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Orthopedic Clinics of North America

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https://www.readbyqxmd.com/read/30224016/quality-value-and-patient-safety-in-orthopedic-surgery
#1
EDITORIAL
Frederick M Azar
No abstract text is available yet for this article.
October 2018: Orthopedic Clinics of North America
https://www.readbyqxmd.com/read/30224015/optimizing-outpatient-total-ankle-replacement-from-clinic-to-pain-management
#2
REVIEW
Michel A Taylor, Selene G Parekh
Outpatient total ankle arthroplasty is a potential significant source of cost savings. The ability to institute an effective outpatient total ankle program depends on appropriate patient selection, surgeon experience with total ankle replacement, addressing preoperative patient expectations, the involvement of an experienced multidisciplinary care team including experienced anesthesiologists, nurse navigators, recovery room nursing staff and physical therapists, and most importantly, such a program requires complete institutional logistical support...
October 2018: Orthopedic Clinics of North America
https://www.readbyqxmd.com/read/30224014/patient-safety-driving-after-foot-and-ankle-surgery
#3
REVIEW
John J Carroll, William D McClain, Thomas C Dowd
This article provides a review of the existing literature regarding driving limitations following lower extremity orthopedic surgery. Medicolegal requirements and insurance recommendations are often vague and subject to interpretation. Several studies have examined the impact of surgery and immobilization on brake reaction time. This study summarizes the findings of these studies. Additionally, the authors consider the impact of lower extremity amputations and peripheral vascular disease on driving. Literature regarding opioid use, obesity, sleep apnea, increasing age, and distraction is also reviewed...
October 2018: Orthopedic Clinics of North America
https://www.readbyqxmd.com/read/30224013/the-volume-value-relationship-in-shoulder-arthroplasty
#4
REVIEW
Prem N Ramkumar, Heather S Haeberle, Joseph P Iannotti, Eric T Ricchetti
Improving value in shoulder arthroplasty has gained increasing importance as procedure volume increases. To enhance the value of shoulder arthroplasty, an improvement of outcomes or a decrease in associated costs must occur. With the recent shift to a value-based care delivery model, analysis of the effects of surgical volume presents an opportunity to improve outcomes and reduce costs in shoulder arthroplasty. There are multiple reports in the literature expanding on the relationship between increased surgeon and hospital procedure volume and increased value for shoulder arthroplasty, by way of improved outcomes or decreased cost...
October 2018: Orthopedic Clinics of North America
https://www.readbyqxmd.com/read/30224012/practicing-cost-conscious-shoulder-surgery
#5
REVIEW
Eric K Bonness, Laurence D Higgins
Second only to the knee, the shoulder is the most commonly reported area of chronic joint pain. By practicing evidence-based methods for improved outcomes at lower costs, providers can increase both efficiency and margin, while patients experience better care and higher satisfaction. Current cost studies on shoulder care provide a base for improving evidence-based care and improving value.
October 2018: Orthopedic Clinics of North America
https://www.readbyqxmd.com/read/30224011/cost-value-and-patient-satisfaction-in-carpal-tunnel-surgery
#6
REVIEW
Joseph Ingram, Benjamin M Mauck, Norfleet B Thompson, James H Calandruccio
The cost of carpal tunnel release (CTR) surgery can be decreased and patient satisfaction increased by a few relatively simple changes. Although cost estimates vary in the literature, most investigators agree that open CTR costs less than endoscopic CTR, and the clinic procedure room or ambulatory surgery center is cheaper than the ambulatory surgery center, which is less than the hospital. Patient satisfaction can be increased by making office visits more patient-centered and improving the quality of dialogue between the surgeon and patient...
October 2018: Orthopedic Clinics of North America
https://www.readbyqxmd.com/read/30224010/quality-safety-and-value-in-pediatric-spine-surgery
#7
REVIEW
Bayard C Carlson, Todd A Milbrandt, A Noelle Larson
The article addresses patient safety topics in spine surgery, including infection, length of stay, instrumentation strategies, pedicle screw malposition, radiation exposure, and neurologic events. Quality, safety, and value are concepts that are practical, easy to understand, and can be implemented on any scale and may be matched to individual practices. Further, with quality improvement, there is a culture shift to openly share information, protocols, and strategies so that more patients can rapidly benefit...
