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Failure-to-rescue

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https://www.readbyqxmd.com/read/27914729/operative-team-communication-during-simulated-emergencies-too-busy-to-respond
#1
W Austin Davis, Seth Jones, Adrianna M Crowell-Kuhnberg, Dara O'Keeffe, Kelly M Boyle, Suzanne B Klainer, Douglas S Smink, Steven Yule
BACKGROUND: Ineffective communication among members of a multidisciplinary team is associated with operative error and failure to rescue. We sought to measure operative team communication in a simulated emergency using an established communication framework called "closed loop communication." We hypothesized that communication directed at a specific recipient would be more likely to elicit a check back or closed loop response and that this relationship would vary with changes in patients' clinical status...
November 30, 2016: Surgery
https://www.readbyqxmd.com/read/27912035/failure-to-rescue-after-infectious-complications-in-a-statewide-trauma-system
#2
Elinore J Kaufman, Emily Earl-Royal, Philip S Barie, Daniel N Holena
BACKGROUND: The failure to rescue (FTR) rate, the rate of death after a complication, measures a center's ability to identify and manage complications by "rescuing" vulnerable patients. Infectious complications are common after trauma, but risk factors for death after infection are not established. We hypothesized that risk factors would differ for FTR after infectious complications, development of infections, and for development of and death after non-infectious complications. PATIENTS AND METHODS: We analyzed trauma registry data for adult patients admitted to all 30 level I and II Pennsylvania trauma centers, 2011-2014...
December 2, 2016: Surgical Infections
https://www.readbyqxmd.com/read/27884410/complications-after-cardiac-operations-all-are-not-created-equal
#3
Todd C Crawford, J Trent Magruder, Joshua C Grimm, Alejandro Suarez-Pierre, Christopher M Sciortino, Kaushik Mandal, Kenton J Zehr, John V Conte, Robert S Higgins, Duke E Cameron, Glenn J Whitman
BACKGROUND: Postoperative complications are associated with increased morbidity and mortality after cardiac operations. We sought to quantify the effect of multiple complications on noninstitutionalized recovery after cardiac operations. METHODS: We identified 2,477 adult patients from our institutional cardiac surgery database who underwent one of seven index cardiac surgical operations from 2011 to 2014. We calculated failure-to-rescue rates for all individual complications and combinations of complications...
November 21, 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27836139/on-the-threshold-of-safety-a-qualitative-exploration-of-nurses-perceptions-of-factors-involved-in-safe-staffing-levels-in-emergency-departments
#4
Lisa A Wolf, Cydne Perhats, Altair M Delao, Paul R Clark, Michael D Moon
: The emergency department is a unique practice environment in that the Emergency Medical Treatment and Active Labor Act (EMTALA), which mandates a medical screening examination for all presenting patients, effectively precludes any sort of patient volume control; staffing needs are therefore fluid and unpredictable. The purpose of this study is to explore emergency nurses' perceptions of factors involved in safe staffing levels and to identify factors that negatively and positively influence staffing levels and might lend themselves to more effective interventions and evaluations...
November 8, 2016: Journal of Emergency Nursing: JEN: Official Publication of the Emergency Department Nurses Association
https://www.readbyqxmd.com/read/27823757/how-does-a-concurrent-diagnosis-of-cancer-influence-outcomes-in-emergency-general-surgery-patients
#5
Adil A Shah, Syed Nabeel Zafar, Awais Ashfaq, Alyssa B Chapital, Daniel J Johnson, Chee-Chee Stucky, Barbara Pockaj, Richard J Gray, Mallory Williams, Edward E Cornwell, Lori L Wilson, Nabil Wasif
BACKGROUND: A significant proportion of hospital admissions in the US are secondary to emergency general surgery (EGS). The aim of this study is to quantify outcomes for EGS patients with cancer. METHODS: The Nationwide Inpatient Sample (2007 to 2011) was queried for patients with a diagnosis of an EGS condition as determined by the American Association for the Surgery of Trauma. Of these, patients with a diagnosis of malignant cancers (ICD-9-CM diagnosis codes; 140-208...
