Day Admission Surgery:
|
|
- Randolph Baker
- 5 years ago
- Views:
Transcription
1 Day Admission Surgery: How to Decrease Hospital Expenses? George Silvay, M.D., Ph.D. Professor, Department of Anesthesiology The Mount Sinai School of Medicine, New York, NY
2 The Mount Sinai School of Medicine, New York
3 DISCLOSURE Nothing at present...but I am hoping..
4 Value of Pre-Anesthesia Evaluation for Surgery: On 1994, France enacted a law making preoperative anesthesia assessment mandatory at least 2 days before a non-emergent operation Ausset S. et al Br J Anesth 2002;88:
5 Value of Pre-Anesthesia Evaluation for Surgery: Australian Incident Monitoring Study 197 (3.1%) of 6,271 patients were not evaluated pre-operatively by an anesthesiologist. Of these, death followed in 7 cases Major morbidity (preventable) in 23 cases Unscheduled admission to ICU in 17 cases Surgery was cancelled in 9 cases Shaarawy T. et al Anesthesia 2000;55:1173-8
6 History of Pre-anesthesia Evaluation for Surgery MSSM: From 2000, all patients for major surgery were admitted to hospital one day prior OR, cardiac and major vascular (CMV) + other 1 3 days prior OR. From 2003 majority of patients were evaluated 3 7 days before elective operation. CMV were not satisfied. From 2007 was open new pre-anesthetic clinic only for CMV patients.
7 Flynn, BC et al Seminars CTVA 2009;13(4):
8 Pre-Anesthesia Clinic for DAS Cardiac and TAA Patients at MSMC Following indication for elective surgery in the Cardiac Surgical and Aortic Aneurysm Center, the patient is scheduled 3 7 days prior the DAS operation Silvay, G et al T. et al HSR Proceedings 2010;2:40-3
9 Pre-Anesthesia Clinic for DAS Cardiac and TAA Patients at MSMC Staff: Cardiac anesthesiologist RN practitioner RN trained in CICU Location: Same floor as CICU & CCU Silvay, G et al T. et al HSR Proceedings 2010;2:40-3
10 Preoperative Assessment of Patients and Organization of the Operating Room is Critical Close communication of anesthesiologist with surgeon, cardiologist, perfusionist, intensivist and OR nurses is necessary to provide an optimal management and perioperative care of the patient. It is important to prevent and avoid surprises in the OR and update the teamwork communication!! Harmony in the OR provide optimal results and decreasing the morbidity and mortality. Silvay G, Stone M Sem Cardiothor Vasc Anesth 2006;10:1015
11 DAS Clinic for Cardiac and Major Vascular Surgery Day before the operation: Staff of PAC confirms all the arrangements for the OR and ICCU: blood bank order, blood conservation strategies, medication refinement. PAC are preparing all records, tests and other documentation. On the day of surgery, patient is admitted to the hospital in the PAC, after basic assessment of the patient to prevent interval changes, Antibacterial prophylaxis, the patient is escorted to the OR. Silvay G, Stone M Sem Cardiothor Vasc Anesth 2006;10:1015
12 PAC for TAA Objectives History, basic examination, airway Consultations with all necessary specialists, usually on same day as PAC visit (hematology, pulmonary. cardiology, pain management) Arrange further tests: carotid doppler, PFT s, dental examination, laboratory testing Perioperative medication reconcilaition: statins, beta-blockers, pacemaker, anti-platelet medications (previous stents), pacemaker, glucose lowering medications
13 PAC for TAA Objectives Neurologic evaluation (cognitive tests) Obtain medical reports: previous cardiac and non cardiac operations, difficulty with previous anesthesia managements, outside care-giver records Inform patients and family about hospitalization, insurance, anesthesia, monitoring and surgery
14 PAC for TAA Objectives Tour CSICU for patient and family Provide electronic information to the anesthesia team, OR, monitoring team, CSICU, pain management Visit patient after operation
15 The Day Before DAS All medical, logistics and administrative requirements are again evaluated: - OR schedule - Blood bank - Antibacterial prophylaxis - Blood conservation strategy - Plan for optimal monitoring - Cardiothoracic SICU - Pain management
16 On the day of surgery Patients are admitted in the same PAC, which maintains familiarity with personnel and location An immediate assessment of the patients is mandatory (no interval changes) IV started and antibiotics begun for prophylaxis!! Smooth, and on time transport to OR
17 Results (1/2007-9/2010) 3,504 evaluations performed in PAC 379 patients for TAA Ascending 17% Arch 21% Root 41% TAAA 21% 98 patients were seen in cardiac catheterization suite prior to urgent operation 48 patients were cancelled (medical or logistical reasons)
18 DeMaria, S et al Anesth Analg 2011 In Press
19 DeMaria, S et al Anesth Analg 2011 In Press
20 Lau H et al Journal of Clinical Anesthesia 2010;22:
21 Lau H et al Journal of Clinical Anesthesia 2010;22:
22 Lau H et al Journal of Clinical Anesthesia 2010;22:
23 Decrease of Complications: The AA Surveillance Program Improved Surgical and Perfusion Techniques Inform OR, CICU and pain management Controlled distal perfusion; MEP s; CSF drainage; hemodynamic manipulation, avoid hypotension and anemia Castillo JG, Silvay G, Fischer GW: In TAAA: Springer-Verlag Italia 2011
24 Cost effective reasons for DAS 1) Patient satisfaction (family environment) 2) Avoid waste of resources in case of cancellation 3) Direct communication between OR staff 4) Bed availability 5) Avoid repeated tests 6) Decreased length of stay 7) Resident and fellow education 8) More efficient consults 9) Dental clearance
25 Conclusion Our preliminary observations include: - Increases in patient satisfaction - Safety and efficiency in the operating room - Decreases cancellation - Ongoing goal to provide cost containment through proper ordering of labs and consultations We believe that not only patients, but all medical personal benefit from a complete preoperative evaluation of these complicated patients and this creates harmony during the entire hospitalization!
