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Operation theatre Quality improvement

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https://www.readbyqxmd.com/read/28546703/histological-surprises-in-benign-cytologies-after-lymph-node-biopsy-surgeon-s-knife-improving-patient-care
#1
Mario Victor Newton, Rakesh S Ramesh, Suraj Manjunath, K ShivaKumar, Hemanth G Nanjappa, Ramu Damuluri, Elvis Peter Joseph, C Prasad
Lymphadenopathy can be due to multitude of causes. Owing to the high prevalence of infectious diseases in India, and malignancy being a life threatening cause for lymphadenopathy; accurate diagnosis is important in preventing delay or misdiagnosis and in improving patient care, thereby increasing longevity with quality. Fine needle aspiration cytology (FNAC) is the first line investigation commonly done. Should the doctor be contented with the benign FNAC or is a lymph node biopsy needed in this age? The aims of this study are the following: (1) to study the spectral pattern of lymph node biopsies done in a surgical oncology unit of tertiary care centre, (2) to assess the yield of malignant cases from lymph node biopsy and (3) to compare the reliability of benign FNAC with lymph node biopsy...
June 2017: Indian Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28524382/an-observational-study-of-patient-care-outcomes-sensitive-to-handover-quality-in-the-post-anaesthetic-care-unit
#2
Nichole Lillibridge, Mari Botti, Beverley Wood, Bernice Redley
AIMS AND OBJECTIVES: To identify patient care outcome indicators sensitive to the quality of interprofessional handover between the anaesthetist and the Post-Anaesthetic Care Unit nurse. BACKGROUND: The relationship between interprofessional clinical handover when patients are transferred from the operating theatre to the Post-Anaesthetic Care Unit and patient outcomes of subsequent patient care delivery is not well understood. DESIGN: Naturalistic, exploratory descriptive design using observation...
May 19, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28523364/-structured-patient-handovers-in-perioperative-medicine-rationale-and-implementation-in-clinical-practice
#3
M J Merkel, V von Dossow, B Zwißler
Clear and consistent communication is pivotal for well-functioning teamwork, in operating theatres as well as intensive care units. However, patient handovers significantly vary between specialties and locations. If communication is not well structured, it might increase the risk for mishaps and malpractice. Therefore, implementing structured handover protocols is pivotal. The perioperative setting is a high-risk environment that is prone to communication failures due to operational design (frequent change of shift due to working time restrictions) and a high work load and multitasking (operating room management, short surgery times, concurrent emergencies)...
May 18, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28498785/laparoscopic-adrenalectomy-for-conn-s-syndrome-is-beneficial-to-patients-and-is-cost-effective-in-england
#4
Ioannis Christakis, John A Livesey, Gregory P Sadler, Radu Mihai
PURPOSE: Adrenalectomy has the potential to cure or improve the control of hypertension in patients with primary hyperaldosteronism due to unilateral adrenal adenoma (Conn's syndrome). This study assesses the patients' perception of, and costs associated with, laparoscopic adrenalectomy for Conn's syndrome. MATERIALS AND METHODS: Clinical, radiological, operative, and pathological data were collected on patients undergoing adrenalectomy for Conn's syndrome over 8-years period in a UK tertiary referral center...
May 12, 2017: Journal of Investigative Surgery: the Official Journal of the Academy of Surgical Research
https://www.readbyqxmd.com/read/28414959/the-visualization-of-the-surgical-field-in-tubular-assisted-spine-surgery-is-there-a-difference-between-hd-endoscopy-and-microscopy
#5
Benedikt W Burkhardt, M Wilmes, Salman Sharif, Joachim M Oertel
OBJECTIVE: Expert spinal surgeons criticized endoscopic procedures for poor image quality, in comparison to microscopic visualization. The recent introduction of high definition (HD) digital cameras has shown good results in spinal endoscopy. The aim of this study was to assess endoscopic HD image quality in comparison with microscopic visualization. PATIENTS AND METHODS: All posterior lumbar and cervical spinal surgeries of this study were performed with the EasyGO-system in HD resolution...
April 11, 2017: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/28348262/rare-progression-of-cholangiocarcinoma-distal-femoral-metastasis
#6
Sam A MacKenzie, Joaquim Stanislas Olivier Goffin, Conor Rankin, Tom Carter
Cholangiocarcinoma (CCA) is a rare cancer of the bile duct epithelial cells, with metastases to long bones rarely reported. We present the case of a woman aged 61 years, diagnosed with CCA 6 years previously. She presented with right thigh discomfort, rapidly progressing to immobility with severe pain. Radiological investigations revealed a lytic lesion in her right distal femur, most likely a metastatic deposit, at high risk of pathological fracture. This was managed with an en bloc resection and implantation of a distal femoral replacement...
March 27, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28281432/the-impact-of-a-modified-world-health-organization-surgical-safety-checklist-on-maternal-outcomes-in-a-south-african-setting-a-stratified-cluster-randomised-controlled-trial
#7
M Naidoo, J Moodley, P Gathiram, B Sartorius
BACKGROUND: In South Africa (SA), the Saving Mothers Reports have shown an alarming increase in deaths during or after caesarean delivery. OBJECTIVE: To improve maternal surgical safety in KwaZulu-Natal Province, SA, by implementing the modified World Health Organization surgical safety checklist for maternity care (MSSCL) in maternity operating theatres. METHODS: The study was a stratified cluster-randomised controlled trial conducted from March to November 2013...
