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10 papers 0 to 25 followers Papers reflecting cool ideas, disruptive thinking, and digitalhealth advances - cool stuff in anesthesia and perioperative medicine
By Ron George Anesthesiologist with special interests in Obstetrics, Pain, and Global Health
https://www.readbyqxmd.com/read/28279297/the-academic-medical-system-reinvention-to-survive-the-revolution-in-health-care
#1
REVIEW
Marvin A Konstam, Joseph A Hill, Richard J Kovacs, Robert A Harrington, James A Arrighi, Amit Khera
Academic medical centers (AMCs) are presently facing enormous challenges arising from a prospective decline in government funding for research and education, shifting payment models emphasizing efficiency and value, and increasing competition. Left unabated, these challenges will drive many AMCs to de-emphasize or forsake their core missions in an effort to survive. Stemming from a symposium held at the 2015 Scientific Sessions of the American College of Cardiology titled, "The Academic Medical Center of the Future," we propose a series of changes, including internal restructuring, system-wide partnership, and novel approaches to support research and education, that are designed to better position AMCs to compete and face their growing challenges in a manner that preserves their essential missions...
March 14, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28284877/midwifery-continuity-of-carer-in-an-area-of-high-socio-economic-disadvantage-in-london-a-retrospective-analysis-of-albany-midwifery-practice-outcomes-using-routine-data-1997-2009
#2
Caroline Se Homer, Nicky Leap, Nadine Edwards, Jane Sandall
OBJECTIVE: in 1997, The Albany Midwifery Practice was established within King's College Hospital NHS Trust in a South East London area of high social disadvantage. The Albany midwives provided continuity of care to around 216 women per year, including those with obstetric, medical or social risk factors. In 2009, the Albany Midwifery Practice was closed in response to concerns about safety, amidst much publicity and controversy. The aim of this evaluation was to examine trends and outcomes for all mothers and babies who received care from the practice from 1997-2009...
February 27, 2017: Midwifery
https://www.readbyqxmd.com/read/28219376/cooperate-a-paradigm-shift-for-health-equity
#3
REVIEW
Wei-Ching Chang, Joy H Fraser
The role of competition and cooperation in relation to the goal of health equity is examined in this paper. The authors explain why the win-lose mentality associated with avoidable competition is ethically questionable and less effective than cooperation in achieving positive outcomes, particularly as it relates to health and health equity. Competition, which differentiates winners from losers, often with the winner-takes-all reward system, inevitably leads to a few winners and many losers, resulting in social inequality, which, in turn, engenders and perpetuates health inequity...
February 21, 2017: International Journal for Equity in Health
https://www.readbyqxmd.com/read/28110382/economic-evaluations-alongside-efficient-study-designs-using-large-observational-datasets-the-pleasant-trial-case-study
#4
Matthew Franklin, Sarah Davis, Michelle Horspool, Wei Sun Kua, Steven Julious
BACKGROUND: Large observational datasets such as Clinical Practice Research Datalink (CPRD) provide opportunities to conduct clinical studies and economic evaluations with efficient designs. OBJECTIVES: Our objectives were to report the economic evaluation methodology for a cluster randomised controlled trial (RCT) of a UK NHS-delivered public health intervention for children with asthma that was evaluated using CPRD and describe the impact of this methodology on results...
January 21, 2017: PharmacoEconomics
https://www.readbyqxmd.com/read/28077235/drivers-of-poor-medical-care
#5
REVIEW
Vikas Saini, Sandra Garcia-Armesto, David Klemperer, Valerie Paris, Adam G Elshaug, Shannon Brownlee, John P A Ioannidis, Elliott S Fisher
The global ubiquity of overuse and underuse of health-care resources and the gravity of resulting harms necessitate an investigation of drivers to inform potential solutions. We describe the network of influences that contribute to poor care and suggest that it is driven by factors that fall into three domains: money and finance; knowledge, bias, and uncertainty; and power and human relationships. In each domain the drivers operate at the global, national, regional, and individual level, and are modulated by the specific contexts within which they act...
January 6, 2017: Lancet
https://www.readbyqxmd.com/read/27603038/a-model-for-the-departmental-quality-management-infrastructure-within-an-academic-health-system
#6
Simon C Mathews, Renee Demski, Jody E Hooper, Lee Daugherty Biddison, Stephen A Berry, Brent G Petty, Allen R Chen, Peter M Hill, Marlene R Miller, Frank R Witter, Lisa Allen, Elizabeth C Wick, Tracey S Stierer, Lori Paine, Hans A Puttgen, Rafael J Tamargo, Peter J Pronovost
As quality improvement and patient safety come to play a larger role in health care, academic medical centers and health systems are poised to take a leadership role in addressing these issues. Academic medical centers can leverage their large integrated footprint and have the ability to innovate in this field. However, a robust quality management infrastructure is needed to support these efforts. In this context, quality and safety are often described at the executive level and at the unit level. Yet, the role of individual departments, which are often the dominant functional unit within a hospital, in realizing health system quality and safety goals has not been addressed...
September 6, 2016: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/27440636/surgicric-2-a-comparative-bench-study-with-two-established-emergency-cricothyroidotomy-techniques-in-a-porcine-model
#7
L Chrisman, W King, K Wimble, S Cartwright, K B Mohammed, B Patel
BACKGROUND: 'Can't Intubate, Can't Oxygenate' is a rare but life threatening event. Anaesthetists must be trained and have appropriate equipment available for this. The ideal equipment is a topic of ongoing debate. To date cricothyroidotomy training for anaesthetists has concentrated on cannula techniques. However cases reported to the NAP4 audit illustrated that they were associated with a high failure rate. A recent editorial by Kristensen and colleagues suggested all anaesthetists must master a surgical technique...
August 2016: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/18257379/a-move-to-universal-or-start-times-a-case-study-of-leading-change-in-an-academic-anesthesia-department
#8
Kathleen Donahue, Berend Mets
Learn how leaders at Penn State Milton S. Hershey Medical Center successfully implemented universal operating room start times and the impact it had on patient flow.
January 2008: Physician Executive
https://www.readbyqxmd.com/read/27524393/addition-of-a-non-immersive-virtual-reality-component-to-treadmill-training-to-reduce-fall-risk-in-older-adults-v-time-a-randomised-controlled-trial
#9
RANDOMIZED CONTROLLED TRIAL
Anat Mirelman, Lynn Rochester, Inbal Maidan, Silvia Del Din, Lisa Alcock, Freek Nieuwhof, Marcel Olde Rikkert, Bastiaan R Bloem, Elisa Pelosin, Laura Avanzino, Giovanni Abbruzzese, Kim Dockx, Esther Bekkers, Nir Giladi, Alice Nieuwboer, Jeffrey M Hausdorff
BACKGROUND: Age-associated motor and cognitive deficits increase the risk of falls, a major cause of morbidity and mortality. Because of the significant ramifications of falls, many interventions have been proposed, but few have aimed to prevent falls via an integrated approach targeting both motor and cognitive function. We aimed to test the hypothesis that an intervention combining treadmill training with non-immersive virtual reality (VR) to target both cognitive aspects of safe ambulation and mobility would lead to fewer falls than would treadmill training alone...
September 17, 2016: Lancet
https://www.readbyqxmd.com/read/27524394/virtual-reality-and-the-prevention-of-falls-in-the-real-world
#10
COMMENT
Stephen R Lord
No abstract text is available yet for this article.
September 17, 2016: Lancet
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