October 2018: Orthopedic Clinics of North America
https://www.readbyqxmd.com/read/30224009/standardization-of-care-of-common-pediatric-fractures
#8
REVIEW
Jaime Rice Denning, Kevin J Little
Distal radius fractures are the most common site of fracture in the pediatric population. Supracondylar humerus fractures are the most common pediatric elbow fracture. Although there is abundant literature discussing treatment and outcomes of these fractures, there is only emerging literature specifically discussing the variation in care among surgeons. There is need for standardization of these types of injuries to optimize the quality, safety, and value for patients. Quality improvement methodology differs from traditional research and is meant to be shared and used to implement changes quickly...
October 2018: Orthopedic Clinics of North America
https://www.readbyqxmd.com/read/30224008/perioperative-safety-keeping-our-children-safe-in-the-operating-room
#9
REVIEW
Kerwyn C Jones, Todd Ritzman
The entire operating room team is responsible for the safety of children in the operating room. As a leader in the operating room, the surgeon is impactful in ensuring that all team members are committed to providing this safe environment. This is achieved by the use of perioperative huddles or briefings, the use of appropriate surgical checklists, operating room standardization, surgeons proficient in the care they provide, and team members that embrace Just Culture.
October 2018: Orthopedic Clinics of North America
https://www.readbyqxmd.com/read/30224007/mri-safety-with-orthopedic-implants
#10
REVIEW
Zachary A Mosher, Jeffrey R Sawyer, Derek M Kelly
The literature within the last 10 years on MRI use in patients with orthopedic implants is reviewed. A literature search returned 15 relevant articles. Only 2 discussed pediatric patients. Overall, significant displacement of implants was infrequent. Radiofrequency-induced heating of implants differed among the studies, but most reported increases of less than 1°C. The authors conclude MRI is safe in patients with orthopedic implants because implant displacement and heating pose little risk to patients. A risk-to-benefit ratio is warranted, however, to assess the clinical utility and necessity of the study...
October 2018: Orthopedic Clinics of North America
https://www.readbyqxmd.com/read/30224006/the-role-of-business-education-in-the-orthopedic-curriculum
#11
REVIEW
Peter L Althausen, Kyle E Lybrand
The field of orthopedics is becoming increasingly complex as the demands for success are not merely clinical competence and good interpersonal skills. To achieve practice stability strategic planning, contract negotiation, health care law, practice management, health care economics, and personal finance are all needed skills. Unfortunately, most of these areas of professional growth require some basic background in business principles. This is an area that most recent residency graduates feel is neglected as a core educational competency...
October 2018: Orthopedic Clinics of North America
https://www.readbyqxmd.com/read/30224005/the-role-of-value-based-implants-in-orthopedic-trauma
#12
REVIEW
Kyle E Lybrand, Peter L Althausen
Health care costs in the United States continue to rise, and economic pressures influencing the care of the orthopedic trauma patient have never been greater. Value-based health care is vital to the survival of the current health care system, and the use of value-based implants is central to success. Value-based implants have similar clinical outcomes to conventional implants; however, multiple barriers exist. Despite biomechanical equivalence and significant cost savings, surgeons have difficultly changing implant use without financial incentive...
October 2018: Orthopedic Clinics of North America
https://www.readbyqxmd.com/read/30224004/osteolysis-as-it-pertains-to-total-hip-arthroplasty
#13
REVIEW
Brian Kurcz, Joseph Lyons, Zain Sayeed, Afshin A Anoushiravani, Richard Iorio
Osteolysis is a long-term complication of total hip arthroplasty (THA). As the projected number of THAs performed annually increases, osteolysis will likely continue to occur. However, because of advancements in prosthesis design, metallurgy, and enhanced bearing surfaces, fewer revision THAs will be linked to osteolysis and aseptic loosening. Despite these improvements, no preventative therapies are currently available for the management of osteolysis other than removing and replacing the source of bearing wear...