February 27, 2017: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
https://www.readbyqxmd.com/read/28247111/prospective-review-of-30-day-morbidity-and-mortality-in-a-paediatric-neurosurgical-unit
#8
REVIEW
Emer Campbell, Thomas Beez, Lorraine Todd
PURPOSE: The purpose of this study is to record the 30-day and inpatient morbidity and mortality in paediatric patients in a tertiary neuroscience centre over a 2-year period. The intentions were to establish the frequency of significant adverse events, review the current published rates of morbidity in paediatric neurosurgical patients and propose three clinical indicators for future comparison. METHODS: All deaths and adverse events were prospectively recorded from 1 January 2014 to 31 December 2015...
March 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28243441/improving-theatre-turnaround-time
#9
Daniel Fletcher, David Edwards, Stephen Tolchard, Richard Baker, James Berstock
The NHS Institute for Innovation and Improvement has determined that a £7 million saving can be achieved per trust by improving theatre efficiency. The aim of this quality improvement project was to improve orthopaedic theatre turnaround without compromising the patient safety. We process mapped all the stages from application of dressing to knife to skin on the next patient in order to identify potential areas for improvement. Several suggestions arose which were tested in multiple PDSA cycles in a single theatre...
2017: BMJ Quality Improvement Reports
https://www.readbyqxmd.com/read/28228966/objective-image-analysis-of-real-time-three-dimensional-intraoperative-ultrasound-for-intrinsic-brain-tumour-surgery
#10
Sophie J Camp, Vasileios Apostolopoulos, Vasileios Raptopoulos, Amrish Mehta, Kevin O'Neill, Mohammed Awad, Babar Vaqas, David Peterson, Federico Roncaroli, Dipankar Nandi
BACKGROUND: There is growing evidence that maximal surgical resection of primary intrinsic brain tumours is beneficial, both by improving progression free and overall survival and also by facilitating postoperative chemotherapy and radiotherapy. Hence, there has been an increase in the popularity of real-time intraoperative imaging in brain tumour surgery. The complex theatre arrangements, prohibitive cost and prolonged theatre time of intraoperative MRI have restricted its application...
2017: Journal of Therapeutic Ultrasound
https://www.readbyqxmd.com/read/28165791/improving-documentation-in-surgical-operation-notes
#11
Hammad Parwaiz, Rushan Perera, John Creamer, Hamish Macdonald, Ian Hunter
BACKGROUND: Accurate documentation in surgical operation notes is crucial in facilitating the postoperative care of surgical patients and forms an important medicolegal document. This study audited the quality and completeness of documentation in surgical operation notes at a single district general hospital against the Royal College of Surgeons (2014) Good Surgical Practice guidelines, and looked to improve clinical practice through improved compliance with these guidelines. METHOD: A total of 101 operation notes were audited from a variety of surgical specialities in November 2014 (cycle 1) and 100 notes in May 2015 (cycle 2)...
February 2, 2017: British Journal of Hospital Medicine
https://www.readbyqxmd.com/read/28121035/recent-developments-in-the-surgical-management-of-complex-intra-abdominal-infection
#12
REVIEW
M Soop, G L Carlson
BACKGROUND: Current guidance on the management of sepsis often applies to infection originating from abdominal or pelvic sources, which presents specific challenges and opportunities for efficient and rapid source control. Advances made in the past decade are presented in this article. METHODS: A qualitative systematic review was undertaken by searching standard literature databases for English-language studies presenting original data on the clinical management of abdominal and pelvic complex infection in adults over the past 10 years...
January 2017: British Journal of Surgery
https://www.readbyqxmd.com/read/28067569/optimizing-postoperative-handover-to-the-intensive-care-unit-at-a-tertiary-centre
#13
Shankar Kumar, Andrew R McKean, Andrew Ramwell, Carolyn Johnston, Susannah Leaver
BACKGROUND: Comprehensive handover of patients transferred from operating theatre to the intensive care unit is crucial in ensuring ongoing quality and safety of care. Handover in this setting poses unique challenges, yet few studies have considered or tested approaches to improve the process. A quality improvement project was undertaken to assess and improve the quality of information transfer during the handover of postoperative patients to the general intensive care unit at a tertiary centre...
January 2, 2017: British Journal of Hospital Medicine
https://www.readbyqxmd.com/read/28009731/combining-systems-and-teamwork-approaches-to-enhance-the-effectiveness-of-safety-improvement-interventions-in-surgery-the-safer-delivery-of-surgical-services-s3-program
#14
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...
January 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28003798/a-patient-preference-cohort-study-of-office-versus-inpatient-uterine-polyp-treatment-for-abnormal-uterine-bleeding
#15
Natalie A M Cooper, Lee Middleton, Paul Smith, Elaine Denny, Lynda Stobert, Jane Daniels, T Justin Clark
Uterine polyps can cause abnormal bleeding in women. Conventional practise is to remove them under general anaesthesia but advances in technology have made it possible to perform polypectomy in the office setting. We conducted a patient-preference study to explore women's preferences for treatment setting and to evaluate the effectiveness and treatment experience of women undergoing uterine polypectomy. Three hundred ninety-nine women with abnormal uterine bleeding who were found to have uterine polyps at diagnostic hysteroscopy were recruited...
2016: Gynecological Surgery
https://www.readbyqxmd.com/read/27770497/hospital-wide-implementation-of-an-electronic-workflow-solution-aiming-to-make-surgical-practice-improvement-easy
#16
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...
March 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/27762159/experience-of-plastic-surgery-registrars-in-a-european-working-time-directive-compliant-rota
#17
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
#18
MULTICENTER STUDY
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
#19
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
#20
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...
January 2017: Medical Education
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