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Surgical care quality

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https://www.readbyqxmd.com/read/28334592/using-an-electronic-perioperative-documentation-tool-to-identify-returns-to-operating-room-ror-in-a-tertiary-care-academic-medical-center
#1
Robert R Cima, Sarah R Dhanorker, Christopher L Ostendorf, Mfonabasi Ntekpe, Raghu V Mudundi, Elizabeth B Habermann, Claude Deschamps
BACKGROUND: The metric "Unplanned returns to operating room (ROR)" is being tracked in surgical quality dashboards; 70% of unplanned RORs may be related to surgical complications. With increasing regionalization of trauma and complex surgical care at tertiary care academic centers, it is unclear if a simple ROR metric is a valid assessment of surgical quality at such centers. METHOD: A real-time electronic tool was used to identify all RORs-planned and unplanned-in a high-volume, high-complexity academic surgical practice at Mayo Clinic-Rochester within 45 days of the index operation...
March 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28333904/-intestinal-endometriosis-a-case-report
#2
Sławomir Krzemiński
Endometriosis intestines due to its non-specific symptoms can pose diagnostic problems, a lack of or incorrect treatment worsens the quality of life, sometimes leading to serious complications. The differential diagnosis of abdominal pain, especially in patients of reproductive age should be taken disease into account. Often abdominal pain in young women are classified as a functional gastrointestinal disorder, and only carefully collected intelligence allows you to focus on the diagnosis of endometriosis, especially if the symptoms significantly impair quality of life...
March 21, 2017: Polski Merkuriusz Lekarski: Organ Polskiego Towarzystwa Lekarskiego
https://www.readbyqxmd.com/read/28332057/the-impact-of-operative-approach-on-postoperative-complications-following-colectomy-for-colon-caner
#3
Benedetto Mungo, Christina M Papageorge, Miloslawa Stem, Daniela Molena, Anne O Lidor
BACKGROUND: Colectomy is one of the most common major abdominal procedures performed in the USA. A better understanding of risk factors and the effect of operative approach on adverse postoperative outcomes may significantly improve quality of care. METHODS: Adult patients with a primary diagnosis of colon cancer undergoing colectomy were selected from the National Surgical Quality Improvement Program 2013-2015 targeted colectomy database. Patients were stratified into five groups based on specific operative approach...
March 22, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28331362/anesthesia-for-the-patient-undergoing-total-knee-replacement-current-status-and-future-prospects
#4
REVIEW
Zachary A Turnbull, Dahniel Sastow, Gregory P Giambrone, Tiffany Tedore
Total knee arthroplasty (TKA) has become one of the most common orthopedic surgical procedures performed nationally. As the population and surgical techniques for TKAs have evolved over time, so have the anesthesia and analgesia used for these procedures. General anesthesia has been the dominant form of anesthesia utilized for TKA in the past, but regional anesthetic techniques are on the rise. Multiple studies have shown the potential for regional anesthesia to improve patient outcomes, such as a decrease in intraoperative blood loss, length of stay, and patient mortality...
2017: Local and Regional Anesthesia
https://www.readbyqxmd.com/read/28329247/coronary-endarterectomy-with-coronary-artery-bypass-graft-decreases-graft-patency-compared-with-isolated-coronary-artery-bypass-graft-a-meta-analysis
#5
Yangwu Song, Fei Xu, Junzhe Du, Jiqiang Zhang, Wei Feng
OBJECTIVES: This meta-analysis aims to assess the graft patency quantitatively and statistically. METHODS: Eleven observational studies were identified by systematic literature search, incorporating 3311 patients undergoing coronary endarterectomy (CE) + coronary artery bypass graft (CABG) and 3990 undergoing isolated CABG, which were analysed using random-effects modelling. Heterogeneity, quality of scoring and risk of bias were assessed and reangiographic outcomes were documented...
March 17, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28328683/surgical-support-during-the-terrorist-attacks-in-paris-13-november-2015-experience-at-b%C3%A3-gin-military-teaching-hospital
#6
Olivier Barbier, Brice Malgras, Camille Choufani, Antoine Bouchard, Didier Ollat, Gilbert Versier
BACKGROUND: Recent conflicts have allowed the French Army Health Service to improve management quality for wartime-injured people during military operations. On 13 November 2015, it was in Paris that France was directly attacked and Bégin Military Teaching Hospital, like several hospitals in Paris, had to face a large number of gunshot victims. Thanks to our operational experience, injured people hospitalized in military hospitals benefited from a management based on triage and damage control (DC) principles...
March 21, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28328640/we-are-going-to-name-names-and-call-you-out-improving-the-team-in-the-academic-operating-room-environment
#7
Richard Bodor, Brian J Nguyen, Kevin Broder
INTRODUCTION: Communication failures between multidisciplinary teams can impact efficiency, performance, and morale. Academic operating rooms (ORs) often have surgical, anesthesia, and nursing teams, each teaching multiple trainees. Incorrectly identifying name and "rank" (postgraduate year [PGY]) of resident trainees can disrupt performance evaluations and team morale and even potentially impair delivery of quality care when miscommunication errors proliferate. METHODS: Our OR-based survey asked 50 participants (18 surgeons, 14 anesthesiologists, and 18 nursing members), to recall basic identification data including provider names and PGY levels from their recent collaborating OR teams...
