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[PMID]:28453822
[Au] Autor:Berian JR; Thomas JM; Minami CA; Farrell PR; O'Leary KJ; Williams MV; Prachand VN; Halverson AL; Bilimoria KY; Johnson JK
[Ad] Endereço:Illinois Surgical Quality Improvement Collaborative (ISQIC), 633 N. St Clair St., 20th Floor, Chicago, IL 60611, USA.
[Ti] Título:Evaluation of a novel mentor program to improve surgical care for US hospitals.
[So] Source:Int J Qual Health Care;29(2):234-242, 2017 Apr 01.
[Is] ISSN:1464-3677
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Objective: To evaluate a novel mentor program for 27 US surgeons, charged with improving quality at their respective hospitals, having been paired 1:1 with 27 surgeon mentors through a state-wide quality improvement (QI) initiative. Design: Mixed-methods utilizing quantitative surveys and in-depth semi-structured interviews. Setting: The Illinois Surgical Quality Improvement Collaborative (ISQIC) utilized a novel Mentor Program to guide surgeons new to QI. Participants: All mentor-mentee pairs received the survey (n = 27). Purposive sampling identified a subset of mentors (n = 8) and mentees (n = 4) for in-depth semi-structured interviews. Intervention: Surgeons with expertise in QI mentored surgeons new to QI. Main outcome measures: (i) Quantitative: self-reported satisfaction with the mentor program; (ii) Qualitative: key themes suggesting actions and strategies to facilitate mentorship in QI. Results: Mentees expressed satisfaction with the mentor program (n = 24, 88.9%) and agreed that mentorship is vital to ISQIC (n = 24, 88.9%). Analysis of interview data revealed four key themes: (i) nuances of data management, (ii) culture of quality and safety, (iii) mentor-mentee relationship and (iv) logistics. Strategies from these key themes include: utilize raw data for in-depth QI understanding, facilitate presentations to build QI support, identify opportunities for in-person meetings and establish scheduled conference calls. The mentor's role required sharing experiences and acting as a resource. The mentee's role required actively bringing questions and identifying barriers. Conclusions: Mentorship plays a vital role in advancing surgeon knowledge and engagement with QI in ISQIC. Key themes in mentorship reflect strategies to best facilitate mentorship, which may serve as a guide to other collaboratives.
[Mh] Termos MeSH primário: Mentores
Melhoria de Qualidade/organização & administração
Cirurgiões/psicologia
Centro Cirúrgico Hospitalar/normas
[Mh] Termos MeSH secundário: Comportamento Cooperativo
Feminino
Seres Humanos
Relações Interprofissionais
Masculino
Satisfação Pessoal
Avaliação de Programas e Projetos de Saúde
Inquéritos e Questionários
[Pt] Tipo de publicação:EVALUATION STUDIES; JOURNAL ARTICLE
[Em] Mês de entrada:1711
[Cu] Atualização por classe:180308
[Lr] Data última revisão:
180308
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170429
[St] Status:MEDLINE
[do] DOI:10.1093/intqhc/mzx005


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[PMID]:28453064
[Au] Autor:Ortiz-Barrios MÁ; Felizzola-Jiménez HA
[Ad] Endereço:Universidad de la Costa CUC, Barranquilla, Colombia, mortiz1@cuc.edu.co.
[Ti] Título:[Diagnosis of healthcare issues in clinics and hospital of Barranquilla].
[Ti] Título:Diagnóstico de problemáticas asistenciales en clínicas y hospitales de Barranquilla..
[So] Source:Rev Salud Publica (Bogota);18(4):592-604, 2016 Aug.
[Is] ISSN:0124-0064
[Cp] País de publicação:Colombia
[La] Idioma:spa
[Ab] Resumo:Objective To identify and assess the main healthcare issues found in clinics and hospitals in Barranquilla. Methods Descriptive study applied on two populations: clinics [23] and hospitals [5]. A confidence level of 95 % and the alpha level of 5 % and p=0.5 were used in the study. The resulting sample size for clinics and hospitals was 18 and 4, respectively. Clinics and hospitals were randomly and a 21-question survey was designed to find out the status of the different healthcare processes in the Health Care Sector. The results were processed by using Microsoft Excel 2010 software. Results On one hand, 50 % of the hospitals expressed having problems in outpatient, hospitalization and statistical departments. On the other hand, 61.1 % of the clinics have difficulties in Emergency rooms, 50 % in Surgical Services, 50% in Hospitalization and 38.9 % in Outpatient Department. Conclusions The diagnosis regarding healthcare issues in clinics and hospitals of Barranquilla determines that although the Hospitalization process is a common point for potential improvement in both hospitals and clinics of the city, the greatest priority should be given to Surgical Services, Emergency Department and Statistical Department, due to their average intervention priority.