26 Thank You Dakujem za pozornost
27 Flynn, BC et al Seminars CTVA 2009;13(4):
28 Complex Aortic Surgery and Surveillance Program 3-6 months F/U all patients with TAA Established and timely execution the type of treatment for elective TAA Medical Conservative approach Surgical repair DAS Endovascular stent Educated patient and family about disease. Silvay, G et al T. et al HSR Proceedings 2010;2:40-3
29 Chiesa R. et al:h.san Raffaele Proceeding 2009;1: 47-55
30 DAS Clinic for Cardiac and Major Vascular Surgery 3-7 days before OR: Multi-disciplinary preoperative evaluation, updated history, physical and dental Basic examinations (Physical, EKG, chest X ray) Specific laboratory and clinical test Medication refinement: beta-blockers, recent PCI, antiplatelet therapy, glucose control, etc. Patients and their families are offered a tour of the CICU with discussions on what to expect postoperatively. Silvay G, Stone M Sem Cardiothor Vasc Anesth 2006;10:1015
31 Preoperative assessment and data collection Preoperative assessment of all organ subsystems. Information about size, location, and extent of TAA. Patient medication (e.g. discontinue Plavix, warfarin or other anticoagulants). Laboratory studies Preoperative antibacterial prophylaxis. Position / one lung anesthesia Silvay G, Stone M Sem Cardiothor Vasc Anesth 2006;10:1015
32 Preoperative assessment and data collection Plan for brain protection during DHCA (jugular bulb oxygen saturation, brain monitoring) Strategy for spinal cord protection (e.g. CSF drainage, mild hypothermia, SSEPs, MEPs, steroids). Blood conservation strategy (antifibrinolytics, cell saver). Optimize perioperative and postoperative monitoring Silvay G, Stone M Sem Cardiothor Vasc Anesth 2006;10:1015
33 Decrease of Complications: The AA Surveillance Program Detail Preoperative Assessment - DAS in PAC CMVS Dental clearance!! Avoid surprises in the operating room Silvay G et al Aortic Symposium 2010 Abstract (p 291)
34 Lau H et al Journal of Clinical Anesthesia 2010;22:
ENVIRONMENT Preoperative evaluation clinic. Preoperative evaluation clinic. Preoperative evaluation clinic. clinic. clinic. Preoperative evaluation
Goals and Objectives, Preoperative Evaluation Clinic Rotation, CA-1 and CA-2 year UCSD DEPARTMENT OF ANESTHESIOLOGY PREOPERATIVE EVALUATION CLINIC ROTATION GOALS AND OBJECTIVES, CA-1 and CA-2 YEAR PATIENT
More informationDomain 5 Cardiothoracic Standards RCoA Accreditation 2017
1 PRIORITY The Care Pathway 5.4.1.1 The process for preoperative assessment presenting for cardiac and thoracic patients (including thoracic aortic) is defined within the patient pathway. 1 A clinical
More informationCritical Care Curriculum for Two-Month Rotation as Part of an Anesthesiology Residency
DEPARTMENT OF ANESTHESIA Critical Care Curriculum for Two-Month Rotation as Part of an Anesthesiology Residency 1. An anesthesiology resident, during a two month rotation should gain exposure to the scope
More informationPRE OPERATIVE MANAGEMENT FOR PEDIATRIC HOSPITALISTS
Before the Operating Room: PRE OPERATIVE MANAGEMENT FOR PEDIATRIC HOSPITALISTS Presenters: Anjna Melwani, MD Sonaly McClymont, MD David Rappaport, MD Sarah Denniston, MD David Pressel, MD Amy Vinson, MD
More informationPart 4. Change Concepts for Improving Adult Cardiac Surgery. In this section, you will learn a group. of change concepts that can be applied in
Change Concepts for Improving Adult Cardiac Surgery Part 4 In this section, you will learn a group of change concepts that can be applied in different ways throughout the system of adult cardiac surgery.
