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Failure-to-rescue

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https://www.readbyqxmd.com/read/28647072/failure-to-rescue-in-thoracic-surgery
#1
REVIEW
Farhood Farjah
Variability in outcomes not attributable to case mix or chance is an indicator of low-quality care. Failure-to-rescue is an outcome measure defined as death during a hospitalization among patients who experience a complication. Researchers have used this measure to better understand the determinants of an untimely death-preventing complications, rescue, or both. Studies repeatedly find that complication rates vary little, if at all, across hospitals ranked by risk-adjusted mortality rates, suggesting that hospitals are equally capable (or incapable) of preventing complications...
August 2017: Thoracic Surgery Clinics
https://www.readbyqxmd.com/read/28637554/the-g60-trauma-center-a-future-consideration
#2
Marko Bukur, Joshua Simon, Joseph Catino, Margaret Crawford, Ivan Puente, Fahim Habib
With a considerably increasing elderly population, we sought to determine whether the volume of elderly trauma patients treated impacted outcomes at two different Level I trauma centers. This is a retrospective review of all elderly patients (>60 years) at two state-verified Level I trauma centers over the past five years. The elderly trauma center (ETC) saw a greater proportion (52%) of elderly patients than the reference trauma center (30%, TC). Demographic and clinical characteristics were abstracted and stratified into ETC and TC groups for comparison...
June 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28624046/failure-to-rescue-following-cytoreductive-surgery-and-hyperthermic-intraperitoneal-chemotherapy
#3
Kevin Y Li, Ali A Mokdad, Rebecca M Minter, John C Mansour, Michael A Choti, Mathew M Augustine, Patricio M Polanco
BACKGROUND: Cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (CRS/HIPEC) can significantly improve the survival in selected patients with peritoneal carcinomatosis. This study aims to identify perioperative patient characteristics predictive of failure to rescue (FTR), mortality following postoperative complications from CRS/HIPEC. METHODS: Patients suffering a complication following CRS/HIPEC between 2005 and 2013 were identified in the American College of Surgeons National Surgical Quality Improvement Program data set...
June 15, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28624034/factors-influencing-failure-to-rescue-after-pancreaticoduodenectomy-a-national-surgical-quality-improvement-project-perspective
#4
Patrick R Varley, David A Geller, Allan Tsung
BACKGROUND: Failure to rescue is the concept of death after a complication, and it is an important factor driving variation in mortality rates after pancreatic surgery. The purpose of this study was to conduct a retrospective review of a large, multi-institutional data set to describe patient-level risk factors for failure to rescue in greater detail. METHODS: From the American College of Surgeons National Surgical Quality Improvement Program participant use file, 14,557 patients who underwent pancreaticoduodenectomy were identified...
June 15, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28605474/digital-innovations-and-emerging-technologies-for-enhanced-recovery-programmes
#5
F Michard, T J Gan, H Kehlet
Enhanced recovery programmes (ERPs) are increasingly used to improve post-surgical recovery. However, compliance to various components of ERPs-a key determinant of success-remains sub-optimal. Emerging technologies have the potential to help patients and caregivers to improve compliance with ERPs.Preoperative physical condition, a major determinant of postoperative outcome, could be optimized with the use of text messages (SMS) or digital applications (Apps) designed to facilitate smoking cessation, modify physical activity, and better manage hypertension and diabetes...
June 9, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28542158/identifying-pathogenicity-of-human-variants-via-paralog-based-yeast-complementation
#6
Fan Yang, Song Sun, Guihong Tan, Michael Costanzo, David E Hill, Marc Vidal, Brenda J Andrews, Charles Boone, Frederick P Roth
To better understand the health implications of personal genomes, we now face a largely unmet challenge to identify functional variants within disease-associated genes. Functional variants can be identified by trans-species complementation, e.g., by failure to rescue a yeast strain bearing a mutation in an orthologous human gene. Although orthologous complementation assays are powerful predictors of pathogenic variation, they are available for only a few percent of human disease genes. Here we systematically examine the question of whether complementation assays based on paralogy relationships can expand the number of human disease genes with functional variant detection assays...
May 2017: PLoS Genetics
https://www.readbyqxmd.com/read/28538625/a-metric-of-our-own-failure-to-rescue-after-trauma
#7
Daniel N Holena, Elinore J Kaufman, M Kit Delgado, Douglas J Wiebe, Brendan G Carr, Jason D Christie, Patrick M Reilly
BACKGROUND: Failure to rescue (FTR) is defined as death after an adverse event. The original metric was derived in elective surgical populations and reclassifies deaths not preceded by recorded adverse events as FTR cases under the assumption these deaths resulted from missed adverse events. This approach lacks face validity in trauma because patients often die without adverse events as a direct result of injury. Another common approach simply excludes deaths without recorded adverse events, but this approach reduces the reliability of the FTR metric...
