Lessons learned from VASM cases. Barry Beiles Clinical Director VASM
|
|
|
- Preston Walters
- 6 years ago
- Views:
Transcription
1 Lessons learned from VASM cases Barry Beiles Clinical Director VASM
2 Operative Mortality by specialty (n=5,184) Specialty Frequency (%) General surgery 2,073 (40.0%) Orthopaedic surgery 1,044 (20.1%) Neurosurgery 617 (11.9%) Cardiothoracic surgery 560 (10.8%) Vascular surgery 449 (8.7%) Urology 197 (3.8%) Plastic surgery 124 (2.4%) Otolaryngology head and neck surgery 56 (1.1%) Paediatric surgery 49 (0.9%) Obstetrics and gynaecology 9 (0.2%) Other surgeries 6 (0.1%) Total 5,184 (100.0%)
3 Victorian Admitted Episodes Database - VAED
4 Postoperative mortality rate - VAED
5 Number of audited deaths Mean age (range) Median age n=6, years (0 day to 104 years) 79 years Gender (Male: Female) 55%: 45% Admission status (Emergency: Elective) 84%: 15% ASA grades ASA 1-2: 8% ASA 3: 27% ASA 4: 45% ASA 5-6: 15% Risk of death prior to surgery Expected: 13% Considerable: 50% Moderate: 25% Small: 9% Minimal: 3% Most common comorbid factors Cardiovascular: 23% Age: 19% Respiratory: 13% Renal: 10% Neurological/Psychiatric: 7% Diabetes: 6% Advanced Malignancy: 5% Obesity: 3% Hepatic: 3% Most common surgical diagnoses Fracture of neck of femur: 19% Carcinoma: 13% Intracranial haemorrhage: 11% Coronary artery disease: 7% Intestinal obstruction: 6% Aortic aneurysm: 5% Operative procedures performed 3: 9% 2: 16% 1: 75% 0: 16%
6 Thromboprophylaxis 6.6% inappropriately withheld
7 Critical care provision Only 8% would have benefited
8 Fluid management issues
9 Trends in clinical management issues over time
10 Top 5 management issues over time
11 Significance of clinical management issues Perceived impact on patient outcome Total occurrences Patients affected by (n=8431 in 6,179 cases) Clinical issues(n=6,179) No issues of management identified 3, (65.4%) Did not affect clinical outcome (7.9%) May have contributed to death 2, (20.2%) Probably contributed to death (5.1%) Missing data (1.3%) Total 6, (100%) Perceived preventability of clinical issues Total occurrences (n=8431 in 6,179 cases) Patients affected by Clinical issues(n=6,179) No issues identified 3, (65.4%) Definitely preventable (6.1%) Probably preventable 1, (12.9%) Probably not preventable 1, (11.8%) Definitely not preventable (1.6%) Missing data (2.2%) Total 6, (100%) 19% of patients had significant preventable issues, which contributed to the death in 5%
12 Preventable deaths in VASM VSCC question at the end is unique to VASM Assessment Type Preventable Non-Preventable Percentage First-Line Assessment 365 4, % Second-Line Assessment % TOTAL 896 5, %
13 Recurring issues in 6,212 operative VASM cohort (85%) Operative management issues Delays Recognition and management of the deteriorating patient Communication and shared care
14 1. Operative management issues No op should have been performed-futile surgery, end of life care A different op should have been performedseniority, choice by surgeon Technical issues in performance of surgery
15 Intraoperative issues FLA 2007-June 2016 Ops 6,212 Ops with CMI 2,171 Intraop Rx could be improved 708 No op should have been done 65 (9.2%)