More informationPrinciples In developing these recommendations the Consensus Panel first established the following principles for anesthesia outcomes capture:
Outcomes of Anesthesia: Core Measures The following Core Measures are the consensus recommendations of the Anesthesia Quality Institute (AQI) and the Multicenter Perioperative Outcomes Group (MPOG). They
More informationInstitutional Handbook of Operating Procedures Policy
Section: Admission, Discharge, and Transfer Institutional Handbook of Operating Procedures Policy 9.1.29 Responsible Vice President: EVP & CEO Health System Subject: Admission, Discharge, and Transfer
More information2018 Collaborative Quality Initiative Fact Sheet
2018 Collaborative Quality Initiative Fact Sheet Blue Cross Blue Shield of Michigan Cardiovascular Consortium Overview The Blue Cross Blue Shield of Michigan Cardiovascular Consortium, commonly called
More informationImproving Compliance
Improving Compliance * The following planners, speakers, moderators, and/or panelists of this CME activity have no relevant financial relationships with commercial interests to disclose: Mary B. Johnson
More informationClinical Fellowship: Cardiac Anesthesia
Anesthesia and Perioperative Medicine Western University Cardiac Anesthesia Program Director Dr. Anita Cave Please visit the Cardiac Anesthesia Fellowship site for most up-to-date information: http://www.schulich.uwo.ca/anesthesia/education/fellowship/fellowships_offered/cardiac_anesthesia.html
More informationCost Effectiveness of Physician Anesthesia J.P. Abenstein, M.S.E.E., M.D. Mayo Clinic Rochester, MN
Mayo Clinic Rochester, MN Introduction The question of whether anesthesiologists are cost-effective providers of anesthesia services remains an open question in the minds of some of our medical colleagues,
More informationSARASOTA MEMORIAL HOSPITAL PERIOPERATIVE DEPARTMENT POLICY
PS1070 SARASOTA MEMORIAL HOSPITAL PERIOPERATIVE DEPARTMENT POLICY TITLE: ADMISSION/DISCHARGE CRITERIA: POST ANESTHESIA CARE UNITS (PACU) EFFECTIVE DATE: REVIEWED/REVISED DATE: POLICY TYPE: Job Title of
More informationBeth Israel Deaconess Medical Center Department of Anesthesia, Critical Care, and Pain Medicine Rotation: Post Anesthesia Care Unit (CA-1, CA-2, CA-3)
Beth Israel Deaconess Medical Center Department of Anesthesia, Critical Care, and Pain Medicine Rotation: Post Anesthesia Care Unit (CA-1, CA-2, CA-3) Goals GOALS AND OBJECTIVES To analyze and interpret
More informationGENERAL PROGRAM GOALS AND OBJECTIVES
BENJAMIN ATWATER RESIDENCY TRAINING PROGRAM DIRECTOR UCSD MEDICAL CENTER DEPARTMENT OF ANESTHESIOLOGY 200 WEST ARBOR DRIVE SAN DIEGO, CA 92103-8770 PHONE: (619) 543-5297 FAX: (619) 543-6476 Resident Orientation
More informationBeth Israel Deaconess Medical Center Perioperative Services Manual. Guidelines for Perioperative Handoffs from OR to receiving units.
Beth Israel Deaconess Medical Center Perioperative Services Manual Title: Guidelines for Perioperative Handoffs from OR to receiving units. Policy #: PSM 100-102A Purpose: This guideline provides a standard
More informationPreparing your Patient for Surgery at The Valley Hospital
Preparing your Patient for Surgery at The Valley Hospital Ensuring a smooth preoperative course to provide safe and efficient care Cristina Smith, RN, BSN, CPAN HOUSEKEEPING Bathroom location Cell Phone
More information4/10/2013. Learning Objective. Quality-Based Payment Models
Creating Best in Class Perioperative Services under Accountable Care and Value- Based Purchasing Becker s Healthcare Jeffry Peters Learning Objective How ACA/VBP changes how we measure surgical services
More informationENVIRONMENT Preoperative evaluation clinic, Preoperative holding area. Preoperative evaluation clinic, Postoperative care unit, Operating room
Goals and Objectives, Main Operating Room Anesthesia, VAMC, CA-3 year UCSD DEPARTMENT OF ANESTHESIOLOGY OPERATING ROOM CLINICAL ANESTHESIA AT VAMC GOALS AND OBJECTIVES, CA-3 YEAR PATIENT CARE: To provide
More informationSurgical Treatment. Preparing for Your Child s Surgery
Surgical Treatment Preparing for Your Child s Surgery If your child needs an operation, it will be performed at a hospital that has special expertise in heart surgery for children. This may be a hospital
More informationPhysician Executive Council. Using the Perioperative Surgical Home to Improve Joint Replacement
Physician Executive Council Using the Perioperative Surgical Home to Improve Joint Replacement 9 Today s Presenters Julie Riley Physician Executive Council Senior Consultant 202-266-5628 RileyJu@advisory.com
More informationROLE OF THE ANESTHETIST IN ORGANIZING AMBULATORY SURGERY. Dr. Paul Vercruysse M.D. Belgium
ROLE OF THE ANESTHETIST IN ORGANIZING AMBULATORY SURGERY Dr. Paul Vercruysse M.D. Belgium DISCLOSURES - Conflicts of interest? I am an anesthesiologist... TRADITIONAL ROLE OF THE ANESTHESIOLOGIST EVOLVING
