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Operation theatre Quality improvement

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https://www.readbyqxmd.com/read/27770497/hospital-wide-implementation-of-an-electronic-workflow-solution-aiming-to-make-surgical-practice-improvement-easy
#1
Magdalena M Sakowska, Megan V Thomas, Saxon Connor, Ross Roberts
BACKGROUND: In measuring quality of health-care delivery, digital infrastructure is essential. The aim at this tertiary centre was to create a hospital-wide workflow system that collected data prospectively as part of daily practice. METHODS: In moving towards an electronic health record, a hospital-wide integrated workflow system was introduced in 2013, which electronically managed the perioperative patient journey while simultaneously facilitating surgical audit...
October 21, 2016: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/27762159/experience-of-plastic-surgery-registrars-in-a-european-working-time-directive-compliant-rota
#2
Catherine de Blacam, Sean Tierney, Odhran Shelley
BACKGROUND: Surgical training requires exposure to clinical decision-making and operative experience in a supervised environment. It is recognised that learning ability is compromised when fatigued. The European Working Time Directive requires a decrease in working hours, but compliance reduces trainees' clinical exposure, which has profound implications for plastic surgery training. The aim of this study was to evaluate plastic surgery registrars' experience of an EWTD-compliant rota, and to examine its impact on patient care, education, and logbook activity...
October 20, 2016: Journal of Plastic Surgery and Hand Surgery
https://www.readbyqxmd.com/read/27741109/patient-safety-walkaround-a-communication-tool-for-the-reallocation-of-health-service-resources-an-italian-experience-of-safety-healthcare-implementation
#3
Davide Ferorelli, Fiorenza Zotti, Silvio Tafuri, Angela Pezzolla, Alessandro Dell'Erba
The study aims to evaluate the use of Patient Safety Walkaround (SWR) execution model in an Italian Hospital, through the adoption of parametric indices, survey tools, and process indicators.In the 1st meeting an interview was conducted to verify the knowledge of concepts of clinical risk management (process indicators). One month after, the questions provided by Frankel (survey tool) were administered.Each month after, an SWR has been carried trying to assist the healthcare professionals and collecting suggestions and solutions...
October 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27667290/estimated-costs-before-during-and-after-the-introduction-of-the-emergency-laparotomy-pathway-quality-improvement-care-elpquic-bundle
#4
M O Eveleigh, T E Howes, C J Peden, T M Cook
Implementation of a quality improvement bundle for peri-operative management of emergency laparotomy (ELPQuIC) improved mortality in a previous study. We used data from one site that participated in that study to examine whether it was associated with the cost of care. We collected data from 396 patients: 144 before, 144 during and 108 after implementation of the bundle. We estimated costs incurred using previously published methodology based on the time the patient spent in hospital, in the operating theatre and in critical care...
November 2016: Anaesthesia
https://www.readbyqxmd.com/read/27580703/beyond-a-good-story-from-hawthorne-effect-to-reactivity-in-health-professions-education-research
#5
Elise Paradis, Gary Sutkin
CONTEXT: Observational research is increasingly being used in health professions education (HPE) research, yet it is often criticised for being prone to observer effects (also known as the Hawthorne Effect), defined as a research participant's altered behaviour in response to being observed. This article explores this concern. METHODS: First, this article briefly reviews the initial Hawthorne studies and the original formulation of the Hawthorne Effect, before turning to contemporary studies of the Hawthorne Effect in HPE and beyond...
August 31, 2016: Medical Education
https://www.readbyqxmd.com/read/27468732/a-cost-effectiveness-modelling-study-of-strategies-to-reduce-risk-of-infection-following-primary-hip-replacement-based-on-a-systematic-review
#6
Nicholas Graves, Catherine Wloch, Jennie Wilson, Adrian Barnett, Alex Sutton, Nicola Cooper, Katharina Merollini, Victoria McCreanor, Qinglu Cheng, Edward Burn, Theresa Lamagni, Andre Charlett
BACKGROUND: A deep infection of the surgical site is reported in 0.7% of all cases of total hip arthroplasty (THA). This often leads to revision surgery that is invasive, painful and costly. A range of strategies is employed in NHS hospitals to reduce risk, yet no economic analysis has been undertaken to compare the value for money of competing prevention strategies. OBJECTIVES: To compare the costs and health benefits of strategies that reduce the risk of deep infection following THA in NHS hospitals...
July 2016: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/27380050/-performance-development-of-a-university-operating-room-after-implementation-of-a-central-operating-room-management
#7
R M Waeschle, B Sliwa, M Jipp, H Pütz, J Hinz, M Bauer
The difficult financial situation in German hospitals requires measures for improvement in process quality. Associated increases in revenues in the high income field "operating room (OR) area" are increasingly the responsibility of OR management but it has not been shown that the introduction of an efficiency-oriented management leads to an increase in process quality and revenues in the operating theatre. Therefore the performance in the operating theatre of the University Medical Center Göttingen was analyzed for working days in the core operating time from 7...