16 Intraoperative issues FLA 2007-June 2016 Ops 6,212 Ops with CMI 2,171 Intraop Rx could be improved 708 Different op should have been done 138(19.5%)
17 Intraoperative issues FLA 2007-June 2016 Ops 6,212 Ops with CMI 2,171 Intraop Rx could be improved 708 Technical problem (haem, injury, leak) 117(16.5%)
18 2. Delays Delay in diagnosis 8 % Delay in starting treatment - 2%, surgeon, 3% FLA, 13% SLA Delay in transfer - 2%
19 Delay in 588/6,212(9.5%) of patients having an operation
20 Reasons for delay in diagnosis 2015 VASM report
21 Inter-hospital transfer issues 2015 VASM report
22 3. The deteriorating patient Failure to recognize Failure to react Junior staff education NB. Timing (out of hours) Location
23 4. Communication NB in the deteriorating patient-reluctance to contact superiors Inter-specialty referral should be timely and response should be rapid Documentation poor-poor or illegible data entry by clinicians, especially lack of consultant record entry
24 Conclusion VASM can identify factors contributing to surgical mortality Recurring themes must focus attention on prevention through better educational tools Continual expansion of the scope of ASM (anaesthetists, radiologists) and a shift in the role of this audit to better identify hospital outliers is a future goal that will be expected by our funder (DHHS)
How to conduct second line assessments. Barry Beiles-Clinical Director VASM
How to conduct second line assessments Barry Beiles-Clinical Director VASM ASM receives notification of death Surgical case form sent to surgeon for completion by paper or Fellows Interface Completed paper
Australian and New Zealand Audit of Surgical Mortality. Royal Australasian College of Surgeons
Australian and New Zealand Audit of Surgical Mortality Royal Australasian College of Surgeons National Report 2012 CONTACT Royal Australasian College of Surgeons Australia and New Zealand Audit of Surgical
ANNUAL REPORT Tasmanian Audit of Surgical Mortality
ROYAL AUSTRALASIAN COLLEGE OF SURGEONS ANNUAL REPORT Tasmanian Audit of Surgical Mortality Contact Lisa Lynch Project Manager TASM 2 Gore Street South Hobart Tasmania 7004 Mr Rob Bohmer Chairman TASM 2
2017 SPECIALTY REPORT ANNUAL REPORT
2017 SPECIALTY REPORT ANNUAL REPORT National Commission on Certification of Physician Assistants Table of Contents Message from the President... 3 About the Data Collection and Methodology...4 All Specialties....
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
St. James s Hospital, Dublin.
Position Senior House Officer in Anaesthesia Organisational Area Department of Anaesthesia, St. James s Hospital. Closing Date Sunday the 9 th July 2018 SACC Directorate. The Surgery, Anaesthesia and Critical
Candidate Information Pack. Clinical Lead Plastic Surgery & Burns
Candidate Information Pack Clinical Lead Plastic Surgery & Burns Welcome from Professor Tim Briggs, National Director of Clinical Quality & Efficiency and Clinical Chair of the GIRFT Programme The original
UNIVERSITY HOSPITALS OF MORECAMBE BAY NHS FOUNDATION TRUST TRUST BOARD
UNIVERSITY HOSPITALS OF MORECAMBE BAY NHS FOUNDATION TRUST TRUST BOARD Date of meeting: 25 July 2012 Title / Subject: Vascular Services at UHMBFT; the Impact of Centralising Inpatient and Emergency Vascular
St. James s Hospital, Dublin.
