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Hospital caseload

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https://www.readbyqxmd.com/read/29025099/dutch-surgeons-views-on-the-volume-outcome-mechanism-in-surgery-a-qualitative-interview-study
#1
R Mesman, M J Faber, G P Westert, H J J M Berden
Objective: To contribute to a better understanding of volume-outcome relationships in surgery by exploring Dutch surgeons' views on the underlying mechanism. Design: A qualitative study based on face-to-face semi structured interviews and an inductive content analysis approach. Setting: Interviews were conducted in eight hospitals in the Netherlands (2 university, 4 teaching and 2 general). Participants: Twenty surgeons (gastrointestinal, vascular and trauma)...
August 9, 2017: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/28981491/the-new-zealand-major-trauma-registry-the-foundation-for-a-data-driven-approach-in-a-contemporary-trauma-system
#2
Siobhan Isles, Grant Christey, Ian Civil, Peter Hicks
AIM: To describe the development of the New Zealand Major Trauma Registry (NZ-MTR) and the initial experiences of its use. METHOD: The background to the development of the NZ-MTR was reviewed and the processes undertaken to implement a single-instance of a web-based national registry described. A national minimum dataset was defined and utilised. Key structures to support the Registry such as a data governance group were established. RESULTS: The NZ-MTR was successfully implemented and is the foundation for a new, data-driven model of quality improvement...
October 6, 2017: New Zealand Medical Journal
https://www.readbyqxmd.com/read/28974070/hypotension-during-induction-of-anaesthesia-is-neither-a-reliable-nor-a-useful-quality-measure-for-comparison-of-anaesthetists-performance
#3
R H Epstein, F Dexter, E S Schwenk
Background: Identification of statistically reliable outcomes for comparison among anaesthetists is challenging. Time-weighted intraoperative mean arterial pressure <65 mm Hg (AUC 65 ) is associated with increased odds for myocardial damage. We explored retrospectively whether such hypotension before incision was statistically reliable for peer comparison. Methods: We retrieved electronic data between 2006 and 2015 at a tertiary care, academic hospital in the USA for patients at risk for myocardial damage (inpatient after surgery, ASA physical status ≥III, ≥50 yr of age, and case duration ≥60 min)...
July 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28973498/failure-to-rescue-and-mortality-following-resection-of-intracranial-neoplasms
#4
Hani Malone, Michael Cloney, Jingyan Yang, Dawn L Hershman, Jason D Wright, Alfred I Neugut, Jeffrey N Bruce
BACKGROUND: There is growing recognition that perioperative complication rates are similar between hospitals, but mortality rates are lower at high-volume centers. This may be due to differences in the ability to rescue patients from major complications. OBJECTIVE: To examine the relationship between hospital caseload and failure to rescue from complications following resection of intracranial neoplasms. METHODS: We identified adults in the Nationwide Inpatient Sample diagnosed with glioma, meningioma, brain metastasis, or acoustic neuroma, who underwent surgical resection between 1998 and 2010...
August 1, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28964707/operationalising-caseload-midwifery-in-the-australian-public-maternity-system-findings-from-a-national-cross-sectional-survey-of-maternity-managers
#5
Kate Dawson, Della A Forster, Helen L McLachlan, Michelle S Newton
BACKGROUND: Despite high-level evidence of the benefits of caseload midwifery for women and babies, little is known about specific practice arrangements, organisational barriers and facilitators, nor about workforce requirements of caseload. This paper explores how caseload models across Australia operate. METHODS: A national cross-sectional, online survey of maternity managers in public maternity hospitals with birthing services was undertaken. Only services with a caseload model are included in the analysis...