[Mh] Termos MeSH primário: Assistência Ambulatorial
Serviço Hospitalar de Emergência
Hospitalização
Qualidade da Assistência à Saúde
Centro Cirúrgico Hospitalar
[Mh] Termos MeSH secundário: Assistência Ambulatorial/economia
Assistência Ambulatorial/estatística & dados numéricos
Cidades
Colômbia
Serviço Hospitalar de Emergência/economia
Serviço Hospitalar de Emergência/estatística & dados numéricos
Custos de Cuidados de Saúde
Indicadores Básicos de Saúde
Hospitalização/economia
Hospitalização/estatística & dados numéricos
Hospitais
Seres Humanos
Melhoria de Qualidade
Centro Cirúrgico Hospitalar/economia
Centro Cirúrgico Hospitalar/estatística & dados numéricos
Inquéritos e Questionários
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180216
[Lr] Data última revisão:
180216
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170429
[St] Status:MEDLINE


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[PMID]:28468569
[Au] Autor:Kocián P; Whitley A; Blaha M; Hoch J
[Ad] Endereço:a Department of Surgery, 2nd Faculty of Medicine , Charles University and Motol University Hospital , Prague , Czech Republic.
[Ti] Título:Colorectal cancer in patients under the age of 40 years: experience from a tertiary care centre in the Czech Republic.
[So] Source:Acta Chir Belg;117(6):356-362, 2017 Dec.
[Is] ISSN:0001-5458
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: Colorectal cancer (CRC) in young patients is not an uncommon disease. Reports on its behaviour in young patients are conflicting. The aim of this study was to investigate patient and tumour characteristics, treatment and prognosis of this disease. METHODS: Our study group comprised all patients under the age of 40 years treated with CRC at the Department of Surgery at Motol University Hospital in Prague between the years 2005 and 2015. RESULTS: Thirty-eight patients under 40 years of age diagnosed with CRC were included in the study. Five patients had Lynch syndrome and six had first-degree relatives with CRC. There were 22 rectal tumours. All but four patients underwent resection of the primary tumour, all patients received chemotherapy and 13 patients received biological therapy. Disease recurrence occurred in 25.8%. Five-year survival was 47.9%. Advanced disease and adverse histological subtypes were identified as poor prognostic factors. CONCLUSIONS: Colorectal cancer in young patients has a high incidence of predisposing conditions, aggressive histological features and advanced disease. Young patients are of a good state of health and thus should receive aggressive therapy. Clinicians should pay more attention to symptoms of CRC in young patients to be able to initiate early treatment.
[Mh] Termos MeSH primário: Adenocarcinoma/terapia
Neoplasias Colorretais/terapia
[Mh] Termos MeSH secundário: Centros Médicos Acadêmicos
Adenocarcinoma/mortalidade
Adenocarcinoma/patologia
Adolescente
Adulto
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico
Índice de Massa Corporal
Carcinoma de Células em Anel de Sinete/terapia
Criança
Colectomia/métodos
Neoplasias do Colo/terapia
Neoplasias Colorretais/mortalidade
Neoplasias Colorretais/patologia
Neoplasias Colorretais Hereditárias sem Polipose/terapia
República Tcheca
Feminino
Seres Humanos
Estimativa de Kaplan-Meier
Masculino
Obesidade/complicações
Sobrepeso/complicações
Prognóstico
Neoplasias Retais/terapia
Estudos Retrospectivos
Fatores de Risco
Centro Cirúrgico Hospitalar
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180208
[Lr] Data última revisão:
180208
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170505
[St] Status:MEDLINE
[do] DOI:10.1080/00015458.2017.1321270


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[PMID]:28466618
[Au] Autor:Avinadav E; Almog A; Kravarusic D; Seguier E; Samuk I; Nika A; Freud E
[Ad] Endereço:Department of Pediatric and Adolescent Surgery, Schneider's Children Medical Center of Israel, Petah Tikva, affiliated with Sacker Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
[Ti] Título:Point-of-Care Ultrasound in a Department of Pediatric and Adolescent Surgery.