Position Fellowship in Anaesthesia for Advanced Airway Management Assignment Department of Anaesthesia, St. James s Hospital. Commencement Date Monday, 09 th July, 2018. Purpose of the Post The St. James
7 NON-ELECTIVE SURGERY IN THE NHS
Recommendations Debate whether, in the light of changes to the pattern of junior doctors working, non-essential surgery can take place during extended hours. 7 NON-ELECTIVE SURGERY IN THE NHS Ensure that
VASM TASM Collaborative Workshop 2015
Victoria Tasmania Annual Surgical Meeting Coping with Change VASM TASM Collaborative Workshop 2015 Would you have changed the management of this patient s course to death? 16 October 2015 12.30pm-5.00pm
MSc Surgical Care Practice
MSc Surgical Care Practice Professional Accreditation UCAS Code: Course Length: 2 Years Full-Time Start Dates: September 2015, September 2016 Department: Faculty of Health and Social Care Location: Armstrong
Enhanced Recovery: Measurement for Improvement Monthly Data Submission Guidance. Version 1.0
Enhanced Recovery: Measurement for Improvement Monthly Data Submission Guidance Version 1.0 Document Control Version Version 1.0 Date Issued January 2014 Document To provide guidance for the monthly collection
The Royal College of Surgeons of England
The Royal College of Surgeons of England Provision of Trauma Care Policy Briefing This policy briefing outlines the view of the Royal College of Surgeons of England in relation to the planning and provision
O U T C O M E. record-based. measures HOSPITAL RE-ADMISSION RATES: APPROACH TO DIAGNOSIS-BASED MEASURES FULL REPORT
HOSPITAL RE-ADMISSION RATES: APPROACH TO DIAGNOSIS-BASED MEASURES FULL REPORT record-based O U Michael Goldacre, David Yeates, Susan Flynn and Alastair Mason National Centre for Health Outcomes Development
Carol J. Peden BSC, MB ChB, MD, FRCA, FFICM, MPH Royal United Hospital, Bath
Carol J. Peden BSC, MB ChB, MD, FRCA, FFICM, MPH Royal United Hospital, Bath Up to 25,000 surgical deaths per year 5-10% of surgical cases are high risk 79% of deaths occur in the high risk group Overall
NCEPOD Recommendations that remain current
NCEPOD Recommendations that remain current All recommendations from subsequent NCEPOD reports are considered current (Last updated 2014) 1989 The information systems, particularly clinical information
Calendar Year 2014 Medicare Physician Fee Schedule Final Rule
Calendar Year 2014 Medicare Physician Fee Schedule Final Rule Non-Facility Cap After receiving many negative comments on this issue from physician groups, along with the House GOP Doctors Caucus letter
Supervision 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
COST. It s the name of the healthcare reform game. Jennifer Searfoss, ESQ, CPOM, CHCI, CMCS Founder, SCG Health
COST. It s the name of the healthcare reform game Jennifer Searfoss, ESQ, CPOM, CHCI, CMCS Founder, SCG Health Today s Session Session Description Under the second year of the Medicare Merit-based Incentive
Board of Directors Meeting
Board of Directors Meeting Date: 30 July 2008 Agenda item: 10.2, Part 1 Title: Prepared by: Presented by: Action required: Elaine Hobson, Director of Operations Elaine Hobson, Director of Operations The
SOP no: A/003. To be revised in Date: February 2009
PGWC Standard Operating Procedure Category: Operating theatre activity data Recording and reporting of cancellation of elective theatre operations and/or procedures Compiled by: Theatre Efficiencies Task
Question 1 a) What is the Annual net expenditure on the NHS from 1997/98 to 2007/08 in Scotland? b) Per head of population
NHS SPENDING - SCOTLAND Question 1 a) What is the Annual net expenditure on the NHS from 1997/98 to 2007/08 in Scotland? b) Per head of population Question 2 a) Annual real (GDP deflated) increase in net
NATIONAL CLINICAL PROGRAMME IN SURGERY
NATIONAL CLINICAL PROGRAMME IN SURGERY PROGRAMME REPORT 2013 TABLE OF CONTENTS Page INTRODUCTION 3 PURPOSE AND OBJECTIVES OF THE SURGERY PROGRAMME 3 UNDERSTANDING THE SURGICAL WORKLOAD 7 CONSULTANT SURGICAL
Evidence on the quality of medical note keeping: Guidance for use at appraisal and revalidation
Health Informatics Unit Evidence on the quality of medical note keeping: Guidance for use at appraisal and revalidation April 2011 Funded by: Acknowledgements This project was funded by the Academy of
COURSE DESCRIPTIONS. Emergency Health Sciences (EMSP)
` COURSE DESCRIPTIONS Emergency Health Sciences (EMSP) EMSP 4010. Emer Med Serv-Ambulance. 4 Credit Hours. Orientation to the San Antonio Fire Department Standard Medical Operating Procedures (SMOPs) and
Hot Spotter Report User Guide
PATIENT-CENTERED CARE Hot Spotter Report User Guide Overview The Hot Spotter Report is designed to give providers and care team members a heads up when their attributed patients appear to be at risk for
Ref No 001/18. Incremental credit will be awarded in accordance with experience and qualifications.
