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https://www.readbyqxmd.com/read/28319519/process-improvement-initiative-for-the-perioperative-management-of-patients-with-a-cardiovascular-implantable-electronic-device
#1
Margaret K Menzel Ellis, Miriam M Treggiari, Jamie M Robertson, Marc A Rozner, Peter F Graven, Michael F Aziz, Matthias J Merkel, Edward A Kahl, Norman A Cohen, Eric C Stecker, Peter M Schulman
BACKGROUND: Economic, personnel, and procedural challenges often complicate and interfere with efficient and safe perioperative care of patients with cardiovascular implantable electronic devices (CIEDs). In the context of a process improvement initiative, we created and implemented a comprehensive anesthesiologist-run perioperative CIED service to respond to all routine requests for perioperative CIED consultations at a large academic medical center. This study was designed to determine whether this new care model was associated with improved operating room efficiency, reduced institutional cost, and adequate patient safety...
March 17, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28306212/tracheal-extubation-practices-following-adenotonsillectomy-in-children-effects-on-operating-room-efficiency-between-two-institutions
#2
Hiromi Kako, Marco Corridore, Sarah Seo, Charles Elmaraghy, Meredith Lind, Joseph D Tobias
BACKGROUND: Adenotonsillectomy is one of the most commonly performed operative procedures in children. It is imperative to find the most efficient and cost-effective methods of practice to facilitate operating room management while maintaining patient safety. We investigated the efficiency of two different approaches of tracheal extubation in pediatric patients following adenotonsillectomy at two tertiary care pediatric hospitals with large surgical volumes. The primary aim of the study was to determine the difference in the operating room time according to the institutional practice of tracheal extubation in the postanesthesia care unit (PACU) as compared to the operating room...
March 17, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28299272/three-dimensional-planning-in-craniomaxillofacial-surgery
#3
Josep Rubio-Palau, Alejandra Prieto-Gundin, Asteria Albert Cazalla, Miguel Bejarano Serrano, Gemma Garcia Fructuoso, Francisco Parri Ferrandis, Alejandro Rivera Baró
INTRODUCTION: Three-dimensional (3D) planning in oral and maxillofacial surgery has become a standard in the planification of a variety of conditions such as dental implants and orthognathic surgery. By using custom-made cutting and positioning guides, the virtual surgery is exported to the operating room, increasing precision and improving results. MATERIALS AND METHODS: We present our experience in the treatment of craniofacial deformities with 3D planning. Software to plan the different procedures has been selected for each case, depending on the procedure (Nobel Clinician, Kodak 3DS, Simplant O&O, Dolphin 3D, Timeus, Mimics and 3-Matic)...
July 2016: Annals of Maxillofacial Surgery
https://www.readbyqxmd.com/read/28296715/evaluating-the-use-of-tissue-oximetry-to-decrease-intensive-unit-monitoring-for-free-flap-breast-reconstruction
#4
Joseph A Ricci, Christina R Vargas, Olivia A Ho, Samuel J Lin, Adam M Tobias, Bernard T Lee
BACKGROUND: Postoperative free flap care has historically required intensive monitoring for 24 hours in an intensive care unit. Continuous monitoring with tissue oximetry has allowed earlier detection of vascular compromise, decreasing flap loss and improving salvage. This study aims to identify whether a fast-track postoperative paradigm can be safely used with tissue oximetry to decrease intensive monitoring and costs. MATERIALS AND METHODS: All consecutive microsurgical breast reconstructions performed at a single institution were reviewed (2008-2014) and cases requiring return to the operating room were identified...
