The Swiss cheese model of adverse event occurrence—Closing the holes
This article introduces human factors science and its applicability to teamwork, surgical culture, medical error, and individual accountability. (Source: Seminars in Pediatric Surgery)
Source: Seminars in Pediatric Surgery - August 28, 2015 Category: Pediatrics Authors: James E. Stein, Kurt Heiss Source Type: research
Quality, patient safety, and professional values
From the time of Earnest Codman until recently, measuring and improving quality has variably been viewed as a supportive group in the hospital, or an irritating “fringe” movement in health care. A more thoughtful view of quality improvement (QI) is that it is a central tenet of surgical professionalism, and really what we signed up for when we accepted the responsibility of healing patients using surgery as our methodology. The following article uses a patient safety event to highlight the successful use of a well-known method of improving care, while engaging trainees in the principles of physician engagement, account...
Source: Seminars in Pediatric Surgery - August 28, 2015 Category: Pediatrics Authors: David Skarda, Doug Barnhart Source Type: research
Optimization of care for the pediatric surgical patient: Why now?
In 2015, the American College of Surgeons (ACS) has begun to verify hospitals and ambulatory centers which meet consensus based optimal resource standards as “Children׳s Surgical Centers.” The intent is to identify children-specific resources available within an institution and using a stratification system similar to the ACS Trauma Program match these to the needs of infants and children with surgical problems. This review briefly summarizes the history, supporting data and processes which drove this initiative. (Source: Seminars in Pediatric Surgery)
Source: Seminars in Pediatric Surgery - August 28, 2015 Category: Pediatrics Authors: Marjorie J. Arca, Adam B. Goldin, Keith T. Oldham Source Type: research
Patient-centered care and quality: Activating the system and the patient
We describe the implementation of a new approach to this patient population that serves as an example of redesigning a system of care to optimize safety using the principles of patient-centered care while delivering safe, effective, timely, efficient, and equitable care. (Source: Seminars in Pediatric Surgery)
Source: Seminars in Pediatric Surgery - August 28, 2015 Category: Pediatrics Authors: Morgan K. Richards, Adam B. Goldin Source Type: research
Quality improvement 101 for surgeons: navigating the alphabet soup
This article summarizes the history of ‘improvement science’ and its intersection with the field of surgery. It attempts to clarify principles and jargon that may be new or confusing to surgeons with a different vocabulary and experience. (Source: Seminars in Pediatric Surgery)
Source: Seminars in Pediatric Surgery - August 28, 2015 Category: Pediatrics Authors: Matthew T. Santore, Saleem Islam Source Type: research
Essentials of navigating and teaching surgical quality improvement
Quality improvement (QI) has become a focus of contemporary surgical practice. The purpose of this review is to provide a framework of working knowledge regarding QI for the practicing surgeon. QI design, implementation methods, measurement tactics, statistical analysis, and presentation tools based on the Institute of Healthcare Improvement model are reviewed. Additional principles to optimize QI success such as fostering communication, building a culture of QI, leadership involvement, and financial planning are also explored. (Source: Seminars in Pediatric Surgery)
Source: Seminars in Pediatric Surgery - August 28, 2015 Category: Pediatrics Authors: Mehul V. Raval, Brian D. Kenney Source Type: research
The swiss cheese model of adverse event occurrence- closing the holes
This article introduces human factors science and its applicability to teamwork, surgical culture, medical error and individual accountability. (Source: Seminars in Pediatric Surgery)
Source: Seminars in Pediatric Surgery - August 28, 2015 Category: Pediatrics Authors: James Stein, Kurt Heiss Source Type: research
Preface
In February 2002, Kurt Newman edited an issue of Seminars in Pediatric Surgery that introduced the concept of Quality Improvement to pediatric surgeons. In describing to the reader the “state of the art”, circa 2002, he describes a focus on quality of care for children as one of the foundational strengths of our profession:“An argument can be made, with much justification, that pediatric surgery has been engaged in quality improvement efforts since its inception. Children's Hospitals were built to provide special care for children. (Source: Seminars in Pediatric Surgery)
Source: Seminars in Pediatric Surgery - August 28, 2015 Category: Pediatrics Authors: Kurt Heiss Source Type: research
Culture of safety: A foundation for patient care
The 1999 IOM report on patient safety identified the house of medicine as a culture that tolerated injury at a frightening level. Identifying other industries that had cultures that would not tolerate such levels of error has begun to change the culture of healthcare to a more “high reliability” culture. Various organizational and standardized communication tools have been imported from the military, airline and energy industries to flatten the hierarchy and improve the reliability of communication and hand-offs in healthcare. (Source: Seminars in Pediatric Surgery)
Source: Seminars in Pediatric Surgery - August 28, 2015 Category: Pediatrics Authors: KuoJen Tsao, Marybeth Browne Source Type: research
Quality, patient safety and professional values
From the time of Earnest Codman until recently, measuring and improving quality has variably been viewed as a supportive group in the hospital, or an irritating “fringe” movement in health care. A more thoughtful view of Quality Improvement (QI) is that it is a central tenet of surgical professionalism, and really what we signed up for when we accepted the responsibility of healing patients using surgery as our methodology. The following article uses a patient safety event to highlight the successful use of a well-known method of improving care, while engaging trainees in the principles of physician engagement, account...