Post Title Consultant Oral and Maxillofacial Surgeon St. James s Hospital 15hrs / HSE Primary Care (Orthognathic) 16hrs / Our Lady s Children s Hospital Crumlin 8hrs. Ref No 001/18 Tenure Permanent This
TRUST BOARD SAFETY AND QUALITY MONTHLY REPORT SEPTEMBER 2013
TRUST BOARD SAFETY AND QUALITY MONTHLY REPORT SEPTEMBER 2013 1. EXECUTIVE SUMMARY As reported to the Board last month, the reporting on safety and quality to the Trust Board has changed. Each month a summary
The deteriorating patient recognition and management Dave Story
The deteriorating patient recognition and management Dave Story MBBS, MD, BMedSci, FANZCA Professor and Foundation Chair of Anaesthesia Head of Anaesthesia, Perioperative and Pain Medicine Unit (APPMU)
Victorian Telehealth Specialist Clinic Funding Projects Summary Report February to July 2017
Victorian Telehealth Specialist Clinic Funding Projects Summary Report February to July 2017 1 Disclaimer & Accessibility Statement Please note the contents of this publication cannot be replicated or
CCT in Anaesthetics Assessment Guidance 2017
CCT in Anaesthetics Assessment Guidance 2017 Royal College of Anaesthetists Introduction This document describes the various assessment methods used in the anaesthetic training programme. Trainees are
Healthgrades 2016 Report to the Nation
Healthgrades 2016 Report to the Nation Local Differences in Patient Outcomes Reinforce the Need for Transparency Healthgrades 999 18 th Street Denver, CO 80202 855.665.9276 www.healthgrades.com/hospitals
A high percentage of patients were referred to critical care by staff in training; 21% of referrals were made by SHOs.
6. Referral process Key findings A high percentage of patients were referred to critical care by staff in training; 21% of referrals were made by SHOs. Consultant physicians had no knowledge or input into
a. 95 guidelines are based on body systems 97 systems based on bullet points.
Interview questions for freshers Medical Coding Interview Questions 1) What is the basic difference between 95 and 97 guidelines? a. 95 guidelines are based on body systems 97 systems based on bullet points.
The Society of Thoracic Surgeons
VIA EMAIL Practice Improvement and s Management Support (PIMMS) s Support The STS Headquarters 633 N Saint Clair St, Floor 23 Chicago, IL 60611-3658 (312) 202-5800 sts@sts.org STS Washington Office 20
TRUST BOARD SEPTEMBER Surgical Services Reconfiguration
def Agenda item: 8 (i) TRUST BOARD SEPTEMBER 2011 Surgical Services Reconfiguration PURPOSE: PREVIOUSLY CONSIDERED BY: To provide the Trust Board with an update on plans to reconfigure the Trust s surgical
Emergency Readmission Audit
88 Emergency Readmission Audit Summary 168 patients were identified, 125 (74%) medical records were available and audited. 31 (37%) of readmissions were avoidable. 9 (29%) patients whose readmission was
Surgical Care for the Underserved: US We have our own problems
Surgical Care for the Underserved: US We have our own problems Gregg Marshall Grand Rounds February 27, 2012 Outline Introduction US Statistics Underserved populations in the US Global Health Lack of infrastructure
Student Nurses. [Type text] Wellington Operating Theatre
![Student Nurses. [Type text] Wellington Operating Theatre](/thumbs/86/93366376.jpg "Student Nurses. [Type text] Wellington Operating Theatre")
Student Nurses [Type text] Wellington Operating Theatre Kathy Trezise [CCDHB]Fiona Day-Paku Page 1 2016 Student Name: The Operating Theatre The Operating Theatre Service provides tertiary level surgery,
Appendix 1 - Licensing and Audit Requirements for Emergency Department Services
Appendix 1 - Licensing and Audit Requirements for Emergency Department Services Number Urgent Care Centres Emergency Department Emergency Department with Major Trauma Centre 1. Access 24/7 (This requirement