March 14, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28290954/improving-surgical-complications-and-patient-safety-at-the-nation-s-largest-military-hospital-an-analysis-of-national-surgical-quality-improvement-program-data
#5
Steve Maturo, Charlotte Hughes, George Kallingal, Stephen Silvey, A J Johnson, Douglas Soderdahl, Evan Renz, Joseph Brennan
INTRODUCTION: The U.S. Military Health System cares for over 9 million patients and encompasses 63 hospitals and 413 clinics worldwide. Military medicine balances the simultaneous tasks of caring for those patients wounded in military engagements, treating large numbers of families of service men and women, and training the next generation of health care providers and ancillary staff. Similar to civilian health care delivery in the United States, military medicine has also seen increased scrutiny in the areas of cost and quality...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28288637/exploring-implementation-practices-in-results-based-financing-the-case-of-the-verification-in-benin
#6
Matthieu Antony, Maria Paola Bertone, Olivier Barthes
BACKGROUND: Results-based financing (RBF) has been introduced in many countries across Africa and a growing literature is building around the assessment of their impact. These studies are usually quantitative and often silent on the paths and processes through which results are achieved and on the wider health system effects of RBF. To address this gap, our study aims at exploring the implementation of an RBF pilot in Benin, focusing on the verification of results. METHODS: The study is based on action research carried out by authors involved in the pilot as part of the agency supporting the RBF implementation in Benin...
March 14, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28287015/cost-consequence-analysis-of-two-different-active-flowable-hemostatic-matrices-in-spine-surgery-patients
#7
D Makhija, M Rock, S Ikeme, E Kuntze, J D Epstein, G Nicholson, J S Price, V Patel
OBJECTIVES: A recently published retrospective analysis comparing two different active flowable hemostatic matrices (FLOSEAL and SURGIFLO Kit with Thrombin) showed significantly increased resource use and complications (surgery time, risk of blood product transfusion, and amount of matrix used) with SURGIFLO use compared to FLOSEAL in major spine surgery, and also significantly increased surgical time with SURGIFLO use in severe spine surgery. This analysis was developed as a follow-up to this prior analysis, to evaluate the cost-consequence of using FLOSEAL vs SURGIFLO in major and severe spine surgery...
March 12, 2017: Journal of Medical Economics
https://www.readbyqxmd.com/read/28279396/reprocessed-bipolar-energy-for-laparoscopic-colectomy-is-it-worth-it
#8
Justin T Brady, Avinash Bhakta, Scott R Steele, Joseph A Trunzo, Anthony J Senagore, Krista Holmgren, Anthony Schillero, Bradley J Champagne
BACKGROUND: Reprocessed (re-sterilized) bipolar energy devices represent one effort to reduce operative costs. METHODS: Between January 2014 to October 2015, 76 patients underwent laparoscopic colectomy using a reprocessed bipolar energy device and were case-matched to 76 patients from a prospectively-maintained database from November 2012 to December 2013 when an identical, new device was used. Outcomes included reprocessed device safety, efficiency and hospital costs...
February 20, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28270023/comparison-of-economic-and-clinical-outcomes-between-patients-undergoing-laparoscopic-bariatric-surgery-with-powered-versus-manual-endoscopic-surgical-staplers
#9
Sanjoy Roy, Andrew Yoo, Sashi Yadalam, Elliott J Fegelman, Iftekhar Kalsekar, Stephen S Johnston
AIMS: To compare economic and clinical outcomes between patients undergoing laparoscopic Roux-en-Y gastric bypass (LRY) or laparoscopic sleeve gastrectomy (LSG) with use of powered vs manual endoscopic surgical staplers. MATERIALS AND METHODS: Patients (aged ≥21 years) who underwent LRY or LSG during a hospital admission (January 1, 2012-September 30, 2015) were identified from the Premier Perspective Hospital Database. Use of powered vs manual staplers was identified from hospital administrative billing records...