More informationCA-3 Curriculum for Cardiac Anesthesia West Virginia University Department of Anesthesiology
CA-3 Curriculum for Cardiac Anesthesia West Virginia University Department of Anesthesiology Description of Rotation or Educational Experience This rotation is a continuation of the CA-2 Cardiothoracic
More informationSupervision of Residents/Chain of Command
Supervision of Residents/Chain of Command Creighton University Department of Surgery Residency Training Program Chain of command for Surgery residents at CUMC PGY1: The intern on call covers the two general
More informationKANSAS SURGERY & RECOVERY CENTER
Hospital Reporting Period for Clinical Process Measures: Fourth Quarter 2012 through Third Quarter 2013 Discharges Page 2 of 13 Hospital Quality Measures Your Hospital Aggregate for All Four Quarters 10
More informationValue-based incentive payment percentage 3
Report Run Date: 07/12/2013 Hospital Value-Based Purchasing Value-Based Percentage Payment Summary Report Page 1 of 5 Percentage Summary Report Data as of 1 : 07/08/2013 Total Score Facility State National
More informationDELINEATION OF PRIVILEGES - ANESTHESIOLOGY
KALEIDA HEALTH Name Date DELINEATION OF PRIVILEGES - ANESTHESIOLOGY PLEASE NOTE: Please check the box for each privilege requested. Do not use an arrow or line to make selections. We will return applications
More information9/29/2017. Enhanced Recovery After Surgery at the University of Virginia Medical Center. Disclosures. Objectives. None
Enhanced Recovery After Surgery at the University of Virginia Medical Center Bethany Sarosiek, RN, MSN, MPH, CNL University of Virginia Health System Charlottesville, VA ErasRN@virginia.edu Disclosures
More informationUsing Clinical Criteria for Evaluating Short Stays and Beyond. Georgeann Edford, RN, MBA, CCS-P. The Clinical Face of Medical Necessity
Using Clinical Criteria for Evaluating Short Stays and Beyond Georgeann Edford, RN, MBA, CCS-P The Clinical Face of Medical Necessity 1 The Documentation Faces of Medical Necessity ç3 Setting the Stage
More informationThe Day of Your TAVR
UW MEDICINE PATIENT EDUCATION The Day of Your TAVR What to expect This handout describes what to expect on the day of your transcatheter aortic valve replacement (TAVR). It includes where to check in at
More informationNational Priorities for Improvement:
National Priorities for Improvement: Standardization of Performance Measures, Data Collection, and Analysis Dale W. Bratzler, DO, MPH Principal Clinical Coordinator Oklahoma Foundation Contracting for
More informationInvestigation Outline for a Reportable Incident Non-Hospital Surgical Facility
Investigation Outline for a Reportable Incident Non-Hospital Surgical Facility MANDATORY NOTIFICATION The Medical Director shall notify the College of Physicians & Surgeons of Alberta (Accreditation Department)
More informationOur SAR Looks Great, Now What? ACS NSQIP Pediatric
Our SAR Looks Great, Now What? ACS NSQIP Pediatric Jacqueline Saito, MD, MSCI, FACS St. Louis Children s Hospital Surgeon Champion ACS Children s Surgery Data Committee Vice Chair Disclosures I have no
More informationNeuro Labs and Best Practices in Stroke Programs. Sarah L. Livesay, DNP, RN, ACNP-BC Associate Professor Rush University College of Nursing
Neuro Labs and Best Practices in Stroke Programs Sarah L. Livesay, DNP, RN, ACNP-BC Associate Professor Rush University College of Nursing Objectives Discuss the evolving best practices for neuro lab practice
More informationNeurocritical Care Fellowship Program Requirements
Neurocritical Care Fellowship Program Requirements I. Introduction A. Definition The medical subspecialty of Neurocritical Care is devoted to the comprehensive, multisystem care of the critically-ill neurological
More informationGuidelines for the Preoperative Process
Guidelines for the Preoperative Process Preparation of Patients for Procedural Sedation and Anesthesia. Department of Anesthesiology Thomas May, MD Witold Waberski, MD Department of Internal Medicine Aized
More informationLiverpool Heart and Chest Hospital NHS Foundation Trust
Liverpool Heart and Chest Hospital NHS Foundation Trust Liverpool Heart and Chest Hospital-Vascutek Aorto-Vascular Fellowship Job Description INTRODUCTION The Thoracic Aortic Aneurysm Service at Liverpool
More informationDisclosures No disclosures relevant to this presentation. Opinions are my own, based on 30 + years in the field of CVT surgery and critical care and m
Cardiothoracic Critical Care: The Ongoing Evolution AATS / STS CARDIOTHORACIC CRITICAL CARE SYMPOSIUM Sunday April 29, 2012 San Francisco, CA Nevin M. Katz, M.D. Johns Hopkins University Foundation for
More informationDirect Referral Clinic Why, How and Who?
