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Surgical care quality

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https://www.readbyqxmd.com/read/28527930/outcomes-of-open-and-endovascular-lower-extremity-revascularization-in-active-smokers-with-advanced-peripheral-arterial-disease
#1
Samuel L Chen, Matthew D Whealon, Nii-Kabu Kabutey, Isabella J Kuo, Michael D Sgroi, Roy M Fujitani
OBJECTIVE: Concern over perioperative and long-term durability of lower extremity revascularizations among active smokers is a frequent deterrent for vascular surgeons to perform elective lower extremity revascularization. In this study, we examined perioperative outcomes of lower extremity endovascular (LEE) revascularization and open lower extremity bypass (LEB) in active smokers with intermittent claudication (IC) and critical limb ischemia (CLI). METHODS: Active smokers undergoing LEE or LEB from 2011 to 2014 were identified in the American College of Surgeons (ACS) National Surgical Quality Improvement Program (NSQIP) targeted vascular data set...
June 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28527728/the-patient-s-experience-of-amputation-due-to-peripheral-arterial-disease
#2
Eva Torbjörnsson, Carin Ottosson, Lena Blomgren, Lennart Boström, Ann-Mari Fagerdahl
It is not uncommon that patients with peripheral arterial disease (PAD) need to undergo a lower limb amputation, with or without previous revascularization attempts. Despite that, the patient's experience of the amputation has been scarcely studied. The aim of this qualitative study was to describe the patient's experience of amputation due to PAD. Thirteen interviews were conducted with vascular patients who had undergone a lower limb amputation at tibia, knee, or femoral level. Data were analyzed with content analysis...
June 2017: Journal of Vascular Nursing: Official Publication of the Society for Peripheral Vascular Nursing
https://www.readbyqxmd.com/read/28527613/no-344-opportunistic-salpingectomy-and-other-methods-of-risk-reduction-for-ovarian-fallopian-tube-peritoneal-cancer-in-the-general-population
#3
Shannon Salvador, Stephanie Scott, Julie Ann Francis, Anita Agrawal, Christopher Giede
OBJECTIVE: This guideline reviews the potential benefits of opportunistic salpingectomy to prevent the development of high grade serous cancers (HGSC) of the ovary/fallopian tube/peritoneum based on current evidence supporting the fallopian tube origin of disease. INTENDED USERS: Gynaecologists, obstetricians, family doctors, registered nurses, nurse practitioners, residents, and health care providers. TARGET POPULATION: Adult women (18 and older): OPTIONS: Women considering hysterectomy who wish to retain their ovaries in situ have traditionally also retained their fallopian tubes...
June 2017: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/28526041/implementation-of-enhanced-recovery-after-surgery-a-strategy-to-transform-surgical-care-across-a-health-system
#4
Leah M Gramlich, Caroline E Sheppard, Tracy Wasylak, Loreen E Gilmour, Olle Ljungqvist, Carlota Basualdo-Hammond, Gregg Nelson
BACKGROUND: Enhanced Recovery After Surgery (ERAS) programs have been shown to have a positive impact on outcome. The ERAS care system includes an evidence-based guideline, an implementation program, and an interactive audit system to support practice change. The purpose of this study is to describe the use of the Theoretic Domains Framework (TDF) in changing surgical care and application of the Quality Enhancement Research Initiative (QUERI) model to analyze end-to-end implementation of ERAS in colorectal surgery across multiple sites within a single health system...
May 19, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/28525513/an-observational-assessment-of-anesthesia-capacity-in-madagascar-as-a-prerequisite-to-the-development-of-a-national-surgical-plan
#5
Linden S Baxter, Vaonandianina A Ravelojaona, Hasiniaina N Rakotoarison, Alison Herbert, Emily Bruno, Kristin L Close, Vanessa Andean, Hery H Andriamanjato, Mark G Shrime, Michelle C White
BACKGROUND: The global lack of anesthesia capacity is well described, but country-specific data are needed to provide country-specific solutions. We aimed to assess anesthesia capacity in Madagascar as part of the development of a Ministry of Health national surgical plan. METHODS: As part of a nationwide surgical safety quality improvement project, we surveyed 19 of 22 regional hospitals, representing surgical facilities caring for 75% of the total population. The assessment was divided into 3 areas: anesthesia workforce density, infrastructure and equipment, and medications...