May 22, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28506562/the-impact-of-system-factors-on-quality-and-safety-in-arterial-surgery-a%C3%A2-systematic-review
#8
REVIEW
R Lear, A D Godfrey, C Riga, C Norton, C Vincent, C D Bicknell
OBJECTIVE: A systems approach to patient safety proposes that a wide range of factors contribute to surgical outcome, yet the impact of team, work environment, and organisational factors, is not fully understood in arterial surgery. The aim of this systematic review is to summarize and discuss what is already known about the impact of system factors on quality and safety in arterial surgery. DATA SOURCES: A systematic review of original research papers in English using MEDLINE, Embase, PsycINFO, and Cochrane databases, was performed according to PRISMA guidelines...
May 11, 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28486388/effect-of-beta-blockers-on-mortality-after-open-repair-of-abdominal-aortic-aneurysm
#9
Husain N Alshaikh, Joseph K Canner, Mahmoud Malas
OBJECTIVE: To assess the effect of perioperative beta blocker (BB) use on postoperative in-hospital mortality after open repair of abdominal aortic aneurysm (OAR). BACKGROUND: Postoperative mortality after OAR ranges from 3.0% to 4.5%. Insight about the effect of BBs on postoperative mortality after OAR is currently lacking. METHODS: This is a retrospective study of patients undergoing OAR from 2009-Q3 to 2015-Q1 in the Premier Healthcare Database...
May 8, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28482890/crisis-checklists-for-in-hospital-emergencies-expert-consensus-simulation-testing-and-recommendations-for-a-template-determined-by-a-multi-institutional-and-multi-disciplinary-learning-collaborative
#10
Christian P Subbe, John Kellett, Paul Barach, Catriona Chaloner, Hayley Cleaver, Tim Cooksley, Erik Korsten, Eilish Croke, Elinor Davis, Ashley Jr De Bie, Lesley Durham, Chris Hancock, Jilian Hartin, Tracy Savijn, John Welch
BACKGROUND: 'Failure to rescue' of hospitalized patients with deteriorating physiology on general wards is caused by a complex array of organisational, technical and cultural failures including a lack of standardized team and individual expected responses and actions. The aim of this study using a learning collaborative method was to develop consensus recomendations on the utility and effectiveness of checklists as training and operational tools to assist in improving the skills of general ward staff on the effective rescue of patients with abnormal physiology...
May 8, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28433333/effects-of-hospital-safety-net-burden-and-hospital-volume-on-failure-to-rescue-after-open-abdominal-aortic-surgery
#11
Eric B Rosero, Girish P Joshi, Abu Minhajuddin, Carlos H Timaran, J Gregory Modrall
OBJECTIVE: Failure to rescue (FTR) is defined as the inability to rescue a patient from major perioperative complications, resulting in operative mortality. FTR is a known contributor to operative mortality after open abdominal aortic surgery. Understanding the causes of FTR is essential to designing interventions to improve perioperative outcomes. The objective of this study was to determine the relative contributions of hospital volume and safety-net burden (the proportion of uninsured and Medicaid-insured patients) to FTR...
April 19, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28416153/a-critical-review-of-patient-safety-indicators-attributed-to-trauma-surgeons
#12
Nicole Fox, Rebecca Willcutt, Adrienne Elberfeld, John Porter, Anthony J Mazzarelli
BACKGROUND: The Agency for Health Care Research and Quality (AHRQ) developed patient safety indicators (PSIs) to identify events with a high likelihood of representing medical error. The purpose of this study was to validate PSIs attributed to trauma surgeons and compare validated PSIs to performance improvement (PI) and morbidity and mortality (M&M) data. We hypothesized that PSIs are not an indicator of quality of care in trauma. METHODS: PSI's attributed to trauma surgeons (n=9) at our institution were reviewed (Jan-Dec 2015)...
April 1, 2017: Injury
https://www.readbyqxmd.com/read/28401657/validation-of-a-modified-early-warning-score-linked-situation-background-assessment-recommendation-sbar-communication-tool-a-mixed-methods-study
#13
Debora Burger, Sue Jordan, Una Kyriacos
AIMS AND OBJECTIVES: The objective of this study was to develop and validate a modified Situation-Background-Assessment-Recommendation communication tool incorporating components of the Cape Town Modified Early Warning Score vital signs chart for reporting early signs of clinical deterioration. BACKGROUND: Reporting early signs of physiological and clinical deterioration could prevent 'failure to rescue' or unexpected intensive care admission, cardiac arrest or death...
April 12, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28384381/nurses-experiences-with-patients-who-die-from-failure-to-rescue-after-surgery
#14
Cynthia Thornton Bacon
PURPOSE: To describe the lived experiences of hospital nurses caring for surgical patients who died from failure to rescue (FTR). DESIGN: A qualitative phenomenologic approach was used. Methods to ensure rigor and trustworthiness were incorporated into the design. METHODS: The investigator conducted one-on-one semistructured interviews with 14 nurses, and data were analyzed using Colaizzi's methods. FINDINGS: Six themes were identified: (a) the environment surrounding the FTR was unexpected; (b) FTR was unexpected but not preventable; (c) nurses were emotionally ill-prepared for the FTR; (d) nurse outcomes are different in unexpected versus expected death; (e) nurses' roles as protectors are important; and (f) FTR effects future nursing practice...