March 21, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28327274/physician-extenders-on-surgical-services-a%C3%A2-systematic-review
#8
Jagdeep Johal, Andrew Dodd
BACKGROUND: With the introduction of resident duty hour restrictions and the resulting in-house trainee shortages, a long-term solution to ensure safe and efficient patient care is needed. One solution is the integration of nurse practitioners (NPs) and physician assistants (PAs) in a variety of health care settings. We sought to examine the use of NPs and PAs on surgical/trauma services and their effect on patient outcomes and resident workload. METHODS: We performed a systematic review of EMBASE, Medline, CINAHL, and the Cochrane Central Register of Controlled Trials...
April 1, 2017: Canadian Journal of Surgery. Journal Canadien de Chirurgie
https://www.readbyqxmd.com/read/28325579/burden-of-healthcare-associated-infections-in-china-results-of-the-2015-point-prevalence-survey-in-dong-guan-city
#9
J Wang, J Hu, S Harbarth, D Pittet, M Zhou, W Zingg
BACKGROUND: Healthcare-associated infections (HCAIs) are a major health threat. There are few data about HCAI and antibiotic use in the People's Republic of China in the English literature. AIM: To describe and discuss the prevalence of HCAI and antibiotic use from the 2015 point prevalence survey (PPS) in Dong Guan City. METHODS: In 2015, the Dong Guan (City) Nosocomial Infection Control and Quality Improvement Centre organized its yearly PPS in the secondary and tertiary care hospitals of Dong Guan City...
February 17, 2017: Journal of Hospital Infection
https://www.readbyqxmd.com/read/28325458/chronic-subdural-hematoma-icu-management
#10
REVIEW
Jeremy T Ragland, Kiwon Lee
Patients with cSDH presenting with new or worsening neurological deficits, especially if they are debilitating and adversely affecting quality of life require urgent medical and surgical attention. Neurological and neurosurgical critical care team need to stabilize the patient by reversing any underlying coagulopathy states in order to prevent further hematoma expansion.In the event of brain herniation and presumed ICP elevation and CPP compromise, step-wise ICP management should be instituted promptly.Seizure prophylaxis treatment is reasonable...
April 2017: Neurosurgery Clinics of North America
https://www.readbyqxmd.com/read/28324982/multi-task-transfer-learning-for-in-hospital-death-prediction-of-icu-patients
#11
Chandan Karmakar, Budhaditya Saha, Marimuthu Palaniswami, Svetha Venkatesh
Multi-Task Transfer Learning (MTTL) is an efficient approach for learning from inter-related tasks with small sample size and imbalanced class distribution. Since the intensive care unit (ICU) data set (publicly available in Physionet) has subjects from four different ICU types, we hypothesize that there is an underlying relatedness amongst various ICU types. Therefore, this study aims to explore MTTL model for in-hospital mortality prediction of ICU patients. We used single-task learning (STL) approach on the augmented data as well as individual ICU data and compared the performance with the proposed MTTL model...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28323687/multilevel-factors-associated-with-injurious-falls-in-acute-care-hospitals
#12
Yunchuan Lucy Zhao, Marjorie Bott, Jianghua He, Heejung Kim, Nancy Dunton
Using National Database of Nursing Quality Indicators data from July 2013 to June 2014, this correlational study examined the associations of injurious falls among all patient falls with multilevel factors in hospitals. The sample included all falls recorded in adult medical, surgical, combined medical-surgical, and step-down units (N = 2299) in participating hospitals (N = 488). Hierarchical negative binominal regression analyses were performed. Results revealed hospital and unit organizational factors associated with inpatient injurious falls...
March 20, 2017: Journal of Nursing Care Quality
https://www.readbyqxmd.com/read/28320786/exploring-similarities-and-differences-in-hospital-adverse-event-rates-between-norway-and-sweden-using-global-trigger-tool
#13
Ellen Tveter Deilkås, Madeleine Borgstedt Risberg, Marion Haugen, Jonas Christoffer Lindstrøm, Urban Nylén, Hans Rutberg, Soop Michael
OBJECTIVES: In this paper, we explore similarities and differences in hospital adverse event (AE) rates between Norway and Sweden by reviewing medical records with the Global Trigger Tool (GTT). DESIGN: All acute care hospitals in both countries performed medical record reviews, except one in Norway. Records were randomly selected from all eligible admissions in 2013. Eligible admissions were patients 18 years of age or older, undergoing care with an in-hospital stay of at least 24 hours, excluding psychiatric and care and rehabilitation...