April 2017: Journal of Medical Economics
https://www.readbyqxmd.com/read/28269351/an-rf-based-wearable-sensor-system-for-indoor-tracking-to-facilitate-efficient-healthcare-management
#10
Yuzhe Ouyang, Kai Shan, Francis Minhthang Bui
To understand the utilization of clinical resources and improve the efficiency of healthcare, it is often necessary to accurately locate patients and doctors in a healthcare facility. However, existing tracking methods, such as GPS, Wi-Fi and RFID, have technological drawbacks or impose significant costs, thus limiting their applications in many clinical environments, especially those with indoor enclosures. This paper proposes a low-cost and flexible tracking system that is well suited for operating in an indoor environment...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28262903/an-efficient-route-to-fabricate-fatigue-free-p-vdf-trfe-capacitors-with-enhanced-piezoelectric-and-ferroelectric-properties-and-excellent-thermal-stability-for-sensing-and-memory-applications
#11
Deepa Singh, Deepak, Ashish Garg
P(VDF-TrFE), the best known ferroelectric polymer, suffers from a rather low piezoelectric response as well as poor electrical fatigue life, hampering its application potential. Herein, we report the fabrication of fatigue free poly(vinylidenedifluoride-trifluoroethylene) P(VDF-TrFE)-based capacitors with record piezoelectric coefficients and excellent thermal stability. We proposed a cost-effective and simple solution-based process to fabricate P(VDF-TrFE)-based memory capacitors with large polarization (8...
March 6, 2017: Physical Chemistry Chemical Physics: PCCP
https://www.readbyqxmd.com/read/28244907/oral-and-intravenous-tranexamic-acid-are-equivalent-at-reducing-blood-loss-following-total-hip-arthroplasty-a-randomized-controlled-trial
#12
RANDOMIZED CONTROLLED TRIAL
Erdan Kayupov, Yale A Fillingham, Kamil Okroj, Darren R Plummer, Mario Moric, Tad L Gerlinger, Craig J Della Valle
BACKGROUND: Tranexamic acid is an antifibrinolytic that has been shown to reduce blood loss and the need for transfusions when administered intravenously in total hip arthroplasty. Oral formulations of the drug are available at a fraction of the cost of the intravenous preparation. The purpose of this randomized controlled trial was to determine if oral and intravenous formulations of tranexamic acid have equivalent blood-sparing properties. METHODS: In this double-blinded trial, 89 patients undergoing primary total hip arthroplasty were randomized to receive 1...
March 1, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28240718/a-peripherally-inserted-central-catheter-line-inserted-the-day-before-surgery-decreases-the-time-from-induction-to-incision-for-spinal-deformity-surgery-and-safely-provides-central-venous-access-during-surgery-a-pilot-study
#13
Anne E Stuedemann, Richard M Schwend, Valorie K Thomas, Julia M Leamon, Tammy S Lightner
Pediatric patients undergoing surgery for spinal deformity may benefit from central venous access to provide intraoperative monitoring and fluid resuscitation. For pediatric surgical patients requiring central access, we hypothesized that placing a peripherally inserted central catheter (PICC) line preoperatively should decrease time from induction of anesthesia to incision and result in improved patient safety and decreased operating room charges. This was a retrospective, nonrandomized, and case comparison study...
February 24, 2017: Journal of Pediatric Orthopedics. Part B
https://www.readbyqxmd.com/read/28230583/evaluating-the-impact-of-radio-frequency-identification-retained-surgical-instruments-tracking-on-patient-safety-literature-review
#14
Kumiko O Schnock, Bonnie Biggs, Anne Fladger, David W Bates, Ronen Rozenblum
BACKGROUND: Retained surgical instruments (RSI) are one of the most serious preventable complications in operating room settings, potentially leading to profound adverse effects for patients, as well as costly legal and financial consequences for hospitals. Safety measures to eliminate RSIs have been widely adopted in the United States and abroad, but despite widespread efforts, medical errors with RSI have not been eliminated. OBJECTIVE: Through a systematic review of recent studies, we aimed to identify the impact of radio frequency identification (RFID) technology on reducing RSI errors and improving patient safety...