June 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28525247/-evaluations-by-hospital-ward-physicians-of-patient-care-management-quality-for-patients-hospitalized-after-an-emergency-department-admission
#6
M Bartiaux, P Mols
BACKGROUND: patient management in the acute and sub-acute setting of an Emergency Department is challenging. An assessment of the quality of provided care enables an evaluation of failings. It contributes to the identification of areas for improvement. OBJECTIVES: to obtain an analysis, by hospital-ward physicians, of adult patient care management quality, as well as of the correctness of diagnosis made during emergency admissions. To evaluate the consequences of inadequate patient care management on morbidity, mortality and cost and duration of hospitalization...
2017: Revue Médicale de Bruxelles
https://www.readbyqxmd.com/read/28524902/health-literacy-assessment-feasibility-in-a-breast-surgical-oncology-clinic%C3%A2
#7
Jessica Keim-Malpass, Aubrey Doede, Christine Kennedy, Shayna L Showalter
Health literacy is recognized as an integral component of high-quality health care. However, health literacy has been understudied in the context of cancer care delivery and surgical decision making. The goal of this article is to outline a process for implementation of a health literacy screening assessment within the routine practices of an academic breast surgical oncology clinic. The self-reported health literacy assessment is feasible, particularly with integration of the health literacy screen in the electronic health record...
June 1, 2017: Clinical Journal of Oncology Nursing
https://www.readbyqxmd.com/read/28524747/health-care-students-at-an-argentinean-school-of-medicine-are-they-well-prepared-to-provide-quality-sexual-and-reproductive-health-services
#8
Belén Provenzano-Castro, Silvia Oizerovich, Babill Stray-Pedersen
OBJECTIVES: The aim of our study was to assess what students of the University of Buenos Aires School of Medicine learn about sexual and reproductive health (SRH) and rights, focusing particularly on their knowledge of accessibility to contraception and abortion legislation. METHODS: In this cross-sectional study, self-administered, anonymous questionnaires were administered to 760 first year students and to 695 final year students from different fields of study (medicine, midwifery, nursing, radiology, nutrition, speech therapy and physiotherapy) between 2011 and 2013...
May 19, 2017: European Journal of Contraception & Reproductive Health Care
https://www.readbyqxmd.com/read/28523381/national-clinical-guidelines-for-non-surgical-treatment-of-patients-with-recent-onset-neck-pain-or-cervical-radiculopathy
#9
REVIEW
Per Kjaer, Alice Kongsted, Jan Hartvigsen, Alexander Isenberg-Jørgensen, Berit Schiøttz-Christensen, Bolette Søborg, Charlotte Krog, Christian Martin Møller, Christine Marie Bækø Halling, Henrik Hein Lauridsen, Inge Ris Hansen, Jesper Nørregaard, Karsten Juhl Jørgensen, Lars Valentin Hansen, Marie Jakobsen, Martin Bach Jensen, Martin Melbye, Peter Duel, Steffan W Christensen, Tina Myung Povlsen
PURPOSE: To summarise recommendations about 21 selected non-surgical interventions for recent onset (<12 weeks) non-specific neck pain (NP) and cervical radiculopathy (CR) based on two guidelines from the Danish Health Authority. METHODS: Two multidisciplinary working groups formulated recommendations based on the GRADE approach. RESULTS: Twelve recommendations were based on evidence and nine on consensus. Management should include information about prognosis, warning signs, and advise to remain active...
May 18, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28523314/health-related-quality-of-life-in-patients-with-hallux-valgus
#10
Lavinia Maria Hogea, Bogdan Gheorghe Hogea, Laura Alexandra Nussbaum, Mirela Loredana Grigoraş, Bogdan Corneliu Andor, Codrina Mihaela Levai, Ana Cristina Bredicean
BACKGROUND AND AIMS: No deformity of the forefoot occurs more frequently than hallux valgus (HV), which is considered to be medial deviation of the first metatarsal and lateral deviation and rotation of the hallux, either with or without medial soft tissue enlargement of the metatarsal head. The HV deformity can lead to painful motion of the joint or difficulty in daily joint activity that often requires surgical correction. The aims of this study were to investigate the levels of foot pain and quality of life of patients with HV before and after surgery...