March 20, 2017: BMJ Open
https://www.readbyqxmd.com/read/28320201/analysis-of-never-events-following-adult-cardiac-surgical-procedures-in-the-united-states
#14
Michael P Robich, Brianna M Krafcik, Nishant K Shah, Alik Farber, Denis Rybin, Jeffrey J Siracuse
BACKGROUND: This study was conducted to determine the risk factors, nature, and outcomes of "never events" following open adult cardiac surgical procedures. Understanding of these events can reduce their occurrence, and thereby improve patient care, quality metrics, and cost reduction. METHODS: "Never events" for patients included in the Nationwide Inpatient Sample who underwent coronary artery bypass graft, heart valve repair/replacement, or thoracic aneurysm repair between 2003-2011 were documented...
March 16, 2017: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28319514/do-not-resuscitate-status-is-associated-with-increased-mortality-but-not-morbidity
#15
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/28318891/lessons-from-a-national-audit-of-acute-pancreatitis-a-summary-of-the-ncepod-report-treat-the-cause
#16
REVIEW
D A O'Reilly, S J McPherson, M T Sinclair, N Smith
The National Confidential Enquiry into Patient Outcome and Death (NCEPOD) is an independent organisation whose remit is to review the quality of medical and surgical care provided in the United Kingdom. We undertook a review into the care provided to patients treated for acute pancreatitis during a 6 month study period between 1st January and 30th June 2014. This included assessment of care at an organisational level, clinical level within hospitals and external peer review. From a random sample, 712 patients underwent hospital clinician review and 418 patients had external peer review...
February 17, 2017: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
https://www.readbyqxmd.com/read/28314966/-neuro-urological-diagnosis-and-therapy-of-lower-urinary-tract-dysfunction-in-patients-with-spinal-cord-injury-s2k-guideline-of-the-german-speaking-medical-society-of-paraplegia-dmgp-awmf-register-no-179-001
#17
R Böthig, B Domurath, A Kaufmann, J Bremer, W Vance, I Kurze
BACKGROUND: Most patients with spinal cord injury (SCI) suffer from neurogenic lower urinary tract dysfunction (NLUTD), bowel dysfunction and sexual dysfunction. If these remain untreated, severe medical complications and serious limitations (restrictions) in quality of life are imminent. OBJECTIVES: In the long term, there are considerable differences in the treatment results of highly specialized centers versus other treatment facilities. MATERIALS AND METHODS: Against this background, a consensus-based guideline, according to the AWMF (Association of the Scientific Medical Societies in Germany) criteria (S2k), was developed by the neuro-urology working group of the DMPG (German-Speaking Medical Society of Paraplegia)...
March 17, 2017: Der Urologe. Ausg. A
https://www.readbyqxmd.com/read/28306679/the-american-college-of-surgeons-children-s-surgery-verification-and-quality-improvement-program-implications-for-anesthesiologists
#18
Constance S Houck, Jayant K Deshpande, Randall P Flick
PURPOSE OF REVIEW: The Task Force for Children's Surgical Care, an ad-hoc multidisciplinary group of invited leaders in pediatric perioperative medicine, was assembled in May 2012 to consider approaches to optimize delivery of children's surgical care in today's competitive national healthcare environment. Over the subsequent 3 years, with support from the American College of Surgeons (ACS) and Children's Hospital Association (CHA), the group established principles regarding perioperative resource standards, quality improvement and safety processes, data collection, and verification that were used to develop an ACS-sponsored Children's Surgery Verification and Quality Improvement Program (ACS CSV)...
March 16, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28306646/prevalence-of-musculoskeletal-disorders-among-surgeons-performing-minimally-invasive-surgery-a-systematic-review
#19
Chantal C J Alleblas, Anne Marie de Man, Lukas van den Haak, Mark E Vierhout, Frank Willem Jansen, Theodoor E Nieboer
OBJECTIVE: The aim of this study was to review musculoskeletal disorder (MSD) prevalence among surgeons performing minimally invasive surgery. BACKGROUND: Advancements in laparoscopic surgery have primarily focused on enhancing patient benefits. However, compared with open surgery, laparoscopic surgery imposes greater ergonomic constraints on surgeons. Recent reports indicate a 73% to 88% prevalence of physical complaints among laparoscopic surgeons, which is greater than in the general working population, supporting the need to address the surgeons' physical health...
March 16, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28303913/multiple-system-atrophy-insights-into-a-rare-and-debilitating-movement-disorder
#20
REVIEW
Florian Krismer, Gregor K Wenning
Multiple system atrophy (MSA) is a devastating and fatal neurodegenerative disorder. The clinical presentation of this disease is highly variable, with parkinsonism, cerebellar ataxia and autonomic failure being the most common - and often debilitating - symptoms. These symptoms progress rapidly, and patients die from MSA-related complications after 9 years of symptom duration on average. Unfortunately, the course of the disease cannot be improved by drug or surgical treatment. In addition, symptomatic treatment options are currently limited, and therapeutic benefits are often only transient...
March 17, 2017: Nature Reviews. Neurology
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