Direct Referral Clinic Why, How and Who? Macaila C. Eick, RN CNP American Association for Thoracic Surgery Allied Health Personnel Symposium May 4, 2013 No Disclosures Objectives Describe the function
More informationPerioperative Essentials for Early Discharge and Outpatient Total Joint Arthroplasty
Perioperative Essentials for Early Discharge and Outpatient Total Joint Arthroplasty R. Michael Meneghini MD Associate Professor of Orthopaedic Surgery Indiana University School of Medicine Indianapolis,
More informationThe dawn of hospital pay for quality has arrived. Hospitals have been reporting
Value-based purchasing SCIP measures to weigh in Medicare pay starting in 2013 The dawn of hospital pay for quality has arrived. Hospitals have been reporting Surgical Care Improvement Project (SCIP) measures
More informationPediatric Critical Care Fellowship Program
Pediatric Critical Care Fellowship Program Accredited by the Indian Society of Critical Care Medicine : Pediatric Critical Care Council & The Intensive Care Chapter of the Indian Academy of Pediatrics
More informationPOLICIES AND PROCEDURES
POLICIES AND PROCEDURES POLICY: 535.10 TITLE: EFFECTIVE: 4/13/17 REVIEW: 4/2022 SUPERCEDES: APPROVAL SIGNATURES ON FILE IN EMS OFFICE PAGE: 1 of 14 I. AUTHORITY Division 2.5, California Health and Safety
More informationCourse: Acute Trauma Care Course Number SUR 1905 (1615)
Course: Acute Trauma Care Course Number SUR 1905 (1615) Department: Faculty Coordinator: Surgery Dr. Joseph P. Minei Hospital: Periods Offered: Length: Parkland Health & Hospital System All year 4 weeks
More informationStatement on Safe Use of Propofol (Approved by ASA House of Delegates on October 27, 2004);
CREDENTIALING GUIDELINES FOR PRACTITIONERS WHO ARE NOT ANESTHESIA PROFESSIONALS TO ADMINISTER ANESTHETIC DRUGS TO ESTABLISH A LEVEL OF MODERATE SEDATION (Approved by the House of Delegates on October 25,
More informationCarotid Endarterectomy
P A T IENT INFORMAT ION Carotid Endarterectomy Please bring this book to the hospital on the day of your surgery. CP 16 B (REV 06/2012) THE OTTAWA HOSPITAL Disclaimer This is general information developed
More informationSPINAL CORD STIMULATOR (SCS) SURGERY INFORMATION Dr. Joshua Rosenow
Pre-Operative Checklist SPINAL CORD STIMULATOR (SCS) SURGERY INFORMATION Dr. Joshua Rosenow General Confirm surgery dates: STAGE 1 (Electrodes): STAGE 2 (Battery):. Obtain blood tests/ x-rays/ekg and medical
More informationTRAUMA CENTER REQUIREMENTS
California Trauma Center Level III Criteria California Code of Regulations,, Chapter 7 - Trauma Care System with American College of Surgeons (Green Book) references; includes FAQ clarifications TRAUMA
More informationSCIP-Inf-2, SCIP-Inf-3, SCIP-Inf-4, SCIP-Inf- 9, SCIP-Inf-10, SCIP-VTE-1, SCIP-VTE-2 Anesthesia End Time 5
Release Notes: Alphabetical Data Dictionary Version 3.3 Surgical Care Improvement Project (SCIP) - Data Dictionary The General Abstraction Guidelines explain the different sections of the data element
More informationAnesthesiology 302 Introduction to Anesthesia Goals and Objectives
Anesthesiology 302 Introduction to Anesthesia Goals and Objectives I. The student will be able to perform an appropriate preoperative evaluation, including history, physical exam, and appropriate use of
More informationTeamwork, Communication, O.R. Safety & SSI Reduction
2011 Infection Prevention Leadership Teamwork, Communication, O.R. Safety & SSI Reduction Teamwork, Communication, O.R. Safety & SSI Reduction 2 Presented by: E. Patchen Dellinger, MD, FACS Professor of
More informationAAP SoOr Panel: Comanagement of the Pediatric Orthopedic Patient
AAP SoOr Panel: Comanagement of the Pediatric Orthopedic Patient Joshua M. Abzug, MD, FAAP Becca Rosenberg, MD, MPH, FAAP David I. Rappaport, MD, FAAP Disclaimers We have no relevant conflicts of interests
More informationGoals and Objectives University of Minnesota Department of Anesthesiology Senior Resident Supervising Rotation
UM Anesthesiology Page 1 June, 2007 Introduction Goals and Objectives University of Minnesota Department of Anesthesiology Senior Resident Supervising Rotation The ABA defines the attributes of consultant
More informationFor Vanderbilt Medical Center Carolyn Buppert, NP, JD Law Office of Carolyn Buppert
For Vanderbilt Medical Center Carolyn Buppert, NP, JD Law Office of Carolyn Buppert www.buppert.com Describe the services in critical care that nurse practitioners perform that are billable Discuss what
More informationWhere do you fit in? STEMI System of Care. Saturday, May 16, a.m. to 12:15 p.m.