2017: Romanian Journal of Morphology and Embryology, Revue Roumaine de Morphologie et Embryologie
https://www.readbyqxmd.com/read/28522282/quality-indicators-for-the-use-of-systemic-antibiotics-in-dentistry
#11
Rugzan Jameel Hussein, Robert Krohn, Petra Kaufmann-Kolle, Gerald Willms
BACKGROUND: Risks resulted from using systemic antibiotics such as increasing rates of bacterial resistance, allergy and side effects should be always weighed individually for each patient against any potential benefits. Routine antibiotic prescribing must be therefore discouraged. The Federal Joint Committee ("Gemeinsamer Bundesauschuss", G-BA) commissioned the AQUA-Institute with the development of an external quality assurance procedure, examining systemic antibiotic use in periodontal, conservative and surgical treatments in ambulatory dental health care...
May 15, 2017: Zeitschrift Für Evidenz, Fortbildung und Qualität Im Gesundheitswesen
https://www.readbyqxmd.com/read/28522108/hospital-readmission-after-ovarian-cancer-surgery-are-we-measuring-surgical-quality
#12
Emma L Barber, Kemi M Doll, Paola A Gehrig
OBJECTIVES: Readmission after surgery is a quality metric hypothesized to reflect the quality of care in the index hospitalization. We examined the link between readmissions and a surrogate of surgical quality - major postoperative complication - among ovarian cancer patients. METHODS: Patients who underwent surgery for ovarian cancer between 2012 and 2013 were identified from the National Surgical Quality Improvement Project (NSQIP). Major complications were defined as grade 3 or ≥complications on the validated Claviden-Dindo scale and included both NSQIP and non-NSQIP defined complications based on readmission ICD-9 code...
May 15, 2017: Gynecologic Oncology
https://www.readbyqxmd.com/read/28514469/association-of-very-low-volume-practice-with-vascular-surgery-outcomes-in-new-york
#13
Jialin Mao, Philip Goodney, Jack Cronenwett, Art Sedrakyan
Importance: Little research has focused on very low-volume surgery, especially in the context of decreasing vascular surgery volume with the adoption of endovascular procedures. Objective: To investigate the existence and outcomes of open abdominal aortic aneurysm repair (OAR) and carotid endarterectomy (CEA) performed by very low-volume surgeons in New York. Design, Settings, and Participants: This cohort study examined inpatient data of patients undergoing elective OAR or CEA from 2000 to 2014 from all New York hospitals...
May 17, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28514384/-innovative-endoscopic-technologies-in-multi-field-medical-facility
#14
O E Karpov, P S Vetshev, A S Maady, K I Alekseev, A S Osipov, I V Vasiliev
The modern clinical practice is characterized by intensive introduction of innovative technologies for improving treatment and diagnostic procedures, minimizing their impact on the patient, complications rate and economic reasons. One of the priorities in this area is both diagnostic and therapeutic endoscopy. The degree of practical use of innovative endoscopic technologies depends on not only the quality of care, but also their economic reasons. Endoscopic treatment has become the method of choice for gastrointestional bleeding, extraction of foreign bodies, obstructive jaundice, polyps of the gastrointestinal tract, achalasia, esophageal strictures, etc...
2017: Khirurgiia
https://www.readbyqxmd.com/read/28513887/geriatrics-for-specialists-initiative-an-eleven-specialty-collaboration-to-improve-care-of-older-adults
#15
Andrew G Lee, John A Burton, Nancy E Lundebjerg
In the early 1990s, visionary leaders at the American Geriatrics Society and The John A. Hartford Foundation recognized that the marked and growing shortage of geriatrics healthcare professionals would lead to a U.S. healthcare system ill prepared to provide optimal care for the ever-increasing number of older Americans. Led by the late Dennis W. Jahnigen, MD, they set forth a plan to address this shortage by collaborating with surgical and related medical specialists to create a series of programs to foster the highest quality care of older adults...