September 30, 2016: American Journal of Surgery
https://www.readbyqxmd.com/read/27807846/borderline-operability-in-hepatectomy-patients-is-associated-with-higher-rates-of-failure-to-rescue-after-severe-complications
#6
Bradford J Kim, Ching-Wei D Tzeng, Amanda B Cooper, Jean-Nicolas Vauthey, Thomas A Aloia
BACKGROUND/OBJECTIVE: To understand the influence of age and comorbidities, this study analyzed the incidence and risk factors for post-hepatectomy morbidity/mortality in patients with "borderline" (BL) operability, defined by the preoperative factors: age ≥75 years, dependent function, lung disease, ascites/varices, myocardial infarction, stroke, steroids, weight loss >10%, and/or sepsis. METHODS: All elective hepatectomies were identified in the 2005-2013 ACS-NSQIP database...
November 3, 2016: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/27799174/global-patient-outcomes-after-elective-surgery-prospective-cohort-study-in-27-low-middle-and-high-income-countries
#7
(no author information available yet)
BACKGROUND: As global initiatives increase patient access to surgical treatments, there remains a need to understand the adverse effects of surgery and define appropriate levels of perioperative care. METHODS: We designed a prospective international 7-day cohort study of outcomes following elective adult inpatient surgery in 27 countries. The primary outcome was in-hospital complications. Secondary outcomes were death following a complication (failure to rescue) and death in hospital...
November 2016: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/27788924/failure-to-rescue-after-injury-is-associated-with-preventability-the-results-of-mortality-panel-review-of-failure-to-rescue-cases-in-trauma
#8
Lindsay E Kuo, Elinore Kaufman, Rebecca L Hoffman, Jose L Pascual, Niels D Martin, Rachel R Kelz, Daniel N Holena
BACKGROUND: Failure-to-rescue is defined as the conditional probability of death after a complication, and the failure-to-rescue rate reflects a center's ability to successfully "rescue" patients after complications. The validity of the failure-to-rescue rate as a quality measure is dependent on the preventability of death and the appropriateness of this measure for use in the trauma population is untested. We sought to evaluate the relationship between preventability and failure-to-rescue in trauma...
October 25, 2016: Surgery
https://www.readbyqxmd.com/read/27778336/hospital-costs-of-colorectal-cancer-surgery-for-the-oldest-old-a-dutch-population-based-study
#9
Johannes A Govaert, Marc J P M Govaert, Marta Fiocco, Wouter A van Dijk, Rob A E M Tollenaar, Michel W J M Wouters
: Background Due to increasing healthcare costs, discussions regarding increased hospital costs when operating on high-risk patients is rising. Therefore, the aim of this study was to analyze if oldest-old colorectal cancer patients have a greater impact on hospital costs than their younger counterparts. METHODS: All colorectal cancer procedures performed in 29 Dutch hospitals between 2010 and 2012 and listed in the Dutch Surgical Colorectal Audit were analyzed...
October 25, 2016: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/27775553/a-perioperative-clinical-pathway-can-dramatically-reduce-failure-to-rescue-rates-after-cytoreductive-surgery-for-peritoneal-carcinomatosis-a-retrospective-study-of-666-consecutive-cytoreductions
#10
Guillaume Passot, Delphine Vaudoyer, Laurent Villeneuve, Florent Wallet, Annie-Claude Beaujard, Gilles Boschetti, Pascal Rousset, Naoual Bakrin, Eddy Cotte, Olivier Glehen
OBJECTIVE: To determine whether a perioperative, standardized clinical pathway could impact the failure-to-rescue rate after cytoreductive surgery (CRS) for peritoneal carcinomatosis (PC) in a tertiary center. SUMMARY OF BACKGROUND DATA: Morbidity and mortality remain significant after CRS for PC. Clinical pathways have been associated with better outcomes after surgery. The failure-to-rescue rate is a useful metric for evaluating quality in surgery. MATERIALS AND METHODS: This study included 666 patients that received CRS for PC between 2009 and 2014...