Source: Seminars in Pediatric Surgery - August 28, 2015 Category: Pediatrics Authors: David Skarda, Doug Barnhart Source Type: research
Variation in pediatric surgical care
Variation in care and outcomes are common in the management of children with surgical diseases. Differences in the availability of resources, patient and family preferences, ever-increasing fiscal pressure, and lack of high quality data to guide clinical decision-making are just a few factors that contribute to both the over and under-utilization of healthcare resources. Identification of data-driven, value-based “best-practices” that are sensitive to differences in resource availability and patient preferences may be an important first step in establishing a practical framework for reducing unwarranted practice variat...
Source: Seminars in Pediatric Surgery - August 28, 2015 Category: Pediatrics Authors: Danielle Cameron, Shawn Rangel Source Type: research
Improving quality on the pediatric surgery service: missed opportunities and making it happen
In surgery, quality improvement efforts have evolved from the traditional case-by-case review typical for morbidity and mortality conferences to more accurate and comprehensive data collection accomplished through participation in national registries such as the National Surgical Quality Improvement Program. Gaining administrative support to participate in these kinds of initiatives and commitment of the faculty and staff to make change in a data-driven manner rather than as a reaction to individual events can be a challenge. (Source: Seminars in Pediatric Surgery)
Source: Seminars in Pediatric Surgery - August 28, 2015 Category: Pediatrics Authors: Loren Berman, Charles D. Vinocur Source Type: research
Optimization of care for the pediatric surgical patient why now?
In 2015, the American College of Surgeons (ACS) will begin to verify hospitals and ambulatory centers which meet consensus based optimal resource standards as “Children's Surgical Centers”. A pilot program will conclude June 1, 2015. The intent is to identify children's specific resources available within an institution and using a stratification system similar to the ACS Trauma Program match these to the needs of infants and children with surgical problems. This review briefly summarizes the history, supporting data and processes which drove this initiative. (Source: Seminars in Pediatric Surgery)
Source: Seminars in Pediatric Surgery - August 28, 2015 Category: Pediatrics Authors: Marjorie J. Arca, Adam B. Goldin, Keith T. Oldham Source Type: research
Improving surgeon wellness: The second victim syndrome and quality of care
Improving quality of care logically involves optimizing the duty-readiness and well-being of the healthcare provider. Medical errors and poor outcomes adversely impact the involved providers, especially surgeons, as well as the patients and their families. Unfortunately our current system does little to support these “second victims” who experience various degrees of emotional and psychological stresses including confusion, loss of confidence and debilitating anxiety. These factors contribute to the alarmingly high rates of professional “burn-out,” substance abuse, and suicide of healthcare providers as well as inc...
Source: Seminars in Pediatric Surgery - August 28, 2015 Category: Pediatrics Authors: Louis M. Marmon, Kurt Heiss Source Type: research
Patient-centered care and quality: Activating the system, and the patient
We describe the implementation of a new approach to this patient population that serves as an example of redesigning a system of care to optimize safety using the principles of patient-centered care while delivering safe, effective, timely, efficient, and equitable care. (Source: Seminars in Pediatric Surgery)
Source: Seminars in Pediatric Surgery - August 28, 2015 Category: Pediatrics Authors: Morgan K. Richards, Adam B. Goldin Source Type: research
