Creating a safer operating room: Groups, team dynamics and crew resource management principles
The operating room (OR) is a special place wherein groups of highly skilled individuals must work in a coordinated and harmonious fashion to deliver optimal patient care. Team dynamics and human factors principles were initially studied by the aviation industry to better understand and prevent airline accidents. As a result, crew resource management (CRM) training was designed for all flight personnel to create a highly reliable industry with a commitment to a culture of safety. CRM has since been adapted to health care, resulting in care improvement and harm reduction across a wide variety of medical specialties. (Source:...
Source: Seminars in Pediatric Surgery - February 9, 2018 Category: Pediatrics Authors: Derek Wakeman, Max R. Langham Source Type: research
Creating a Safer Operating Room: Groups, Team Dynamics and Crew Resource Management Principles
The operating room (OR) is a special place wherein groups of highly skilled individuals must work in a coordinated and harmonious fashion to deliver optimal patient care. Team dynamics and human factors principles were initially studied by the aviation industry to better understand and prevent airline accidents. As a result, crew resource management (CRM) training was designed for all flight personnel to create a highly reliable industry with a commitment to a culture of safety. CRM has since been adapted to health care, resulting in care improvement and harm reduction across a wide variety of medical specialties. (Source:...
Source: Seminars in Pediatric Surgery - February 9, 2018 Category: Pediatrics Authors: Derek Wakeman, Max R. Langham Source Type: research
Operating room efficiency
The operating room is the financial hub of any hospital, and maximizing operating room efficiency has important implications for cost savings, patient satisfaction, and medical team morale. Over the past decade, manufacturing principles and processes such as Lean and Six Sigma have been applied to various aspects of healthcare including the operating room. Although time consuming, process mapping and deep examinations of each step of the patient journey from pre-operative visit to post-operative discharge can have multiplicative benefits that extend from cost savings to maintaining the focus on improving quality and patien...
Source: Seminars in Pediatric Surgery - February 8, 2018 Category: Pediatrics Authors: David H. Rothstein, Mehul V. Raval Source Type: research
Operating Room Efficiency
The operating room is the financial hub of any hospital, and maximizing operating room efficiency has important implications for cost savings, patient satisfaction, and medical team morale. Over the past decade, manufacturing principles and processes such as Lean and Six Sigma have been applied to various aspects of healthcare including the operating room. Although time consuming, process mapping and deep examinations of each step of the patient journey from pre-operative visit to post-operative discharge can have multiplicative benefits that extend from cost savings to maintaining the focus on improving quality and patien...
Source: Seminars in Pediatric Surgery - February 8, 2018 Category: Pediatrics Authors: David H. Rothstein, Mehul V. Raval Source Type: research
Preoperative anesthesia evaluation
The preoperative evaluation is the first step in ensuring the safe conduct of anesthetic care in pediatric patients of all ages. Over time, this process has changed significantly from a time when patients were admitted to the hospital the night before surgery to a time when the majority of patients, including those scheduled for major surgical procedures, arrive the day of surgery. For most patients, the preoperative examiantion can be conducted over the phone by a trained nurse or on-line via a survey thereby eliminating the need for a separate visit merely for the preoperative evaluation. (Source: Seminars in Pediatric Surgery)
Source: Seminars in Pediatric Surgery - February 7, 2018 Category: Pediatrics Authors: Joseph D. Tobias Source Type: research
Ambulatory pediatric surgery
has become increasingly common in recent years, with greater numbers of procedures being performed on an outpatient basis. This practice has clear benefits for hospitals and healthcare providers, but patients and families also often prefer outpatient surgery for a variety of reasons. However, maximizing the potential opportunities requires critical attention to patient and procedure selection, as well as anesthetic choice. A subset of outpatient procedures can be performed as single visit procedures, further simplifying the process for families and providers. (Source: Seminars in Pediatric Surgery)
Source: Seminars in Pediatric Surgery - February 7, 2018 Category: Pediatrics Authors: Andrew B. Nordin, Sohail R. Shah, Brian D. Kenney Source Type: research
Patient engagement to enhance recovery for children undergoing surgery
For over 20 years enhanced recovery protocols (ERPs) have been used to decrease the physiologic stress and inflammation of surgery using evidence-based principles. ERPs include optimizing patient preparation, creating less trauma using minimally invasive anesthetic and surgical techniques, and regular audit of outcomes. A critical aspect of ERPs is patient engagement in all phases of care, which facilitates effective team function and focused oversight of patient flow through the system. Counseling extends beyond traditional review of surgical risks and benefits, by creating clear daily patient goals, establishing pain man...