[So] Source:Isr Med Assoc J;18(11):677-679, 2016 Nov.
[Is] ISSN:1565-1088
[Cp] País de publicação:Israel
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Point-of-care ultrasound (POCUS) is becoming a common tool for routine use in emergency medicine, anesthesiology and intensive care for diagnostic and interventional purposes. When a portable ultrasound device became available for the department of Pediatric and Adolescent Surgery at the Schneider's Children Medical Center of Israel, we added POCUS assessments to the physician's daily rounds. POCUS is performed by pediatric surgeons trained in basic ultrasonography skills. Starting September 2015 all POCUS examinations were documented. OBJECTIVES: To describe the current use, diagnostic and therapeutic impacts of POCUS in a department of pediatric and adolescent surgery. METHODS: We conducted an observational study of all the documented POCUS procedures performed during a half-year period. Data regarding patient condition and the POCUS procedures were collected, as well as data on the use of other diagnostic modalities, mainly formal ultrasound exams (by radiologists) and computed tomography scans and their correlation with the POCUS assessment. RESULTS: Fifty-one POCUS exams were performed during the study period, most of which served to define the presence and resolution of a collection - intraabdominal (34%) and subcutaneous (31%). Despite a high rate for formal diagnostic studies (65%), probably due to a relative lack of confidence of surgeons performing the POCUS exams during this initial period, most results (92%) were compatible. CONCLUSIONS: The ability and availability to perform multiple POCUS exams by the attending physician proved to be a valuable aide to the classical physical and laboratory examinations of surgical patients, and we predict its increasing use in quotidian practice.
[Mh] Termos MeSH primário: Sistemas Automatizados de Assistência Junto ao Leito/utilização
Centro Cirúrgico Hospitalar
Tomografia Computadorizada por Raios X/utilização
Ultrassonografia/utilização
[Mh] Termos MeSH secundário: Adolescente
Criança
Pré-Escolar
Feminino
Seres Humanos
Lactente
Israel
Masculino
Ultrassonografia/tendências
[Pt] Tipo de publicação:JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171128
[Lr] Data última revisão:
171128
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170504
[St] Status:MEDLINE


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[PMID]:28806232
[Au] Autor:Locke CL; Pope DS
[Ad] Endereço:Author Affiliations: Clinical Nurse Specialist, Inpatient & Emergency Services Division (Dr Locke), and Nurse Scientist, Department of Nursing Research (Dr Pope), VA Portland Health Care System, Department of Veterans Affairs, Oregon.
[Ti] Título:Assessment of Medical-Surgical Patients' Perception of Hospital Noises and Reported Ability to Rest.
[So] Source:Clin Nurse Spec;31(5):261-267, 2017 Sep/Oct.
[Is] ISSN:1538-9782
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVES: The purpose was to determine if an enhanced privacy curtain (1) impacted ability to rest while hospitalized in the acute care setting and (2) improved patient satisfaction associated with environmental noise. METHODS: The project evaluated a privacy curtain designed to increase speech privacy and intelligibility and reduce reverberation time (echo). The curtain was similar to the existing privacy curtain with 2 exceptions: the curtain panel had pocket inserts that absorbed sound, and curtain panels could be zipped together to reduce sound transmission through gaps. Curtains were evaluated on 2 medical-surgical units. Patients with at least 2 nights' stay and were alert and oriented without behavioral concerns were asked to complete a 12-item restful environment assessment. RESULTS: The project demonstrated some impact on ability to rest. One unit saw an increase in the patient experience sleep measure score and demonstrated a small increase in the patient's self- reported ability to rest during the day and night when using the enhanced curtain. CONCLUSION: Patients on medical-surgical units were bothered by the noises typically heard in those units. Small improvements in patient experience with the enhanced curtain were outweighed by cost and increased housekeeping and laundry staff workload.