September 27, 2017: Women and Birth: Journal of the Australian College of Midwives
https://www.readbyqxmd.com/read/28949100/cancer-multidisciplinary-team-meetings-in-practice-results-from-a-multi-institutional-quantitative-survey-and-implications-for-policy-change
#6
Nicole M Rankin, Michelle Lai, Danielle Miller, Philip Beale, Allan Spigelman, Gabrielle Prest, Kim Turley, John Simes
AIM: Multidisciplinary care is advocated as best practice in cancer care. Relatively little is documented about multidisciplinary team (MDT) meeting functioning, decision making and the use of evidence to support decision making in Australia. This descriptive study aimed to examine team functioning, the role of team meetings and evidence use in MDTs whose institutions are members of Sydney Catalyst Translational Cancer Research Centre. METHODS: We designed a structured 40-item survey instrument about topics that included meeting purpose, organization, resources and documentation; caseload estimates; use of evidence and quality assurance; patient involvement and supportive care needs; and open-ended items about the MDTs strengths and weaknesses...
September 26, 2017: Asia-Pacific Journal of Clinical Oncology
https://www.readbyqxmd.com/read/28943420/impact-of-hospital-caseload-and-elective-admission-on-outcomes-following-extracranial-intracranial-bypass-surgery
#7
Hesam Akbarian-Tefaghi, Piyush Kalakoti, Hai Sun, Kanika Sharma, Jai Deep Thakur, Devi Prasad Patra, Rimal H Dossani, Amey Savardekar, Christina Notarianni, Gregory J Zipfel, Anil Nanda
BACKGROUND: Limited information exists evaluating the impact of hospital caseload and elective admission on outcomes following patients undergoing extracranial-intracranial (ECIC) bypass surgery. Using the Nationwide Inpatient Sample (NIS) for the years 2001 through 2014, we evaluated the impact of hospital caseload and elective admission on outcomes following bypass. METHODS: In an observational cohort study, weighted estimates were used to investigate the association of hospital caseload and elective admission on short-term outcomes following bypass surgery using multivariable regression techniques...
September 21, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28913493/an-evaluation-of-operating-room-throughput-in-a-stand-alone-soft-tissue-trauma-operating-theatre
#8
Brian D O'Donnell, Ken Walsh, Aileen Murphy, Brendan McElroy, Gabriella Iohom, George D Shorten
BACKGROUND: Operating room time is a limited, expensive commodity in acute hospitals. Strategies aimed at reduction of non-operative time improve operating room throughput and capacity. We conducted a prospective study to evaluate and augment operating room throughput and capacity using context-specific work practice changes. METHODS: Following institutional and ethical approval, an interdisciplinary group designed and introduced a series of work practice changes specific to a stand-alone soft tissue trauma theatre, comprising modifications to patient processing, staff behaviours and additional anaesthesiologist hours...
April 2017: Rom J Anaesth Intensive Care
https://www.readbyqxmd.com/read/28911286/the-effect-of-a-surgery-specific-cardiac-output-guided-haemodynamic-algorithm-on-outcomes-in-patients-undergoing-pancreaticoduodenectomy-in-a-high-volume-centre-a-retrospective-comparative-study
#9
L Weinberg, J Banting, L Churilov, R L McLeod, K Fernandes, I Chao, T Ho, D Ianno, V Liang, V Muralidharan, C Christophi, M Nikfarjam
In this retrospective observational study performed in a high-volume hepatobiliary-pancreatic unit, we evaluated the effect of a surgery-specific goal-directed therapy (GDT) physiologic algorithm on complications and length of hospital stay. We compared patients who underwent pancreaticoduodenectomy with either a standardised Enhanced Recovery After Surgery program (usual care group), or a standardised Enhanced Recovery After Surgery program in combination with a surgery-specific cardiac output-guided algorithm (GDT group)...
September 2017: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/28885506/the-theory-and-practice-of-pancreatic-surgery-in-france
#10
Olivier Farges, Noelle Bendersky, Stéphanie Truant, Jean Robert Delpero, François René Pruvot, Alain Sauvanet
OBJECTIVE: Measure the caseload of pancreatectomies that influences their short-term outcome, at a national level, and assess the applicability of a centralization policy. BACKGROUND: There is agreement that pancreatectomies should be centralized. However, previous studies have failed to accurately define a "high-volume" center. METHODS: French healthcare databases were screened to identify all adult patients who had elective pancreatectomies between 2007 and 2012...