Perioperative management of the higher risk surgical patient with an acute surgical abdomen undergoing emergency surgery
CLINICAL GUIDELINE Perioperative management of the higher risk surgical patient with an acute surgical abdomen undergoing emergency surgery CG10214-2 For use in (clinical areas): For use by (staff groups):
Excellence and Choice. Right Treatment, Right Place A Consultation on a Proposal to Reorganise the Delivery of Acute Services in Belfast
Excellence and Choice Right Treatment, Right Place A Consultation on a Proposal to Reorganise the Delivery of Acute Services in Belfast VASCULAR SURGERY 5 July 31 October 2010 Contents Foreword Patricia
5/30/2012. ICD 10 Implementation HCCA. Agenda. Understanding ICD 10. June 8, ICD 10 Overview Planning Communication Education Physician Training
ICD 10 Implementation HCCA June 8, 2012 1 Agenda ICD 10 Overview Planning Communication Education Physician Training 2 Understanding ICD 10 The key to accepting any change is understanding Why is this
Leaving Canada for Medical Care, 2016
FRASER RESEARCHBULLETIN October 2016 Leaving Canada for Medical Care, 2016 by Bacchus Barua, Ingrid Timmermans, Matthew Lau, and Feixue Ren Summary In 2015, an estimated 45,619 Canadians received non-emergency
Beth 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
Referral Guidance DIRECT REFERRAL SERVICE FOR THE ELDERLY DEAF
Referral Guidance A & E GPs are strongly requested to contact the specialty teams DIRECTLY WHEN APPROPRIATE to avoid unnecessary delays for their patients in A & E. Relevant non-urgent conditions can be
Community Nurses Module
Community Nurses Module Community nurses are registered health professionals who provide care in the community at people s homes, residential homes, schools, local surgeries and health centres. The Community
Surgical Variance Report General Surgery
Surgical Variance Report General Surgery Table of Contents Introduction to Surgical Variance Report: General Surgery 1 Foreword 2 Data used in this report 3 Indicators measured in this report 4 Laparoscopic
Health Facility Guidelines
Health Facility Guidelines Template - Role Delineation Matrix XYZ Hospital, Abu Dhabi Introduction: Role Delineation refers to a level of service that describes the complexity of the clinical activities
Factors influencing patients length of stay
Factors influencing patients length of stay Factors influencing patients length of stay YINGXIN LIU, MIKE PHILLIPS, AND JIM CODDE Yingxin Liu is a research consultant and Mike Phillips is a senior lecturer
Subject: Hospital-Acquired Conditions (Page 1 of 5)
Subject: Hospital-Acquired Conditions (Page 1 of 5) Objective: I. To facilitate safe patient care for all Health Share/Tuality Health Alliance (THA) members. II. To encourage and support provider efforts
Perioperative 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,
Lorenzo for clinical outcomes transformation? Ben Bridgewater
Lorenzo for clinical outcomes transformation? Ben Bridgewater Global Trends - Outcomes and Transformation: The Landscape The problems The obstacles The solutions Ageing population and consumerism Increasing
IU Health Goshen CHNA Action Plan:
IU Health Goshen CHNA Action Plan: 2016-2018 The mission of IU Health Goshen is to improve the health of our communities, by providing innovative, outstanding care and services through exceptional people
Clinical Documentation: Beyond The Financials Cheryll A. Rogers, RHIA, CDIP, CCDS, CCS Senior Inpatient Consultant 3M HIS Consulting Services
Clinical Documentation: Beyond The Financials Cheryll A. Rogers, RHIA, CDIP, CCDS, CCS Senior Inpatient Consultant 3M HIS Consulting Services Clinical Documentation: Beyond The Financials Key Points of
27 th May 2011 Anticoagulation in Practice. Dr Jennie Wimperis Consultant Haematologist