April 11, 2016: Annals of Surgery
https://www.readbyqxmd.com/read/27765178/surgical-outcomes-and-failure-to-rescue-events-after-colectomy-in-teaching-hospitals-a-nationwide-analysis
#11
Ara Ko, Lia Aquino, Nicolas Melo, Rodrigo F Alban
BACKGROUND: The relationship between failure-to-rescue (FTR) after colectomy is not well understood, particularly in teaching institutions. We sought to examine this relationship using a large national database. METHODS: Patients undergoing colectomy from 2010 to 2012 were identified in the Nationwide Inpatient Sample database. FTR events were defined as deaths following deep vein thrombosis or pulmonary embolism, sepsis, gastrointestinal bleed, acute myocardial infarction, acute kidney injury, pneumonia, respiratory failure, shock...
September 30, 2016: American Journal of Surgery
https://www.readbyqxmd.com/read/27760245/implications-of-the-patient-protection-and-affordable-care-act-on-insurance-coverage-and-rehabilitation-use-among-young-adult-trauma-patients
#12
Cheryl K Zogg, Fernando Payró Chew, John W Scott, Lindsey L Wolf, Thomas C Tsai, Peter Najjar, Olubode A Olufajo, Eric B Schneider, Elliott R Haut, Adil H Haider, Joseph K Canner
Importance: Trauma is the leading cause of death and disability among young adults, who are also among the most likely to be uninsured. Efforts to increase insurance coverage, including passage of the Patient Protection and Affordable Care Act (ACA), were intended to improve access to care and promote improvements in outcomes. However, despite reported gains in coverage, the ACA's success in promoting use of high-quality care and enacting changes in clinical end points remains unclear...
October 19, 2016: JAMA Surgery
https://www.readbyqxmd.com/read/27726906/the-factors-that-influence-junior-doctors-capacity-to-recognise-respond-and-manage-patient-deterioration-in-an-acute-ward-setting-an-integrative-review
#13
Adele Callaghan, Leigh Kinsman, Simon Cooper, Natalie Radomski
OBJECTIVES: Junior doctors are frequently the first doctor to be called by a nurse to review patients whose clinical status has declined in hospital wards, yet little is known about how well prepared they are to deal with this situation. This paper aims to identify the factors that influence junior doctors' early recognition and management of patient deterioration in an acute ward settings. METHOD: Integrative review methodology was used to allow for the inclusion of broad research designs, summarising current knowledge from existing research and identify gaps in the literature...
October 7, 2016: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
https://www.readbyqxmd.com/read/27720335/inattentional-blindness-and-failures-to-rescue-the-deteriorating-patient-in-critical-care-emergency-and-perioperative-settings-four-case-scenarios
#14
Angela Jones, Megan-Jane Johnstone
BACKGROUND: Failure to identify and respond to clinical deterioration is an important measure of patient safety, hospital performance and quality of care. Although studies have identified the role of patient, system and human factors in failure to rescue events, the role of 'inattentional blindness' as a possible contributing factor has been overlooked. OBJECTIVES: To explore the nature and possible patient safety implications of inattentional blindness in critical care, emergency and perioperative nursing contexts...
October 5, 2016: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
https://www.readbyqxmd.com/read/27706473/variation-in-medicare-expenditures-for-treating-perioperative-complications-the-cost-of-rescue
#15
Jason C Pradarelli, Mark A Healy, Nicholas H Osborne, Amir A Ghaferi, Justin B Dimick, Hari Nathan
Importance: Treating surgical complications presents a major challenge for hospitals striving to deliver high-quality care while reducing costs. Costs associated with rescuing patients from perioperative complications are poorly characterized. Objective: To evaluate differences across hospitals in the costs of care for patients surviving perioperative complications after major inpatient surgery. Design, Setting, and Participants: Retrospective cohort study using claims data from the Medicare Provider Analysis and Review files...