[Mh] Termos MeSH primário: Equipamentos e Provisões Hospitalares
Ruído/prevenção & controle
Pacientes/psicologia
Descanso/psicologia
Centro Cirúrgico Hospitalar
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Feminino
Seres Humanos
Masculino
Meia-Idade
Ruído/efeitos adversos
Satisfação do Paciente/estatística & dados numéricos
Pacientes/estatística & dados numéricos
Privacidade
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170906
[Lr] Data última revisão:
170906
[Sb] Subgrupo de revista:N
[Da] Data de entrada para processamento:170815
[St] Status:MEDLINE
[do] DOI:10.1097/NUR.0000000000000321


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[PMID]:28688658
[Au] Autor:Kuy S; Romero RAL
[Ad] Endereço:Center for Innovations in Quality, Outcomes and Patient Safety, Surgical Service, Overton Brooks Veterans Affairs Medical Center, Shreveport, Louisiana; Department of Surgery, Louisiana State University School of Medicine-New Orleans, LSUHSC School of Medicine, New Orleans, Louisiana; Department of Health, Louisiana Medicaid, Baton Rouge, Louisiana. Electronic address: SreyRam@gmail.com.
[Ti] Título:Decreasing 30-day surgical mortality in a VA Medical Center utilizing the ACS NSQIP Surgical Risk Calculator.
[So] Source:J Surg Res;215:28-33, 2017 Jul.
[Is] ISSN:1095-8673
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: The Overton Brooks VA Medical Center Surgical Service had a high mortality. In an effort to reduce surgical mortality, we implemented a series of quality improvement interventions, including utilization of the ACS Surgical Risk Calculator to identify high-risk surgical patients for discussion in a multidisciplinary Pre-Operative Consultation Committee. METHODS: Retrospective study describing the implementation of a risk stratification intervention incorporating the ACS Surgical Risk Calculator Tool and a multidisciplinary Pre-Operative Consultation Committee to target high-risk patients. Measurement of 30 day surgical mortality and risk adjusted Observed to Expected (O/E) mortality ratio. RESULTS: From May 2013 to September 2014, 614 high-risk patients were selected utilizing the ACS Risk Calculator and presented at the Pre-Operative Consultation Committee. Following implementation of this risk stratification intervention, 30-day mortality decreased by 66% from 0.9% to 0.3%, and risk adjusted O/E mortality ratio decreased from 2.5 to 0.8. Among the high risk patients presented, there was no increase in referrals to other facilities. There was a significant increase in cases requiring further preoperative optimization, from 6.3% at the beginning of the study period to 17.5% at the end of the study period. CONCLUSIONS: Implementation of a preoperative risk stratification intervention utilizing the ACS Surgical Risk Calculator along with a multidisciplinary Pre-Operative Consultation Committee can be successfully accomplished, with a significant decrease in 30-day surgical mortality. This is the first published report of utilization of the ACS Risk calculator as part of a systematic quality improvement tool to decrease surgical mortality.
[Mh] Termos MeSH primário: Técnicas de Apoio para a Decisão
Hospitais de Veteranos/normas
Melhoria de Qualidade/estatística & dados numéricos
Indicadores de Qualidade em Assistência à Saúde/estatística & dados numéricos
Centro Cirúrgico Hospitalar/normas
Procedimentos Cirúrgicos Operatórios/mortalidade
[Mh] Termos MeSH secundário: Hospitais de Veteranos/estatística & dados numéricos
Seres Humanos
Louisiana
Estudos Retrospectivos
Risco Ajustado
Medição de Risco
Centro Cirúrgico Hospitalar/estatística & dados numéricos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171003
[Lr] Data última revisão:
171003
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170710
[St] Status:MEDLINE


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[PMID]:28683893
[Au] Autor:Hicks CW; Liu J; Yang WW; DiBrito SR; Johnson DJ; Brito A; Higgins RSD; Frank SM; Wick EC
[Ad] Endereço:Department of Surgery, Johns Hopkins Hospital, Baltimore, MD, USA. Electronic address: chicks11@jhmi.edu.
[Ti] Título:A comprehensive Choosing Wisely quality improvement initiative reduces unnecessary transfusions in an Academic Department of Surgery.
[So] Source:Am J Surg;214(4):571-576, 2017 Oct.