Dr Jennie Wimperis Consultant Haematologist What is Click for Clots? Why we set it up? How we set it up? More details of what it contains Thrombosis Risk Assessment Hospital aquired/associated Thrombosis
Review Process. Introduction. Reference materials. InterQual Procedures Criteria
InterQual Procedures Criteria Review Process Introduction As part of the InterQual Care Planning family of products, InterQual Procedures Criteria provide healthcare organizations with evidence-based clinical
THE LOGICAL RECORD ARCHITECTURE (LRA)
THE LOGICAL RECORD ARCHITECTURE (LRA) Laura Sato KITH Conference 27 September 2011 Presentation Overview NHS (England) Informatics NHS Data Standards & Products develops and delivers UK terminologies and
DELIVERING THE LONDON QUALITY STANDARDS AND 7 DAY SERVICES
Enclosure I DELIVERING THE LONDON QUALITY STANDARDS AND 7 DAY SERVICES Trust Board Meeting Item: 13 Date: 25 th May 2016 Purpose of the Report: Enclosure: I To update the Board on the Trust s current performance
RESOURCES FOR OPTIMAL CARE OF THE INJURED PATIENT
CALIFORNIA TRAUMA REGULATIONS (Title 22) versus ACS RESOURCES FOR OPTIMAL CARE OF THE INJURED PATIENT 2006 (Green Book) (Level I/II Trauma Centers Only) Requirement TITLE 22 ACS GREEN BOOK Trauma Medical
2015 Survey of Patient Blood Management (PBM)
2015 Survey of Patient Blood Management (PBM) This is the second national Patient Blood Management (PBM) survey. In 2013 you were invited to participate in the first PBM survey which provided valuable
Reducing Readmissions: Potential Measurements
Reducing Readmissions: Potential Measurements Avoid Readmissions Through Collaboration October 27, 2010 Denise Remus, PhD, RN Chief Quality Officer BayCare Health System Overview Why Focus on Readmissions?
Anaesthesia Registrars
Studley Road, Heidelberg, 3084 Anaesthesia Registrars - 2017 Name of Unit / Specialty: Head of Unit: CSU / Department: Anaesthesia A/Prof Larry McNicol Anaesthesia Contact person: Dr Shiva Malekzadeh,
National Theatres Project Report
National Theatres Project Report November 2006 Technical Appendix National Theatres Project Report November 2006 Technical Appendix Scottish Executive, Edinburgh 2007 ii National Theatres Project Crown
Understanding Aexcel. Doctors who meet standards for clinical performance and efficiency. What the blue star means for you
Understanding Aexcel What the blue star means for you Doctors who meet standards for clinical performance and efficiency 38.02.314.1 (2/09) Our Performance Network includes Aexcel-designated doctors in
North Shore Private Hospital
North Shore Private Hospital Hospital Description North Shore Private Hospital (NSPH) is a 272 bed private hospital situated on Sydney's lower north shore and is owned by Ramsay Health Care Limited. Paul
Cause of death in intensive care patients within 2 years of discharge from hospital
Cause of death in intensive care patients within 2 years of discharge from hospital Peter R Hicks and Diane M Mackle Understanding of intensive care outcomes has moved from focusing on intensive care unit
For 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
Pre-operative categorization (triaging) of emergency surgical cases. A tool for improving patient care and emergency operating room efficiency
Pre-operative categorization (triaging) of emergency surgical cases A tool for improving patient care and emergency operating room efficiency Introduction No national or provincial guidelines exist for
OVERALL GOALS AND OBJECTIVES FOR EACH RESIDENT LEVEL 3 rd YEAR GENERAL SURGERY RESIDENT PATIENT CARE
OVERALL GOALS AND OBJECTIVES FOR EACH RESIDENT LEVEL CRITERIA FOR ADVANCEMENT TO PGY-4 YEAR: Satisfactory completion of all rotations and fulfillment of all performance objectives listed above as judges
GENERAL 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
Caring to the End? A review of the care of patients who died in hospital within four days of admission