November 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28876672/civilian-gunshot-wounds-to-the-chest-a-clinicopathological-analysis-of-an-annual-caseload-at-a-level-1-trauma-centre
#11
V M Meijering, A T Hattam, P H Navsaria, A J Nicol, S Edu
BACKGROUND: Gunshot wounds (GSW) to the chest are common presentations to trauma centres in South Africa. The clinical management and outcome of GSW to the chest are significantly altered by missile trajectory and the associated anatomical structures injured making them challenging injuries to treat. Currently, the management of GSW chest is based on scant evidence and treatment is typically according to algorithms based largely on the anecdotal experience of high volume institutions and experienced clinicians...
June 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/28876666/civilian-gunshot-wounds-to-the-chest-a-clinicopathological-analysis-of-an-annual-caseload-at-a-level-1-trauma-centre
#12
V M Meijering, A T Hattam
BACKGROUND: Gunshot wounds (GSW) to the chest are common presentations to trauma centres both in South Africa and internationally. The clinical management and outcome of GSW to the chest are significantly altered by missile trajectory and the associated anatomical structures injured making them challenging injuries to treat. Currently, the management of GSW chest is based on scant evidence and treatment is typically according to algorithms based largely on the anecdotal experience of high volume institutions and experienced clinicians...
June 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/28867267/testing-and-linkage-to-hiv-care-in-china-a-cluster-randomised-trial
#13
Zunyou Wu, Zhenzhu Tang, Yurong Mao, Paul Van Veldhuisen, Walter Ling, David Liu, Zhiyong Shen, Roger Detels, Guanghua Lan, Lynda Erinoff, Robert Lindblad, Diane Gu, Houlin Tang, Lian Hu, Qiuying Zhu, Li Lu, Neal Oden, Albert L Hasson, Yan Zhao, Jennifer M McGoogan, Xianmin Ge, Nanci Zhang, Keming Rou, Jinhui Zhu, Hui Wei, Cynthia X Shi, Xia Jin, Jian Li, Julio S G Montaner
BACKGROUND: Multistage, stepwise HIV testing and treatment procedures can result in lost opportunities to provide timely antiretroviral therapy (ART). Incomplete engagement of patients along the care cascade translates into high preventable mortality. We aimed to identify whether a structural intervention to streamline testing and linkage to HIV health care would improve testing completeness, ART initiation, and viral suppression and reduce mortality. METHODS: We did a cluster-randomised, controlled trial in 12 hospitals in Guangxi, China...
August 31, 2017: Lancet HIV
https://www.readbyqxmd.com/read/28845939/-experience-in-ureteroscopy-for-managing-urolithiasis-in-one-clinic-when-does-quantity-transform-into-quality
#14
V Yu Ivanov, V A Malkhasyan, I V Semenyakin, D Yu Pushkar
INTRODUCTION: In recent years, there has been an increasing role of ureteroscopy in managing urinary tract calculi of various locations. Several studies have reported the relationship between the efficacy and safety of ureteroscopic interventions and surgeons skills and hospital caseload volume. The aim of our study was to assess the effectiveness of urethroscopic stone removal, the changes in treatment effectiveness, frequency and types of complications along with gaining experience in these interventions...
July 2017: Urologii︠a︡
https://www.readbyqxmd.com/read/28843944/at-most-hospitals-in-the-state-of-iowa-most-surgeons-daily-lists-of-elective-cases-include-only-1-or-2-cases-individual-surgeons-percentage-operating-room-utilization-is-a-consistently-unreliable-metric
#15
Franklin Dexter, Craig Jarvie, Richard H Epstein
STUDY OBJECTIVE: Percentage utilization of operating room (OR) time is not an appropriate endpoint for planning additional OR time for surgeons with high caseloads, and cannot be measured accurately for surgeons with low caseloads. Nonetheless, many OR directors claim that their hospitals make decisions based on individual surgeons' OR utilizations. This incongruity could be explained by the OR managers considering the earlier mathematical studies, performed using data from a few large teaching hospitals, as irrelevant to their hospitals...