October 5, 2016: JAMA Surgery
https://www.readbyqxmd.com/read/27664885/age-and-preexisting-conditions-as-risk-factors-for-severe-adverse-events-and-failure-to-rescue-after-injury
#16
Emily Earl-Royal, Elinore J Kaufman, Jesse Y Hsu, Douglas J Wiebe, Patrick M Reilly, Daniel N Holena
BACKGROUND: Failure to rescue (FTR: the conditional probability of death after complication) has been studied in trauma cohorts, but the impact of age and preexisting conditions (PECs) on risk of FTR is not well known. We assessed the relationship between age and PECs on the risk of experiencing serious adverse events (SAEs) subsequent FTR in trauma patients with the hypothesis that increased comorbidity burden and age would be associated with increased FTR. MATERIALS AND METHODS: We performed a retrospective cohort analysis at an urban level 1 trauma center in Pennsylvania...
October 2016: Journal of Surgical Research
https://www.readbyqxmd.com/read/27662222/geographic-variation-in-surgical-outcomes-and-cost-between-the-united-states-and-japan
#17
Michael P Hurley, Lena Schoemaker, John M Morton, Sherry M Wren, William B Vogt, Sachiko Watanabe, Aki Yoshikawa, Jay Bhattacharya
OBJECTIVES: Unwarranted geographic variation in spending has received intense scrutiny in the United States. However, few studies have compared variation in spending and surgical outcomes between the United States healthcare system and those of other nations. In this study, we compare the geographic variation in postsurgical outcomes and cost between the United States and Japan. STUDY DESIGN: This retrospective cohort study uses Medicare Part A data from the United States (2010-2011) and similar inpatient data from Japan (2012)...
September 2016: American Journal of Managed Care
https://www.readbyqxmd.com/read/27640120/coronary-angiography-and-failure-to-rescue-after-postoperative-myocardial-infarction-in-patients-with-coronary-stents-undergoing-noncardiac-surgery
#18
Robert H Hollis, Carla N Holcomb, Javier A Valle, Burke P Smith, Aerin J DeRussy, Laura A Graham, Joshua S Richman, Kamal M F Itani, Thomas M Maddox, Mary T Hawn
BACKGROUND: We evaluated coronary angiography use among patients with coronary stents suffering postoperative myocardial infarction (MI) and the association with mortality. METHODS: Patients with prior coronary stenting who underwent inpatient noncardiac surgery in Veterans Affairs hospitals between 2000 and 2012 and experienced postoperative MI were identified. Predictors of 30-day post-MI mortality were evaluated. RESULTS: Following 12,096 operations, 353 (2...
August 20, 2016: American Journal of Surgery
https://www.readbyqxmd.com/read/27620911/complications-and-failure-to-rescue-following-laparoscopic-or-open-gastrectomy-for-gastric-cancer-a-propensity-matched-analysis
#19
Ru-Hong Tu, Jian-Xian Lin, Chao-Hui Zheng, Ping Li, Jian-Wei Xie, Jia-Bin Wang, Jun Lu, Qi-Yue Chen, Long-Long Cao, Mi Lin, Chang-Ming Huang
BACKGROUND: To investigate the incidence of and factors associated with postoperative complications and failure to rescue following laparoscopic and open gastrectomy for gastric cancer. STUDY DESIGN: We analyzed the records of 4124 patients who underwent a laparoscopic or open gastrectomy for gastric cancer. One-to-one propensity score matching was performed to compare the difference between the two groups. RESULTS: A total of 4124 patients were included in the study, 627 of whom (15...
September 12, 2016: Surgical Endoscopy
https://www.readbyqxmd.com/read/27615523/reducing-avoidable-deaths-from-failure-to-rescue-a-discussion-paper
#20
James Waldie, Stephen Tee, Tina Day
AIM: This article proposes a radical new approach to the monitoring and governance of services, and the education and training of nurses to meet 'failure to rescue' requirements. BACKGROUND: Healthcare policy in the UK that seeks to ensure safe and effective services for the acutely ill has largely failed, resulting in adult patients dying unnecessarily. Despite grand rhetoric, UK governments have distanced themselves from implementation, resulting in patchy localised developments and creating inconsistent service responses...
September 8, 2016: British Journal of Nursing: BJN
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