Caring to the End? A review of the care of patients who died in hospital within four days of admission Caring to the End? A review of the care of patients who died in hospital within four days of admission
Portsmouth Hospitals NHS Trust Individual Placement (Job) Descriptions for Foundation Year 1
Portsmouth Hospitals NHS Trust Individual Placement (Job) Descriptions for Foundation Year 1 Placement The department Where the is for the in this F1 Acute Placement Acute Medicine Unit/Surgical Assessment
Surgical Clerkship Goals and Objectives By the end of the surgical clerkship, students are expected to be able to:
Surgical Clerkship Goals and Objectives By the end of the surgical clerkship, students are expected to be able to: Perform complete, accurate histories and physical examinations on adult surgical patients
Hip Hemi-Arthroplasty vs Total Hip Replacement for Displaced Intra-Capsular Hip Fractures: Retrospective Age and Sex Matched Cohort Study
Ulster Med J 28;87():7-2 Clinical Paper Hip Hemi-Arthroplasty vs Total Hip Replacement for Displaced Intra-Capsular Hip Fractures: Retrospective Age and Sex Matched Cohort Study Daniel Dawson, David Milligan,
NURSING COMPUTER SOFTWARE. Level 1- Semester 2. Medical Surgical Nursing/ Clinical Lab
NURSING COMPUTER SOFTWARE Level 1- Semester 2 Nur 1210/ 1210L Medical Surgical Nursing/ Clinical Lab RECOMMENDED FOR ALL COURSES: Successful Test- taking Tips for Windows: (Copyright 1998) Test-Taking
A physician s guide to Aexcel
Quality health plans & benefits Healthier living Financial well-being Intelligent solutions A physician s guide to Aexcel www.aetna.com For designations effective January 1, 2014 38.02.800.1 E (5/13) We
ADVANCED NURSING PRACTICE. Model question paper
I YEAR M.SC (NURSING) DEGREE EXAMINATION ADVANCED NURSING PRACTICE Model question paper Time : Three hours Maximum marks : 100 marks I a. Define the concept of health promotion b. Explain the major assumptions
Payment Policy: Assistant Surgeon Reference Number: CC.PP.029 Product Types: ALL
Payment Policy: Reference Number: CC.PP.029 Product Types: ALL Effective Date: 01/01/2014 Last Review Date: 03/01/2018 Coding Implications Revision Log See Important Reminder at the end of this policy
CMS Quality Program- Outcome Measures. Kathy Wonderly RN, MSEd, CPHQ Consultant Developed: December 2015 Revised: January 2018
CMS Quality Program- Outcome Measures Kathy Wonderly RN, MSEd, CPHQ Consultant Developed: December 2015 Revised: January 2018 Philosophy The Centers for Medicare and Medicaid Services (CMS) is changing
QUALITY REPORT. Part A Patient Experience
QUALITY REPORT Part A Patient Experience 1 Number of complaints Complaints and Patient Advice and Liaison Report 40 Total number of complaints received 30 20 10 Number of complaints received Trendline
USING FRAM IN A CHILDREN S SURGICAL UNIT
USING FRAM IN A CHILDREN S SURGICAL UNIT TO UNDERSTAND WORKFLOW AND DESIGN SOLUTIONS TO DAMPEN VARIABILITY Dr Danielle Franklin BM BSc FRCA Safety- II in Practice 14-15 June 2018 Supported by Ernest Leach
Spina Bifida Adult Resource Team
Spina Bifida Adult Resource Team Overview How the service is delivered Outcome data from a 12 month review Novel resources that have been developed Where to from here If I lived in a society where being
2015 Survey of Patient Blood Management (PBM)
2015 Survey of Patient Blood Management (PBM) This is the second national Patient Blood Management (PBM) survey. In 2013 you were invited to participate in the first PBM survey which provided valuable
Hospital Generated Inter-Speciality Referral Policy Supporting people in Dorset to lead healthier lives
NHS Dorset Clinical Commissioning Group Hospital Generated Inter-Speciality Referral Policy Supporting people in Dorset to lead healthier lives PREFACE This Document outlines the CCG s policy in respect