August 2016: Der Anaesthesist
https://www.readbyqxmd.com/read/27282082/mandibular-fractures-towards-a-national-standard-for-time-to-theatre-national-audit-by-the-baoms-trauma-specialist-interest-group
#8
H Katsarelis, Tfa Lees, Nmh McLeod
Recent studies have shown that in most patients, a delay of several days in the treatment of mandibular fractures is not associated with adverse outcomes, and this has challenged the traditional practice of recommending treatment within 24hours. Longer hospital stays cost more and lower the patients' quality of life, but we know of no standard recommendation about when these patients should be treated. Our aim therefore was to find out how many patients had reduction and fixation of a fractured mandible by the end of the next working day, with a view to developing a national standard...
September 2016: British Journal of Oral & Maxillofacial Surgery
https://www.readbyqxmd.com/read/27193477/is-a-computer-assisted-design-and-computer-assisted-manufacturing-method-for-mandibular-reconstruction-economically-viable
#9
Achille Tarsitano, Salvatore Battaglia, Salvatore Crimi, Leonardo Ciocca, Roberto Scotti, Claudio Marchetti
The design and manufacture of patient-specific mandibular reconstruction plates, particularly in combination with cutting guides, has created many new opportunities for the planning and implementation of mandibular reconstruction. Although this surgical method is being used more widely and the outcomes appear to be improved, the question of the additional cost has to be discussed. To evaluate the cost generated by the management of this technology, we studied a cohort of patients treated for mandibular neoplasms...
July 2016: Journal of Cranio-maxillo-facial Surgery
https://www.readbyqxmd.com/read/27158497/introducing-paediatric-grommet-rapid-turnover-lists-a-quality-improvement-project
#10
Rachel Easto, Rishi Shukla, Charlie Rowland, Richard Williams
Paediatric grommet insertions are a common ENT procedure which is typically carried out as a daycase procedure. National guidelines exist (NICE CG60) outlining the criteria for grommet insertions. At our institution it was noted that children were experiencing long waits for their grommet surgery with 78% breaching the national 18 week RTT target by time of surgery in the preceding 6 months. 38% of children were attending for surgery with out of date audiograms and as a consequence, due to children no longer meeting the NICE criteria for grommet insertions, 8% of children were being cancelled on the day of surgery...
2016: BMJ Quality Improvement Reports
https://www.readbyqxmd.com/read/27116583/a-simple-intervention-to-improve-patient-safety-save-time-and-improve-staff-experience-in-the-amu-procedure-room
#11
Gary Peter Misselbrook, Juliane Kause, Su-Ann Yeoh
Over the last decade, operating theatres and Intensive Care Units (ICUs) have established systematic methods for performing procedures on patients that have been shown to reduce complications and improve patient safety. Whilst the use of procedure rooms on Acute Medicine Units (AMUs) is highly recommended by patient safety groups and Royal College publications, they are not universally available or appropriately utilised. In this article we discuss a quality improvement project that was undertaken on an AMU at a large university teaching hospital in the United Kingdom, highlighting its successes and challenges...
2016: Acute Medicine
https://www.readbyqxmd.com/read/27069827/the-impact-of-long-term-institutional-collaboration-in-surgical-training-on-trauma-care-in-malawi
#12
Sven Young, Leonard Banza, Nyengo Mkandawire
BACKGROUND: Attempts to address the huge, and unmet, need for surgical services in Africa by training surgical specialists in well established training programmes in high-income countries have resulted in brain drain, as most trainees do not return home on completion of training for various reasons. Local postgraduate training is key to retaining specialists in their home countries. International institutional collaborations have enabled Kamuzu Central Hospital (KCH) in Lilongwe, Malawi, to start training their own surgical specialists from 2009...
2016: SpringerPlus
https://www.readbyqxmd.com/read/27066972/non-technical-skills-in-minimally-invasive-surgery-teams-a-systematic-review
#13
Kirsten Gjeraa, Lene Spanager, Lars Konge, René H Petersen, Doris Østergaard
BACKGROUND: Root cause analyses show that up to 70 % of adverse events are caused by human error. Strong non-technical skills (NTS) can prevent or reduce these errors, considerable numbers of which occur in the operating theatre. Minimally invasive surgery (MIS) requires manipulation of more complex equipment than open procedures, likely requiring a different set of NTS for each kind of team. The aims of this study were to identify the MIS teams' key NTS and investigate the effect of training and assessment of NTS on MIS teams...
December 2016: Surgical Endoscopy
https://www.readbyqxmd.com/read/27004503/bar-code-based-management-to-enhance-efficiency-of-a-sterile-supply-unit-in-singapore
#14
Meh Meh Goh, Agnes B H Tan, Mike H W Leong
Sterile surgical instruments are essential for successful surgical outcomes. The Singapore General Hospital's Theatre Sterile Supplies Unit (TSSU) has faced many challenges, including increasing demand for instruments and the need to maintain instruments of greater complexity. To address these challenges, stakeholders from key departments at Singapore General Hospital formed a multidisciplinary team to transform operations in the TSSU. The team adopted and implemented the TSSU Instrument Management System (TIMS) in three phases over five years...