[Is] ISSN:1879-1883
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: We implemented a comprehensive Choosing Wisely initiative to reduce unnecessary transfusions in an Academic Department of Surgery. METHODS: We conducted a survey- and lecture-based educational intervention to increase awareness about published transfusion guidelines. Monthly transfusion reports were subsequently distributed to all faculty, fellows, residents, and mid-level practitioners. Blood utilization measures were compared pre- vs. post-intervention to assess effectiveness. RESULTS: 7994 blood product orders (5388 pre-intervention, 2606 post-intervention) were placed (07/2014-06/2016). Red blood cell (RBC) (45% vs. 55%; P < 0.001) and plasma (68% vs. 75%; P = 0.02) compliance improved post-intervention, with a corresponding 15% decrease in RBC utilization (0.47 ± 0.02 vs. 0.40 ± 0.02 units/patient; P = 0.01), and 24% decrease in plasma (0.25 ± 0.02 vs. 0.19 ± 0.02 units/patient; P = 0.06). These reductions translate into $125,558 in blood product acquisition cost avoidance (RBC = $114,386, plasma = $11,172). CONCLUSIONS: Implementation of a comprehensive Choosing Wisely campaign targeting individual providers at all levels significantly improved transfusion practices and decreased costs within the Department of Surgery.
[Mh] Termos MeSH primário: Transfusão de Sangue/normas
Comportamento de Escolha
Melhoria de Qualidade
Centro Cirúrgico Hospitalar/normas
Procedimentos Desnecessários/estatística & dados numéricos
[Mh] Termos MeSH secundário: Centros Médicos Acadêmicos
Atitude do Pessoal de Saúde
Seres Humanos
Capacitação em Serviço
Guias de Prática Clínica como Assunto
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170926
[Lr] Data última revisão:
170926
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170708
[St] Status:MEDLINE


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[PMID]:28637570
[Au] Autor:Messick CA; Hammel JP; Hull T
[Ti] Título:Risk Factors that Predict Recurrent Clostridium difficile Infections in Surgical Patients.
[So] Source:Am Surg;83(6):653-659, 2017 Jun 01.
[Is] ISSN:1555-9823
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Clostridium difficile (C. difficile) infection (CDI) is a serious problem mostly studied during patients' index infections. The aim of this study is to define the incidence of primary and recurrent postoperative (postop) CDI in a single institution's entire surgical population and to identify risk factors that influence disease recurrence. Using electronic medical records from 2002 to 2012, charts were reviewed from all patients with laboratory-proven (enzyme-linked immunosorbent assay or polymerase chain reaction methods) C. difficile-positive stool samples. Index postop CDI was defined as a positive C. difficile assay (CDA) within 30 days of surgery and recurrence was defined as a positive CDA within 30 days of any surgery in a patient with a previously documented positive CDA. Patient demographics, surgical diagnoses, and laboratory data were recorded. Approximately 342,000 surgeries were performed in the study period with a 0.6 per cent (2188 patients) incidence of index postop CDI. Patients undergoing musculoskeletal surgery had the highest recurrent CDI rate [odds ratio (OR) 3.09 (1.47-6.49), P = 0.003]. Use of any steroid (OR 2.45 [1.43-4.20], P = 0.002) or other immunosuppressant (OR 2.64 [1.09-6.38], P = 0.011) within six months of surgery was associated with an increased risk of the development of a recurrent CDI. Across surgical specialties at our institution, postop index CDI is low and patients have about a 5-fold increased risk for developing recurrent CDI. Patients undergoing musculoskeletal surgery are at greater risk for CDI recurrence and younger age, use of steroids and immune modulators, and surgery by organ system are independent risk factors for a recurrent CDI.
[Mh] Termos MeSH primário: Infecções por Clostridium/epidemiologia
Infecções por Clostridium/microbiologia
Clostridium difficile/isolamento & purificação
Infecção Hospitalar/epidemiologia
Infecção Hospitalar/microbiologia
Centro Cirúrgico Hospitalar/estatística & dados numéricos
[Mh] Termos MeSH secundário: Adolescente
Adulto
Idoso
Idoso de 80 Anos ou mais
Criança
Pré-Escolar
Infecções por Clostridium/diagnóstico
Infecção Hospitalar/diagnóstico
Procedimentos Cirúrgicos Eletivos/estatística & dados numéricos
Registros Eletrônicos de Saúde
Feminino
Seres Humanos
Incidência
Lactente
Masculino
Meia-Idade
Recidiva
Estudos Retrospectivos
Fatores de Risco
Estados Unidos/epidemiologia
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171106
[Lr] Data última revisão:
171106
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170623
[St] Status:MEDLINE


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[PMID]:28637571
[Au] Autor:Nakayama DK
[Ti] Título:Workforce Issues in Pediatric Surgery.
[So] Source:Am Surg;83(6):660-665, 2017 Jun 01.