Risk Factor Analysis for Postoperative Unplanned Intubation and Ventilator Dependence
Risk Factor Analysis for Postoperative Unplanned Intubation and Ventilator Dependence Adam P. Johnson MD, MPH, Anisha Kshetrapal MD, Harold Hsu MD, Randi Altmark RN, BSN, Herbert E Cohn MD, FACS, Scott
@ncepod #tracheostomy
@ncepod #tracheostomy 1 Introduction Tracheostomy: Remedy upper airway obstruction Avoid complications of prolonged intubation Protection & maintenance of airway The number of temporary tracheostomies
Medicare s Inpatient Final Rule for Claire Kapilow, Director, Regulatory Affairs
Medicare s Inpatient Final Rule for 2013 Claire Kapilow, Director, Regulatory Affairs Publisher Notice Although we have tried to include accurate and comprehensive information in this presentation, please
Understanding the Implications of Total Cost of Care in the Maryland Market
Understanding the Implications of Total Cost of Care in the Maryland Market January 29, 2016 Joshua Campbell Director KPMG LLP Matthew Beitman Sr. Associate KPMG LLP The concept of total cost of care is
Coroner's Corner - Inquest into the death of Gwendoline Mead
Coroner's Corner - Inquest into the death of Gwendoline Mead Date of Findings: 22 June 2017 Coroner: Ainslie Kirkegaard Inquest Place: Brisbane Date of Death: 1 March 2015 Factual Summary: Gwendoline Mead
Chapter 1 INTRODUCTION TO THE ACS NSQIP PEDIATRIC. 1.1 Overview
Chapter 1 INTRODUCTION TO THE ACS NSQIP PEDIATRIC 1.1 Overview A highly visible and important issue facing the medical profession and the healthcare industry today is the quality of care provided to patients.
Organisational Audit Questions - Links to recommendations, standards and evidence
Question Quoted recommendation/ standard / evidence Source Notes Section 1 - Hospital characteristics 1. a) How many adult in-patient or overnight beds (including 23- hours stay) are currently available
Post operative pain assessment and delirium in the orthopaedic patient A Review of the literature
Post operative pain assessment and delirium in the orthopaedic patient A Review of the literature Caroline Costello Orthopaedic and Plastic surgery Department Cork University Hospital Presentation overview
UNIVERSITY OF MASSACHUSETTS MEDICAL SCHOOL ANESTHESIOLOGY RESIDENCY PROGRAM GOALS AND OBJECTIVES
UNIVERSITY OF MASSACHUSETTS MEDICAL SCHOOL ANESTHESIOLOGY RESIDENCY PROGRAM GOALS AND OBJECTIVES CA-2/CA-3 REQUIRED ROTATIONS IN PEDIATRIC ANESTHESIOLOGY The Department of Anesthesiology has established
Minnesota Statewide Quality Reporting and Measurement System: Appendices to Minnesota Administrative Rules, Chapter 4654
This document is made available electronically by the Minnesota Legislative Reference Library as part of an ongoing digital archiving project. http://www.leg.state.mn.us/lrl/lrl.asp Minnesota Statewide
ereferrals The New Zealand Approach
ereferrals The New Zealand Approach New Zealand Last Loneliest. Loveliest. Agenda The New Zealand healthcare system Health system automation Primary secondary care interface An ereferrals Initiative Demonstration
Ryan O Gowan, MBA, PA-C, FCCM 28 Bourque Road Cumberland, RI 02068
Ryan O Gowan, MBA, PA-C, FCCM 28 Bourque Road Cumberland, RI 02068 Mission To provide excellent care in a critical care environment and to design and implement tools which maximize the utilization of all
Training Requirements for the Specialty of. Paediatric Surgery
Association internationale sans but lucratif International non-profit organisation Training Requirements for the Specialty of Paediatric Surgery European Standards of Postgraduate Medical Specialist Training
We plan. We achieve.
We plan. We achieve. Salford Royal NHS Foundation Trust has a lot to tell you... l Achievements of 2008/09 l Our plans for 2009/10 l Our commitments for the next five years. We are committed to providing