Source: Seminars in Pediatric Surgery - February 7, 2018 Category: Pediatrics Authors: Kurt F. Heiss, Mehul V. Raval Source Type: research
Advances in perioperative quality and safety
For decades, safe surgery focused on intraoperative technique and decision-making. The traditional hierarchy placed the surgeon as the leader with ultimate authority and responsibility. Despite the advances in surgical technique and equipment, too many patients have suffered unnecessary complications and suboptimal care. Today, we understand that the conduct of safe and effective surgery requires evidence-based decision-making, multifaceted treatment approaches to prevent complications, and effective communication in and out of the operating room. (Source: Seminars in Pediatric Surgery)
Source: Seminars in Pediatric Surgery - February 7, 2018 Category: Pediatrics Authors: Kathryn T. Anderson, Rachel Appelbaum, Marisa A. Bartz-Kurycki, KuoJen Tsao, Marybeth Browne Source Type: research
Telemedicine in the perioperative experience
Telemedicine, the remote diagnosis and treatment of patients by means of technology, provides an alternative means for patients to gain access to health care services. Telemedicine is a general term that includes the use of various communication technologies, including telephone, email, or videoconferencing. Telemedicine has the potential to reduce inefficiencies in the delivery of healthcare, diminish patient travel and wait times, and increase access to specialists for patients in rural settings. (Source: Seminars in Pediatric Surgery)
Source: Seminars in Pediatric Surgery - February 7, 2018 Category: Pediatrics Authors: Aaron P. Lesher, Sohail R. Shah Source Type: research
Importance of patient and family satisfaction in perioperative care
As healthcare systems increasingly shift focus toward providing high-quality and high-value care to patients, there has been a simultaneous growth in assessing the patient's experience through patient-reported outcomes. Along with well-known patient reported outcomes such as health-related quality of life and current health state, patient satisfaction can be a valuable assessment of quality. Patient and family satisfaction measures not only affect a patient ’s clinical course and influence overall patient compliance, but are increasingly used to gauge physician performance and guide reimbursement. (Source: Seminars in Pediatric Surgery)
Source: Seminars in Pediatric Surgery - February 7, 2018 Category: Pediatrics Authors: Kristen A. Calabro, Mehul V. Raval, David H. Rothstein Source Type: research
Preoperative anesthesia evaluation
The preoperative evaluation is the first step in ensuring the safe conduct of anesthetic care in pediatic patients of all ages. Over time, this process has changed significantly from a time when patients were admitted to the hospital the night before surgery to a time when the majority of patients, including those scheduled for major surgical procedures, arrive the day of surgery. For most patients, the preoperative examiantion can be conducted over the phone by a trained nurse or on-line via a survey thereby eliminating the need for a separate visit merely for the preoperative evaluation. (Source: Seminars in Pediatric Surgery)
Source: Seminars in Pediatric Surgery - February 7, 2018 Category: Pediatrics Authors: Joseph D. Tobias Source Type: research
Ambulatory Pediatric Surgery
Ambulatory pediatric surgery has become increasingly common in recent years, with greater numbers of procedures being performed on an outpatient basis. This practice has clear benefits for hospitals and healthcare providers, but patients and families also often prefer outpatient surgery for a variety of reasons. However, maximizing the potential opportunities requires critical attention to patient and procedure selection, as well as anesthetic choice. A subset of outpatient procedures can be performed as single visit procedures, further simplifying the process for families and providers. (Source: Seminars in Pediatric Surgery)
Source: Seminars in Pediatric Surgery - February 7, 2018 Category: Pediatrics Authors: Andrew B. Nordin, Sohail R. Shah, Brian D. Kenney Source Type: research
Patient engagement to enhance recovery for children undergoing surgery
For over 20 years enhanced recovery protocols (ERPs) have been used to decrease the physiologic stress and inflammation of surgery using evidence-based principles. ERPs include optimizing patient preparation, creating less trauma using minimally invasive anesthetic and surgical techniques, and regular audit of outcomes. A critical aspect of ERPs is patient engagement in all phases of care, which facilitates effective team function and focused oversight of patient flow through the system. Counseling extends beyond traditional review of surgical risks and benefits, by creating clear daily patient goals, establishing pain man...
Source: Seminars in Pediatric Surgery - February 7, 2018 Category: Pediatrics Authors: Kurt F. Heiss, Mehul V. Raval Source Type: research
Advances in Perioperative Quality and Safety
For decades, safe surgery focused on intraoperative technique and decision-making. The traditional hierarchy placed the surgeon as the leader with ultimate authority and responsibility. Despite the advances in surgical technique and equipment, too many patients have suffered unnecessary complications and suboptimal care. Today, we understand that the conduct of safe and effective surgery requires evidence-based decision-making, multifaceted treatment approaches to prevent complications, and effective communication in and out of the operating room. (Source: Seminars in Pediatric Surgery)
Source: Seminars in Pediatric Surgery - February 7, 2018 Category: Pediatrics Authors: Kathryn T. Anderson, Rachel Appelbaum, Marisa A. Bartz-Kurycki, KuoJen Tsao, Marybeth Browne Source Type: research