[Is] ISSN:1555-9823
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:High salaries indicate a demand for pediatric surgeons in excess of the supply, despite only a slight growth in the pediatric-age population and a sharp increase in numbers of trainees. Top-level neonatal intensive care units require 24-hour-7-day pediatric surgical availability, so hospitals are willing to pay surgeons a premium and engage high-priced locum tenens surgeons to fill vacancies in coverage. With increased supply comes an erosion of the numbers of cases performed by trainees and surgeons in practice. Caseloads may be inadequate to gain expertise and maintain skills. A quality initiative sponsored by the American College of Surgeons and the American Pediatric Surgical Association will discourage underresourced community facilities and surgeons without specialty training from performing operations on children, mostly common conditions such as appendicitis. This will further increase demand for specialty-trained practitioners. Receiving less attention are considerations of value, the ratio of quality per dollar cost. Cost concerns, paramount among buyers of health care (businesses, insurance companies, and governmental health agencies), will prefer community hospitals that have lower cost structures than specialty children's facilities. Less recognized are the costs to families, who for a myriad of reasons would prefer closer alternatives. Cost considerations support providing pediatric surgical services in local facilities. Quality considerations may be addressed by a tiered system where top centers would care for conditions that require technical expertise and advanced modalities. Evidence indicates that pediatric surgeons already direct such cases to more specialized centers.
[Mh] Termos MeSH primário: Assistência à Saúde/economia
Hospitais Comunitários/economia
Pediatria
Especialidades Cirúrgicas/economia
Cirurgiões/provisão & distribuição
Centro Cirúrgico Hospitalar/economia
[Mh] Termos MeSH secundário: Criança
Cirurgia Geral/economia
Necessidades e Demandas de Serviços de Saúde
Seres Humanos
Qualidade da Assistência à Saúde
Especialidades Cirúrgicas/recursos humanos
Estados Unidos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171106
[Lr] Data última revisão:
171106
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170623
[St] Status:MEDLINE


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[PMID]:28601337
[Au] Autor:Hill J; Janko M; Angell KF; Day K; Noujaim MG; Kalil J; Steele SR
[Ad] Endereço:Department of Surgery, University Hospitals Cleveland Medical Center and Case Western Reserve University School of Medicine, Cleveland, Ohio.
[Ti] Título:Hospital text paging communication as a surgical quality improvement initiative.
[So] Source:J Surg Res;213:84-89, 2017 Jun 01.
[Is] ISSN:1095-8673
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Studies on medicine wards have shown that numeric pages can be disruptive of workflow and patient care. We created a quality improvement program among surgical ward nurses and residents and hypothesized that a text-based, urgency-stratified initiative would improve communication at no detriment to patient care. METHODS: Surgery residents recorded preintervention data for 1 mo including number of total pages, text pages, and numeric pages received from surgical floors. Nurses and residents completed surveys to assess preintervention satisfaction with communication, responsiveness, and workflow. Nurses were then instructed to use text paging for nonurgent issues. Paging data were again recorded for 1 mo, surveys repeated, and patient safety and satisfaction data collected. Primary endpoints evaluated included patient safety and satisfaction data. Secondary endpoints included communication satisfaction of nurses and residents. RESULTS: After text paging implementation, 40.1% of nonurgent pages sent from nurses to resident physicians were alphanumeric texts versus only 17.9% before implementation (P < 0.0001). There was a 19.5% reduction in the number of nonurgent numeric pages sent (P < 0.0001). Overall, 70% of nurses responded postintervention that text paging was the preferred method of contacting a physician and that the text paging initiative improved efficiency. After implementation, 62% of nurses thought that overall communication with clinicians improved. In addition, there was no change in patient safety issues or patient satisfaction. CONCLUSIONS: Our text paging initiative for all nonurgent pages from nurses to residents improved physician-nurse workflow and communication on the surgical ward with no decrease in patient satisfaction or safety.
[Mh] Termos MeSH primário: Relações Interprofissionais
Melhoria de Qualidade/organização & administração
Centro Cirúrgico Hospitalar/organização & administração
Mensagem de Texto
[Mh] Termos MeSH secundário: Atitude do Pessoal de Saúde
Eficiência Organizacional
Seres Humanos
Internato e Residência
Enfermeiras e Enfermeiros
Ohio
Segurança do Paciente
Satisfação do Paciente
Fluxo de Trabalho
[Pt] Tipo de publicação:CLINICAL TRIAL; JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170919
[Lr] Data última revisão:
170919
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170612
[St] Status:MEDLINE



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