October 2018: Orthopedic Clinics of North America
https://www.readbyqxmd.com/read/30224003/walk-a-mile-in-the-leadership-s-shoes-why-focus-on-quality-improvement
#14
REVIEW
Anthony J Mells, Muhammad T Padela, Bilal Sleiman, Brett Chamernik, Bradley J Zarling, Zain Sayeed
Quality Improvement (QI) throughout health care in the United States continues to be of growing importance to both patients and providers. Leaders in health care including physicians, nurses, hospital administrators, and payors are all responsible for ensuring the continuation and growth of QI initiatives. This article will discuss various ways that healthcare leaders, with specific regard to orthopedic surgery, have utilized QI measures to provide better, more efficient, care to patients.
October 2018: Orthopedic Clinics of North America
https://www.readbyqxmd.com/read/30224002/professional-formation-of-physicians-focused-on-improving-care-how-do-we-get-there
#15
REVIEW
Siddartha Simha, Zain Sayeed, Muhammad T Padela, Alberto Criado, Karun Amar, Walid Yassir
As the Accreditation Council for Graduate Medical Education (ACGME) and National Academy of Medicine (NAM) increase emphasis on quality improvement (QI), continuing medical education must also adapt to meet these increasing demands. In fellowship programs and for attending physicians, QI initiatives exist but are more rare compared with initiatives during residency programs, and they are even more rare for orthopedic surgery residents, fellows, and attending physicians. A QI curriculum should be in place at all stages of continuing medical education, as they help meet the criteria of the ACGME and NAM and promote better clinical practice and minimize errors...
October 2018: Orthopedic Clinics of North America
https://www.readbyqxmd.com/read/30224001/improving-total-joint-replacement-with-continuous-quality-improvement-methods-and-tools
#16
REVIEW
Eric W Guo, Zain Sayeed, Muhammad T Padela, Mohsin Qazi, Mark Zekaj, Patrick Schaefer, Hussein F Darwiche
Faced with increasing pressure to reduce costs, hospitals must find new ways to eliminate waste while simultaneously maintaining the highest quality of care. For any institution, these can types of changes can be complex and burdensome. This article outlines several methods that have been successful in reducing costs while maintaining high quality and highlights feasible methodologies that can help health care providers implement new quality improvement protocols.
October 2018: Orthopedic Clinics of North America
https://www.readbyqxmd.com/read/30224000/the-role-of-patient-education-in-arthritis-management-the-utility-of-technology
#17
REVIEW
Thomas A Einhorn, Feroz A Osmani, Yousuf Sayeed, Raj Karia, Philip Band, Richard Iorio
Technologies continue to shape the path of medical treatment. Orthopedic surgeons benefit from becoming more aware of how twenty-first century information technology (IT) can benefit patients. The percentage of orthopedic patients utilizing IT resources is increasing, and new IT tools are becoming utilized. These include disease-specific applications. This article highlights the opportunity for developing IT tools applicable to the growing population of patients with osteoarthritis (OA), and presents a potential solution that can facilitate the way OA education and treatment are delivered, and thereby maximize efficiency for the health care system, the physician, and the patient...
October 2018: Orthopedic Clinics of North America
https://www.readbyqxmd.com/read/29929721/obesity
#18
EDITORIAL
Frederick M Azar
No abstract text is available yet for this article.
July 2018: Orthopedic Clinics of North America
https://www.readbyqxmd.com/read/29929720/foot-and-ankle-surgery-in-the-diabetic-population
#19
REVIEW
Aaron J Guyer
The surgical treatment of diabetic patients can be challenging. The physiologic and metabolic abnormalities seen in diabetic patients can adversely affect healing and outcomes in even the simplest of procedures. This article examines some of the special considerations in the treatment of diabetic patients undergoing foot and ankle surgeries.
July 2018: Orthopedic Clinics of North America
https://www.readbyqxmd.com/read/29929719/obesity-in-elective-foot-and-ankle-surgery
#20
REVIEW
Matthew Stewart
Obesity is a global health problem with significant economic and health consequences. There is very little literature in regards to obesity and its effect on foot and ankle surgery, and to the author's knowledge, there has been no consolidated review on this subject to date. The purpose of this article is to provide a comprehensive review as it pertains to foot and ankle surgery, with hopes of improving surgeon decision making, mitigating risk, and providing better outcomes for patients. A better understanding of the effects of obesity also allows for improved prognostic performance...
July 2018: Orthopedic Clinics of North America
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