April 2016: AORN Journal
https://www.readbyqxmd.com/read/26981239/clinical-audit-of-ankle-fracture-management-in-the-elderly
#15
Langhit Kurar
INTRODUCTION: Ankle fractures in the osteoporotic patient are challenging injuries to manage, due to a combination of poor soft tissue, peripheral vascular disease and increased bone fragility, often resulting in more complex fracture patterns. I aim to audit current practice and introduce change by producing recommendations to help improve longer-term functional outcomes. PATIENTS AND METHODS: A retrospective 3-week audit was conducted reviewing results of ankle fracture management in 50 patients aged between 50 and 80 years...
March 2016: Annals of Medicine and Surgery
https://www.readbyqxmd.com/read/26897914/quality-indicators-and-outcomes-of-emergency-caesarean-deliveries-at-a-district-level-maternity-hospital
#16
Melike Harfouche, Mina Hosseinipour, Stephen Kaliti, Jeffrey Wilkinson
The objective of this research study is to identify quality indicators of cesarean deliveries and determine their relationship to neonatal and maternal morbidity and mortality in one high volume maternity hospital in Lilongwe, Malawi. Demographic, perioperative, and postoperative data were collected on all cesarean deliveries over three months. Indicators of quality (antibiotic administration, use of oxytocin, decision-to-incision time, and uterine incision type) were compared to maternal morbidities (postpartum hemorrhage, fistula and wound infection) and neonatal mortality...
September 2015: African Journal of Reproductive Health
https://www.readbyqxmd.com/read/26709678/combining-systems-and-teamwork-approaches-to-enhance-the-effectiveness-of-safety-improvement-interventions-in-surgery-the-safer-delivery-of-surgical-services-s3-program
#17
Peter McCulloch, Lauren Morgan, Steve New, Ken Catchpole, Eleanor Roberston, Mohammed Hadi, Sharon Pickering, Gary Collins, Damian Griffin
IMPORTANCE: Patient safety improvement interventions usually address either work systems or team culture. We do not know which is more effective, or whether combining approaches is beneficial. OBJECTIVE: To compare improvement in surgical team performance after interventions addressing teamwork culture, work systems, or both. DESIGN: Suite of 5 identical controlled before-after intervention studies, with preplanned analysis of pooled data for indirect comparisons of strategies...
December 22, 2015: Annals of Surgery
https://www.readbyqxmd.com/read/26614537/what-is-the-impact-of-multidisciplinary-team-simulation-training-on-team-performance-and-efficiency-of-patient-care-an-integrative-review
#18
REVIEW
Margaret Murphy, Kate Curtis, Andrea McCloughen
BACKGROUND: In hospital emergencies require a structured team approach to facilitate simultaneous input into immediate resuscitation, stabilisation and prioritisation of care. Efforts to improve teamwork in the health care context include multidisciplinary simulation-based resuscitation team training, yet there is limited evidence demonstrating the value of these programmes.(1) We aimed to determine the current state of knowledge about the key components and impacts of multidisciplinary simulation-based resuscitation team training by conducting an integrative review of the literature...
February 2016: Australasian Emergency Nursing Journal: AENJ
https://www.readbyqxmd.com/read/26381643/quality-improvement-in-surgery-combining-lean-improvement-methods-with-teamwork-training-a-controlled-before-after-study
#19
Eleanor Robertson, Lauren Morgan, Steve New, Sharon Pickering, Mohammed Hadi, Gary Collins, Oliver Rivero Arias, Damian Griffin, Peter McCulloch
BACKGROUND: To investigate the effectiveness of combining teamwork training and lean process improvement, two distinct approaches to improving surgical safety. We conducted a controlled interrupted time series study in a specialist UK Orthopaedic hospital incorporating a plastic surgery team (which received the intervention) and an Orthopaedic theatre team acting as a control. STUDY DESIGN: We used a 3 month intervention with 3 months data collection period before and after it...
2015: PloS One
https://www.readbyqxmd.com/read/26380184/improving-the-pathologic-evaluation-of-lung-cancer-resection-specimens
#20
Raymond U Osarogiagbon, Holly L Hilsenbeck, Elizabeth W Sales, Allen Berry, Robert W Jarrett, Christopher S Giampapa, Clara N Finch-Cruz, David Spencer
Accurate post-operative prognostication and management heavily depend on pathologic nodal stage. Patients with nodal metastasis benefit from post-operative adjuvant chemotherapy, those with mediastinal nodal involvement may also benefit from adjuvant radiation therapy. However, the quality of pathologic nodal staging varies significantly, with major survival implications in large populations of patients. We describe the quality gap in pathologic nodal staging, and provide evidence of its potential reversibility by targeted corrective interventions...
August 2015: Translational Lung Cancer Research
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