February 22, 2017: Journal of Patient Safety
https://www.readbyqxmd.com/read/28227593/an-rf-based-wearable-sensor-system-for-indoor-tracking-to-facilitate-efficient-healthcare-management
#15
Yuzhe Ouyang, Kai Shan, Francis Minhthang Bui, Yuzhe Ouyang, Kai Shan, Francis Minhthang Bui, Yuzhe Ouyang, Kai Shan, Francis Minhthang Bui
To understand the utilization of clinical resources and improve the efficiency of healthcare, it is often necessary to accurately locate patients and doctors in a healthcare facility. However, existing tracking methods, such as GPS, Wi-Fi and RFID, have technological drawbacks or impose significant costs, thus limiting their applications in many clinical environments, especially those with indoor enclosures. This paper proposes a low-cost and flexible tracking system that is well suited for operating in an indoor environment...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28223876/evaluation-of-the-impact-of-a-prescribing-guideline-on-the-use-of-intraoperative-dexmedetomidine-at-a-tertiary-academic-medical-center
#16
Abdullah M Alhammad, Nour A Baghdady, Rachel A Mullin, Bonnie C Greenwood
Objective: To evaluate usage patterns of dexmedetomidine in the operating room after implementation of a prescribing guideline. Methods: We conducted a retrospective analysis to evaluate the impact of a prescribing guideline on usage patterns of dexmedetomidine in the operating room at a tertiary, academic medical center during one-month period pre- (July 2010) and post-guideline (July 2011 and July 2012) implementation. Results: A total of 267 patients received intraoperative dexmedetomidine during the study period...
January 2017: Saudi Pharmaceutical Journal: SPJ: the Official Publication of the Saudi Pharmaceutical Society
https://www.readbyqxmd.com/read/28219447/medialization-thyroplasty-versus-injection-laryngoplasty-a-cost-minimization-analysis
#17
Samantha Tam, Hongmei Sun, Sisira Sarma, Jennifer Siu, Kevin Fung, Leigh Sowerby
BACKGROUND: Medialization thyroplasty and injection laryngoplasty are widely accepted treatment options for unilateral vocal fold paralysis. Although both procedures result in similar clinical outcomes, little is known about the corresponding medical care costs. Medialization thyroplasty requires expensive operating room resources while injection laryngoplasty utilizes outpatient resources but may require repeated procedures. The purpose of this study, therefore, is to quantify the cost differences in adult patients with unilateral vocal fold paralysis undergoing medialization thyroplasty versus injection laryngoplasty...
February 20, 2017: Journal of Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/28212911/the-effect-of-instructional-supervision-by-an-operating-room-assistant-on-first-case-starts
#18
Xiaohua Pan, Jun Zhang, Chen Dai, Yibing Si
BACKGROUND: Delays in starting first cases of the day are a common topic associated with high economic costs. PURPOSE: This study aimed to determine if an operating room (OR) assistant using an instructional supervision program could reduce the tardiness of first-case starts. DESIGN: A prospective study was conducted. Data from four ORs were used to compare the effectiveness of an instructional intervention to reduce delays in starting first cases of the day...
February 2017: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
https://www.readbyqxmd.com/read/28203537/robotic-cardiac-surgery-in-brazil
#19
Robinson Poffo, Alisson P Toschi, Renato B Pope, Paola K Montanhesi, Ricardo S Santos, Alexandre Teruya, Dina M Hatanaka, Gabriel F Rusca, Claudio H Fischer, Marcelo C Vieira, Marcia R Makdisse
BACKGROUND: Brazil, the largest country and economy in South America, is a major driving force behind the development of new medical technologies in the region. Robotic cardiac surgery (RCS) has been evolving rapidly since 2010, when the first surgery using the DaVinci(®) robotic system was performed in Latin America. The aim of this article is to evaluate short and mid-term results in patients undergoing robotic cardiac surgery in Brazil. METHODS: From March 2010 to December 2015, 39 consecutive patients underwent robotic cardiac surgery...
January 2017: Annals of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/28197142/home-made-cost-effective-preservation-buffer-is-a-better-alternative-to-commercial-preservation-methods-for-microbiome-research
#20
Sebastian Menke, Mark A F Gillingham, Kerstin Wilhelm, Simone Sommer
The investigation of wildlife gastrointestinal microbiomes by next-generation sequencing approaches is a growing field in microbial ecology and conservation. Such studies often face difficulties in sample preservation if neither freezing facilities nor liquid nitrogen (LQN) are readily available. Thus, in order to prevent microbial community changes because of bacterial growth after sampling, preservation buffers need to be applied to samples. However, the amount of microbial community variation attributable to the different preservation treatments and potentially affecting biological interpretation is hardly known...
2017: Frontiers in Microbiology
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