability
#17
REVIEW
David W Roberson, Elliana R Kirsh
In the 21st century, most medical care is not delivered by a single physician but rather, by a team. A team is a type of system, a set of people and things interacting together for a defined aim. The discipline of systems science concerns itself with how complex teams or organizations function. The application of systems science has had a major positive impact on safety and quality in such diverse disciplines as auto manufacturing, airline safety, and nuclear power generation. A modest understanding of how systems science applies to medical care can help improve safety and quality of care...
February 2019: Otolaryngologic Clinics of North America
https://www.readbyqxmd.com/read/30241765/preventing-and-managing-operating-room-fires-in-otolaryngology-head-and-neck-surgery
#18
REVIEW
Soham Roy, Lee P Smith
Otolaryngologists are at high risk of surgical fire. During surgery in the head and neck region there is close proximity of 3 essential elements: an ignition source, a fuel, and an oxidizing agent. In this article, the authors highlight the scenarios where fire may occur and offer steps that surgeons can take to minimize risk for their patients. By understanding the elements of the fire triad, otolaryngologists can decrease the risk of surgical fire, through careful control of oxidizers, ignition sources, and potential fuels in the operating room...
February 2019: Otolaryngologic Clinics of North America
https://www.readbyqxmd.com/read/30241763/resident-and-fellow-engagement-in-safety-and-quality
#19
REVIEW
Sarah N Bowe, Michael E McCormick
Beyond educational and institutional requirements, there is a need for trainees (residents and fellows) to learn patient safety and quality improvement skills in order to achieve the ultimate goal of providing better patient care. Key steps to engagement include creating a safety and quality culture, supporting faculty development, and selecting appropriate curricular resources. Efforts to align the goals and processes of the graduate medical education institution and teaching hospital can foster a unified mission...
February 2019: Otolaryngologic Clinics of North America
https://www.readbyqxmd.com/read/30390772/management-of-vestibular-schwannoma-including-nf2-facial-nerve-considerations
#20
REVIEW
Vivian Kaul, Maura K Cosetti
Current consensus on optimal treatment of vestibular schwannoma remains poorly established; treatment options include observation, stereotactic radiosurgery, microsurgical resection, medical therapy, or a combination of these. Treatment should be individualized and incorporate the multitude of patient- and tumor-specific characteristics known to affect outcome. Treatment paradigms for sporadic and neurofibromatosis type 2-related tumors are distinct and decision-making in neurofibromatosis type 2 is uniquely challenging...
December 2018: Otolaryngologic Clinics of North America
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