August 24, 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28826868/pilot-use-of-a-novel-tool-to-assess-neurosurgical-capacity-in-uganda
#16
Brittany Ploss, Jihad Abdelgadir, Emily R Smith, Anthony Fuller, Joao Ricardo Vissoci, Alex Muhindo, Moses Galukande, Michael M Haglund
INTRODUCTION: There is a significant burden of unmet surgical need in many low- and middle-income countries; more than 80% in parts of Africa. This need is even larger for specialties like neurosurgery. Surgical capacity tools have been developed and used to assess needs and plan for resource allocation. This study piloted a new tool to assess neurosurgical capacity and describes its use. METHODS: A surgical capacity tool was adapted to assess neurosurgical capacity...
August 18, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28796728/patient-hospital-and-geographic-disparities-in-laparoscopic-surgery-use-among-surveillance-epidemiology-and-end-results-medicare-patients-with-colon-cancer
#17
Kendra L Ratnapradipa, Min Lian, Donna B Jeffe, Nicholas O Davidson, Jan M Eberth, Sandi L Pruitt, Mario Schootman
BACKGROUND: Surgical resection is the primary treatment for colon cancer, but use of laparoscopic approaches varies widely despite demonstrated short- and long-term benefits. OBJECTIVE: The purpose of this study was to identify characteristics associated with laparoscopic colon cancer resection and to quantify variation based on patient, hospital, and geographic characteristics. DESIGN: Bayesian cross-classified, multilevel logistic models calculated adjusted ORs and CIs for patient, surgeon, hospital, and geographic characteristics and unexplained variability (predicted vs...
September 2017: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/28771639/utilisation-of-prehospital-emergency-medical-services-for-hyperglycaemia-a-community-based-observational-study
#18
Melanie Villani, Natalie Nanayakkara, Sanjeeva Ranasinha, Arul Earnest, Karen Smith, Georgia Soldatos, Helena Teede, Sophia Zoungas
AIMS: This study examines prehospital Emergency Medical Service (EMS) utilisation and patterns of demand for hyperglycaemia management, including characteristics of individuals and factors related to hospital transport. MATERIALS AND METHODS: A state-wide, community-based observational study of all patients requiring prehospital EMS for hyperglycaemia during a 7 year study period (Jan 2009-Dec 2015) using electronic data from the Ambulance Victoria data warehouse was conducted...
2017: PloS One
https://www.readbyqxmd.com/read/28752985/considerations-in-minimally-invasive-adrenal-surgery-the-front-or-the-backdoor
#19
Otis M Vrielink, Patrick H Hemmer, Schelto Kruijff
In the last decades, in minimally invasive adrenal surgery, the retroperitoneoscopic adrenalectomy (PRA) has shown favorable results when compared to the laparoscopic transperitoneal adrenalectomy (LTA). However, for many endocrine surgeons it is unclear if, when, and how to transition from LTA to PRA. Although the length of the learning curve for both approaches is comparable, the LTA is a technically more challenging procedure whilst PRA demands an orientation in a new environment in a patient that is positioned upside down...
July 28, 2017: Minerva Chirurgica
https://www.readbyqxmd.com/read/28702784/cementless-modular-distally-fixed-stem-in-hip-revision-arthroplasty-a-single-center-study-of-132-consecutive-hips
#20
Ali Hashem, Ammar Al-Azzawi, Hasan Riyadh, Sebastian Mukka, Arkan Sayed-Noor
PURPOSE: The use of cementless, modular, distally fixed stem in hip revision arthroplasty has increased during the last decades. We aimed to analyze the early and late postoperative complications, re-operation rate, and survival rate of the MP stem operated at our county hospital with relatively limited caseload. METHODS: In this retrospective study, we included 132 hips operated with MP stem between January 2007-2014. An independent observer reviewed patients' medical records in July 2015 (18-102 months postoperatively, median 52...
July 12, 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
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