STEMI System of Care Where do you fit in? Fogelson Forum Auditorium 8200 Walnut Hill Lane Dallas, TX 75231 Saturday, May 16, 2015 8 a.m. to 12:15 p.m. CME presented by www.texashealth.org/cme Conference
More informationSURGICAL RESIDENT CURRICULUM FOR THE DIVISION OF CARDIOTHORACIC SURGERY
SURGICAL RESIDENT CURRICULUM FOR THE DIVISION OF CARDIOTHORACIC SURGERY Residency Years Included: PGY1_X_ PGY2_X_ PGY3 PGY4 PGY5 Fellow I. The Clinical Mission of the Division of Cardiothoracic Surgery
More informationPOMA (Preoperative Medical Assessment ) F.A.Q.
POMA (Preoperative Medical Assessment ) F.A.Q. 1. What is POMA? POMA or Preoperative Medical Assessment is a hospital wide initiative that aims to promote and ensure and improve surgical safety and outcomes.
More informationNEW JERSEY HOSPITAL PERFORMANCE REPORT 2014 DATA PUBLISHED 2016 TECHNICAL REPORT: METHODOLOGY RECOMMENDED CARE (PROCESS OF CARE) MEASURES
NEW JERSEY HOSPITAL PERFORMANCE REPORT 2014 DATA PUBLISHED 2016 TECHNICAL REPORT: METHODOLOGY RECOMMENDED CARE (PROCESS OF CARE) MEASURES New Jersey Department of Health Health Care Quality Assessment
More informationSURGICAL SAFETY CHECKLIST
SURGICAL SAFETY CHECKLIST WHY: INFORMATION, RATIONALE, AND FAQ May 2009 Building a safer health system INFORMATION, RATIONALE, AND FAQ May 2009 - Version 1.0 The aim of this document is to provide information
More informationAnesthesia Elective Curriculum Outline
Department of Internal Medicine Texas Tech University Health Sciences Center Odessa, Texas Anesthesia Elective Curriculum Outline Revision Date: July 10, 2006 Approved by Curriculum Meeting September 19,
More informationOSCE Example Scenarios
THE AMERICAN BOARD OF ANESTHESIOLOGY Advancing the Highest Standards of the Practice of Anesthesiology 4208 Six Forks Road, Suite 1500 Raleigh, NC 27609-5765 Phone: (866) 999-7501 OSCE Example Scenarios
More informationSCIP. Surgical Care Improvement Project. Making Surgeries Safer. By: Roshini Mathew, RN
SCIP Surgical Care Improvement Project Making Surgeries Safer By: Roshini Mathew, RN Importance Hospitals could prevent 13,000 patient deaths and 271,000 surgical complications each year 4 measures are
More informationHow do we know the surgical checklist is making a meaningful. impact in surgical care? Virginia Flintoft, MSc, BN Vancouver, BC March 9, 2010
How do we know the surgical checklist is making a meaningful impact in surgical care? Virginia Flintoft, MSc, BN Vancouver, BC March 9, 2010 1 Show Me the Evidence You simply have to MEASURE! 2 Why Measure?
More informationOlutoyin Abitoye, MD Attending, Department of Internal Medicine Virtua Medical Group New Jersey,USA
Olutoyin Abitoye, MD Attending, Department of Internal Medicine Virtua Medical Group New Jersey,USA Introduce the methods of using core measures to compare quality of health care US hospitals provide Have
More informationABOUT THE CONE HEALTH NETWORK OF SERVICES
THE MOSES H. CONE MEMORIAL HOSPITAL (536 beds) Critical Care Services All system ICU patients are monitored with the help an electronic ICU monitoring system (VISICU ). Emergency Services Medical Intensive
More informationThe curriculum is based on achievement of the clinical competencies outlined below:
ANESTHESIOLOGY CRITICAL CARE MEDICINE FELLOWSHIP Program Goals and Objectives The curriculum is based on achievement of the clinical competencies outlined below: Patient Care Fellows will provide clinical
More informationSTATEMENT ON THE ANESTHESIA CARE TEAM
Committee of Origin: Anesthesia Care Team (Approved by the ASA House of Delegates on October 18, 2006, and last amended on October 21, 2009) Anesthesiology is the practice of medicine including, but not
More informationLos Angeles Medical Center Policies and Procedures
Section: OPERATIONS Title: GUIDELINES FOR RAPID RESPONSE TO CHANGES IN A PATIENT S CONDITION Approved by: POLICY & PROCEDURE COMMITTEE 10/09 MEDICAL EXECUTIVE COMMITTEE 10/09 REFERENCES: Institute for
More informationSTEMI System of Care: Where do you fit in?
presents STEMI System of Care: Where do you fit in? Saturday, April 16, 2016 8 a.m. - 2 p.m. Fogelson Forum Auditorium 8200 Walnut Hill Lane Dallas, TX 75231 TexasHealth.org/CME CME Presented by Conference
More informationPREPARING FOR SURGERY
PREPARING FOR SURGERY SURGICAL SERVICES DEPARTMENT 970-641-7240 WWW.GUNNISONVALLEYHEALTH.ORG/SURGERY HOSPITAL SENIOR CARE CENTER HOME MEDICAL SERVICES ASSISTED LIVING FAMILY MEDICINE CLINIC MOUNTAIN CLINIC
More informationMSTCVS CQI: Michigan Society of Thoracic & CardioVascular Surgeons
MSTCVS CQI: Michigan Society of Thoracic & CardioVascular Surgeons Michigan Data Group Traverse City: August 2012 BCBSM CQI - 2006 Outline Overview Who am I? What is MSTCVS? What do We Do? Why am I Here?