May 17, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28513842/expanding-the-field-of-surgical-researchers-the-jahnigen-career-development-award
#16
Stacie Deiner
Under a long-standing collaboration with the John A. Hartford Foundation (JAHF), the Atlantic Philanthropies (AP), and specialty societies in 10 targeted specialties, the American Geriatrics Society (AGS) has been working to improve quality of care provided to older adults by surgical and related medical specialists. To support and nurture future academic leaders, the Geriatrics-for-Specialists Initiative (GSI) established the Dennis W. Jahnigen Career Development Scholar Award (JCDA) program in 2002, with AP joining JAHF as a core funder of the awards in 2003...
May 17, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28513531/who-should-lead-a-trauma-team-surgeon-or-non-surgeon-a-systematic-review-and-meta-analysis
#17
Shahab Hajibandeh, Shahin Hajibandeh
BACKGROUND: Presence of a trauma team leader (TTL) in the trauma team is associated with positive patient outcomes in major trauma. The TTL is traditionally a surgeon who coordinates the resuscitation and ensures adherence to Advanced Trauma Life Support (ATLS) guidelines. The necessity of routine surgical leadership in the resuscitative component of trauma care has been questioned by some authors. Therefore, it remains controversial who should lead the trauma team. We aimed to evaluate outcomes associated with surgeon versus non-surgeon TTLs in management of trauma patients...
June 1, 2017: Journal of Injury & Violence Research
https://www.readbyqxmd.com/read/28512551/consensus-statements-and-clinical-recommendations-on-treatment-indications-surgical-procedures-prosthetic-protocols-and-complications-following-all-on-4-standard-treatment-9th-mozo-grau-ticare-conference-in-quintanilla-spain
#18
REVIEW
Miguel Penarrocha-Diago, María Penarrocha-Diago, Regino Zaragozí-Alonso, David Soto-Penaloza, Meeting On Behalf Of The Ticare Consensus
OBJECTIVES: The present consensus report critically evaluates the scientific evidence based on a comprehensive systematic review of the All-On-4 treatment concept, focusing primarily on the treatment indications, surgical procedures and prosthetic protocols, and secondarily on the mechanical and biological complications involved. MATERIAL AND METHODS: A systematic review was made in advance of the meeting. Consensus statements, treatment guidelines and recommendations for future research were based on within-group as well as plenary debates and discussions of the systematic review...
May 2017: Journal of Clinical and Experimental Dentistry
https://www.readbyqxmd.com/read/28511946/national-incidence-of-patient-safety-indicators-in-the-total-hip-arthroplasty-population
#19
Joseph E Tanenbaum, Derrick M Knapik, Glenn D Wera, Steven J Fitzgerald
BACKGROUND: The Centers for Medicare & Medicaid Services use the incidence of patient safety indicators (PSIs) to determine health care value and hospital reimbursement. The national incidence of PSI has not been quantified in the total hip arthroplasty (THA) population, and it is unknown if patient insurance status is associated with PSI incidence after THA. METHODS: All patients in the Nationwide Inpatient Sample (NIS) who underwent THA in 2013 were identified using the International Classification of Diseases, Ninth Revision, Clinical Modification codes...
April 12, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28511884/the-impact-of-quality-variations-on-patients-undergoing-surgery-for-renal-cell-carcinoma-a-national-cancer-database-study
#20
Keith A Lawson, Olli Saarela, Robert Abouassaly, Simon P Kim, Rodney H Breau, Antonio Finelli
BACKGROUND: Despite efforts to define metrics assessing hospital-level quality for renal cell carcinoma (RCC) surgical care there remains a paucity of real-world data validating their ability to benchmark performance. Consequently, whether poor performance on hospital-level quality indicators is associated with inferior patient outcomes remains unknown. OBJECTIVES: To determine hospital-level variations in RCC surgical quality after adjusting for differences in patient- and tumor-specific factors...
May 13, 2017: European Urology
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