May 2017: Journal of Nursing Scholarship
https://www.readbyqxmd.com/read/28379871/effect-of-hospital-volume-on-in-hospital-morbidity-and-mortality-following-pancreatic-surgery-in-germany
#15
Christian Krautz, Ulrike Nimptsch, Georg F Weber, Thomas Mansky, Robert Grützmann
OBJECTIVE: We aimed to determine the effect of hospital volume on in-hospital mortality, and failure to rescue following major pancreatic resections using hospital discharge data of every inpatient case in Germany. SUMMARY BACKGROUND DATA: Several studies have found strong volume-outcome relationships in pancreatic surgery, with high mortality in low-volume facilities. However, their datasets were only based on portions of national populations. In addition, these studies did not assess the effect of hospital volume according to other crucial variables such as medical indications, postoperative complications, and failure to rescue...
April 4, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28362914/understanding-hospital-volume-outcome-relationship-in-severe-traumatic-brain-injury
#16
Aziz S Alali, David Gomez, Victoria McCredie, Todd G Mainprize, Avery B Nathens
BACKGROUND: The hospital volume-outcome relationship in severe traumatic brain injury (TBI) population remains unclear. OBJECTIVE: To examine the relationship between volume of patients with severe TBI per hospital and in-hospital mortality, major complications, and mortality following a major complication (ie, failure to rescue). METHODS: In a multicenter cohort study, data on 9255 adults with severe TBI were derived from 111 hospitals participating in the American College of Surgeons Trauma Quality Improvement Program over 2009-2011...
April 1, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28331951/failure-to-rescue-the-elderly-a-superior-quality-metric-for-trauma-centers
#17
G Barmparas, E J Ley, M J Martin, A Ko, M Harada, D Weigmann, K R Catchpole, B L Gewertz
BACKGROUND: Trauma centers require reliable metrics to better compare the quality of care delivered. We compared mortality after a reported complication, termed failure to rescue (FTR), and FTR in the elderly (age >65 years) (FTRE) to determine which is a superior metric to assess quality of care delivered by trauma centers. METHODS: This was a retrospective review of the National Trauma Databank (NTDB) research data sets 2010 and 2011. Patients ≥16 years admitted to centers reporting ≥80% of AIS and/or ≥ 20% of comorbidities with > 200 subjects in the NTDB were selected...
March 22, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/28319514/do-not-resuscitate-status-is-associated-with-increased-mortality-but-not-morbidity
#18
Elisa C Walsh, Ethan Y Brovman, Angela M Bader, Richard D Urman
BACKGROUND: Do-not-resuscitate (DNR) orders instruct medical personnel to forego cardiopulmonary resuscitation in the event of cardiopulmonary arrest, but they do not preclude surgical management. Several studies have reported that DNR status is an independent predictor of 30-day mortality; however, the etiology of increased mortality remains unclear. We hypothesized that DNR patients would demonstrate increased postoperative mortality, but not morbidity, relative to non-DNR patients undergoing the same procedures...
March 17, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28318554/decubitus-ulcers-in-patients-undergoing-vascular-operations-do-not-influence-mortality-but-affect-resource-utilization
#19
J Hunter Mehaffey, Amani D Politano, Castigliano M Bhamidipati, Margaret C Tracci, Kenneth J Cherry, John A Kern, Irving L Kron, Gilbert R Upchurch
BACKGROUND: While it is anticipated that decubitus ulcers are detrimental to outcomes after vascular operations, the contemporary influence of perioperative decubitus ulcers in vascular surgery remains unknown. METHODS: Using the National Impatient Survey, all adult patients who underwent vascular operation were selected. Patients were stratified by the presence or absence (non-decubitus ulcers) of decubitus ulcer. Case-mix adjusted hierarchical mixed-models examined in-hospital mortality, the occurrence of any complication, and discharge disposition...
June 2017: Surgery
https://www.readbyqxmd.com/read/28316308/where-we-fail-location-and-timing-of-failure-to-rescue-in-trauma
#20
Jennifer J Chung, Emily C Earl-Royal, M Kit Delgado, Jose L Pascual, Patrick M Reilly, Douglas J Wiebe, Daniel N Holena
Failure to rescue (FTR) is an outcome metric that reflects a center's ability to prevent mortality after a major complication. Identifying the timing and location of FTR events could help target efforts to reduce FTR rates. We sought to characterize the timing and location of FTR occurrences at our center, hypothesizing that FTR rates would be highest early after injury and in settings of lower intensity of care. We used data, prospectively collected from 2009 to 2013, on patients ≥16 years old with minimum Abbreviated Injury Score ≥2 from a single institution...
March 1, 2017: American Surgeon
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