More informationPolicy on Resident Supervision. University of South Florida College of Medicine General Surgery Residency Rev. July 2013
Policy on Resident Supervision University of South Florida College of Medicine General Surgery Residency Rev. July 2013 Policy Definitions: 1. Resident: A medical school graduate who is enrolled in the
More informationPerioperative Surgical Home
None Disclosures Debnath Chatterjee, M.D. Associate Professor of Anesthesiology CRASH 2015 - Vail, Colorado 2 Learning Objectives What is the PSH model? Describe the concept of the Perioperative Surgical
More informationPREVENTION OF POSTOPERATIVE PULMONARY COMPLICATIONS: Reducing Postoperative Mechanical Ventilation
PREVENTION OF POSTOPERATIVE PULMONARY COMPLICATIONS: Reducing Postoperative Mechanical Ventilation Rowena Chona O. Sano, MSN, RN, CNL, CPHQ Memorial Hermann Greater Heights Hospital Houston, TX Nothing
More informationCommission on Accreditation of Allied Health Education Programs
Standards and Guidelines for the Accreditation of Educational Programs in Perfusion Essentials/Standards initially adopted in 1980; revised in 1989, 1994, 2000, 2005, and 20-- by the: American Academy
More informationMillikin University Decatur, Illinois. Nursing Internship Application for Summer 2018
Millikin University Decatur, Illinois Nursing Internship Application for Summer 2018 Applicant s Anticipated Graduation Date (Circle Response) December 2018 OR May 2019 * Please complete this application
More informationEnhancing Patient Safety through Team Work and Communication Strategies
Enhancing Patient Safety through Team Work and Communication Strategies St. Joseph Medical Center- Towson Maryland Program/Project Description. In July 2009, Catholic Health Initiatives, of which St Joseph
More informationOscar Guillamondegui, MD, MPH, FACS Associate Professor of Surgery Tennessee Surgical Quality Collaborative
Oscar Guillamondegui, MD, MPH, FACS Associate Professor of Surgery Tennessee Surgical Quality Collaborative NSQIP 2014 A Collaborative that has Reduced Surgical Site Infections Tennessee Surgical Quality
More informationIMPROVING HCAHPS, PATIENT MORTALITY AND READMISSION: MAXIMIZING REIMBURSEMENTS IN THE AGE OF HEALTHCARE REFORM
IMPROVING HCAHPS, PATIENT MORTALITY AND READMISSION: MAXIMIZING REIMBURSEMENTS IN THE AGE OF HEALTHCARE REFORM OVERVIEW Using data from 1,879 healthcare organizations across the United States, we examined
More informationHighmark Reimbursement Policy Bulletin
Highmark Reimbursement Policy Bulletin Bulletin Number: Subject: RP-033 Anesthesia Services Effective Date: March 12, 2018 End Date: Issue Date: June 11, 2018 Source: Reimbursement Policy Applicable Commercial
More informationUniversity of Minnesota Anesthesiology Residency Program PEDIATRIC ANESTHESIA ROTATION GOALS AND OBJECTIVES
University of Minnesota Anesthesiology Residency Program PEDIATRIC ANESTHESIA ROTATION GOALS AND OBJECTIVES Goals: The overall goal of the rotation is to provide an introduction and understanding of the
More informationUNMH Anesthesiology Clinical Privileges
For eligibility to request privileges in Anesthesiology, applicants must have appointment as a Faculty member of the UNM Department of Anesthesiology & Critical Care Medicine. All new applicants must meet
More informationSAMPLE Bariatric Surgery Program Survey for Facilities and Surgeons
I. Facility Section (to be completed by the facility s risk and/or quality department) Facility Name: Address: Date: Contact Person: Directions Please check the appropriate yes or no answer boxes where
More informationHospital Inpatient Quality Reporting (IQR) Program Measures (Calendar Year 2012 Discharges - Revised)
The purpose of this document is to provide a reference guide on submission and Hospital details for Quality Improvement Organizations (QIOs) and hospitals for the Hospital Inpatient Quality Reporting (IQR)
More informationPost-operative "Fast-Track" pathways for lung resection. Dennis A. Wigle Division of Thoracic Surgery Mayo Clinic
Post-operative "Fast-Track" pathways for lung resection Dennis A. Wigle Division of Thoracic Surgery Mayo Clinic Post-operative "Fast-Track" pathways for lung resection Dennis A. Wigle Division of Thoracic
More informationEuroELSO GUIDELINES FOR TRAINING & CONTINUING EDUCATION OF ECMO PHYSICIANS
EuroELSO GUIDELINES FOR TRAINING & CONTINUING EDUCATION OF ECMO PHYSICIANS PURPOSE The "EuroELSO Guidelines for Training & Continuing Education of ECMO Physicians" is a document developed by the Extracorporeal
More informationPatent Foramen Ovale Closure
A GUIDE FOR CARDIOVASCULAR CATH LAB PATIENTS Patent Foramen Ovale Closure Bring this booklet on the day of your procedure. Dale Michels Center for Heart Care 430 E. Division Street, Fond du Lac Cardiology
More informationImproving Hospital Performance Through Clinical Integration
white paper Improving Hospital Performance Through Clinical Integration Rohit Uppal, MD President of Acute Hospital Medicine, TeamHealth In the typical hospital, most clinical service lines operate as
More information3 SCIP-Inf-2, SCIP-Inf-3, SCIP-Inf-4, SCIP-Inf-9, SCIP-Inf-10, SCIP-VTE-1, SCIP-VTE-2 Anesthesia End Time
Release Notes: Alphabetical Data Dictionary Version 3.0b Surgical Care Improvement Project (SCIP) - Data Dictionary The General Abstraction Guidelines explain the different sections of the data element
More informationThe following policy was adopted by the San Luis Obispo County EMS Agency and will become effective March 1, 2012 at 0800 hours.
SLO County Emergency Medical Services Agency Bulletin 2012-02 PLEASE POST New Trauma System Policies and Procedures February 9, 2012 To All SLO County EMS Providers and Training Institutions: The following
More informationCommission on Accreditation of Allied Health Education Programs
RED Text is language that is new/different from the current Standards version (2012) and has been approved by the AC-PE for inclusion in the new Standards; Starred items * notate CAAHEP template language
More informationNON-HOSPITAL MEDICAL AND SURGICAL FACILITIES ACCREDITATION PROGRAM Accreditation Standards. Overnight Stay
NON-HOSPITAL MEDICAL AND SURGICAL FACILITIES ACCREDITATION PROGRAM NON-HOSPITAL MEDICAL AND SURGICAL FACILITIES ACCREDITATION PROGRAM INTRODUCTION Overnight stay is considered a post-anesthesia level of
More informationAPPENDIX I QUESTIONNAIRE FOR INTERVIEWING THE ANAESTHESIA PROVIDER
APPENDIX I QUESTIONNAIRE FOR INTERVIEWING THE ANAESTHESIA PROVIDER We are carrying out a survey to establish the quality of anaesthesia care provided to Obstetric patients in East Africa. We therefore
More informationWorking together to improve health care quality, outcomes, and affordability in Washington State. Coronary Artery Bypass Graft Surgical Bundle
Working together to improve health care quality, outcomes, and affordability in Washington State. Coronary Artery Bypass Graft Surgical Bundle TBD 2015 The intent of the Coronary Artery Bypass Graft Surgical
More informationHIT Incentives: Issues of Concern to Hospitals in the CMS Proposed Meaningful Use Stage 2 Rule
HIT Incentives: Issues of Concern to Hospitals in the CMS Proposed Meaningful Use Stage 2 Rule Lori Mihalich-Levin, J.D. lmlevin@aamc.org; 202-828-0599 Jennifer Faerberg jfaerberg@aamc.org; 202-862-6221
More informationAlabama Trauma Center Designation Criteria
2 Alabama Trauma Center Designation Criteria Office of Emergency Medical Services Master Checklist Alabama Trauma Center Designation Trauma Center Criteria: APPENDIX A Trauma Rules The following table
More informationThe ASA defines anesthesiology as the practice of medicine dealing with but not limited to:
1570 Midway Pl. Menasha, WI 54952 920-720-1300 Procedure 1205- Anesthesia Lines of Business: All Purpose: This guideline describes Network Health s reimbursement of anesthesia services. Procedure: Anesthesia
More informationChinwe Nwosu, GE/NMF Scholar Supervisor: Dr. Stephen Ttendo, Senior Lecturer/ Head of Department of Anesthesia
Chinwe Nwosu, GE/NMF Scholar Supervisor: Dr. Stephen Ttendo, Senior Lecturer/ Head of Department of Anesthesia According to the Uganda Ministry of Health 2010 Clinical Guidelines Read the notes/ medical
More informationJOHNS HOPKINS HEALTHCARE Physician Guidelines
Page 1 of 7 ACTION New Procedure Amending Procedure Number: Superseding Procedure Number: Repealing Procedure Number: REFERENCES: AMPT Committee ASA Guidelines CMS Guidelines I. GENERAL ANESTHESIA PROCEDURE:
More informationHow to build a TAVI Team
How to build a TAVI Team TAVI Summit, Seoul, Korea, September 3rd, 2011 Alain Cribier, MD Charles Nicolle Hospital, University of Rouen, France Disclosure Consultant and involved in the Training / Proctoring
More informationEnhanced Recovery After Surgery in OB/GYN
Enhanced Recovery After Surgery in OB/GYN Audra Williams, MD Ashley Wright, MD University of Alabama at Birmingham Department of OB/GYN Women s Reproductive Healthcare Division Outline Brief background
More information