Standardizing for Efficiency: Enhanced Recovery. Lillian S. Kao, MD, MS, CMQ July 23, 2018
|
|
- Morgan Melanie Lang
- 5 years ago
- Views:
Transcription
1 Standardizing for Efficiency: Enhanced Recovery Lillian S. Kao, MD, MS, CMQ July 23, 2018
2 Disclosures Small intestine section editor for UpToDate.
3 ERAS Preoperative Intraoperative Postoperative Enhanced Recovery after Surgery
4 Preoperative Optimization Consider prehab Selective bowel prep Carb drink No long acting sedatives Reduce preop fasting
5 Intraoperative Lap surgery Fluid balance No tubes, drains, lines Nerve blocks Prevent PONV Normothermia Anesthesia protocol
6 Postoperative Diet ASAP No Foley MMP regimen No ileus HL IV Mobilize ASAP Daily care maps
7 ? Clinical Practice Guideline Standardized Pathway
8 ? Clinical Practice Guidelines Standardized Pathways
9 Enhanced Recovery EQUIFINALITY Standardized Pathways
10 ? My Hospital Clinical Practice Guidelines Our Standardized Pathway
11 Cookbook Analogy GOALS/ METRICS Are you hoping just to make a cake that looks good? is edible? that family/ guests will eat? EVIDENCE Is the recipe from a reputable chef/cookbook? What do reviews say about the recipe? Do you plan to use the recipe as is? make some modifications? make a recipe up from scratch? TEAM Who is making the cake? Do you bake frequently? Have you ever made a cake before?
12 Cookbook Analogy STRATEGIES & TOOLS Can anything be bought premade? Should you take a baking class? CONTEXT Is the kitchen prepared for you to succeed with the recipe? What kind of ingredients/ equipment are needed? Are they in the pantry? Are they easily obtained? STANDARDIZATION What worked well? What did not work well? Will you make the cake again? How will you modify the recipe for next time?
13 Strategies & Tools Evidence Team
14 Compliance Complications Readmissions Ljungqvist O et al. JAMA Surg, (Overview) Stone AB et al. J Am Coll Surg, (Costs) Etc. Length of stay Costs Satisfaction
15 Strategies & Tools Evidence Context Team Goals/ Metrics
16 Influence-Importance Chart High Importance Low Importance High Influence Essential to the project; collaborate High risk; involve to increase interest Low Influence Protect and defend; strengthen influence Do not spend resources Surgeons Anesthesiologists Nurses QI personnel Nutritionists Pharmacists PT/OT Administrators Patients Adapted from Tague NR, The Quality Toolbox, 2nd edition
17 Strategies & Tools Evidence Context Team Goals/ Metrics
18 Search & screen Review & evaluate Select Adopt or adapt
19 Search and Screen
20 Review and Evaluate Strength of recs Disease prevalence Currency of evidence Quality of evidence Quality of guideline Context Values & preferences Wang Z, Norris SL, Bero L. Implementation Science, 2018.
21 GRADE Implication Preoperative Intraoperative Postoperative 1A/ 1B Strong recommendation, can apply to most patients in most circumstances without reservation 1C Strong recommendation but may change when higher quality evidence becomes available 2A/ 2B Weak recommendation, best action may differ depending on circumstances or patients or societal values 2C Very weak recommendations; other alternatives may be reasonable Carmichael JC et al. Dis Colon Rectum, 2017.
22 Multimodal Pain Management Plan Acetaminophen Celecoxib Gabapentin Do epidurals improve outcome? Borzellino G et al. Surg Res Pract, Ketamine Lidocaine Magnesium Ketorolac Helander EM. J Laparoendosc Adv Surg Tech A, 2017 Do NSAIDs increase anastomotic leak rate? Modasi A et al, Surg Endosc
23 Select GRADE: 1A EVIDENCE COSTS STAKEHOLDER BUY-IN DIFFICULTY OF IMPLEMENTATION
24 Adopt, adapt, or not 1. Adopt recommendations without modification 2. Adapt recommendations to the new context 3. Develop recommendations de novo based on existing reviews of evidence 4. Develop recommendations de novo based on new evidence synthesis CONSENSUS
25 Strategies & Tools Evidence Context Team Goals/ Metrics
26 CONTEXT Patient Safety Practices Effectiveness & Harms Implementation Adoption & Spread
27 External factors Teamwork, leadership, and patient safety culture Organizational structural characteristics Management tools
28 Hospital: Safety-net hospital ~200 beds 60% patients uninsured External factors Disproportionate penalties with healthcare reform programs (HRRP, VBP) Organizational structural characteristics Decreased financial strength Teamwork, leadership, and patient safety culture Need for improvement in patient safety culture Supportive leadership Management tools Limited resources for collecting process measure (and outcome) data for ERAS Limited number of QI professionals
29 Strategies & Tools Evidence Context Team Goals/ Metrics
30 Tailor strategies Develop relationships Train and educate Engage patients Change structure Evaluate Incentivize financially Support clinicians IMPLEMENTATION STRATEGIES Waltz et al. Implementation Science, 2015.
31
32 Strategies and Tools Strategy Use evaluative and iterative strategies Provide interactive assistance Adapt and tailor to context Develop stakeholder interrelationships Train and educate stakeholders Support clinicians Engage consumers (patients) Utilize financial strategies Change infrastructure Tool Provider report card Help desk Generic alternative Interdisciplinary task force Seminar Checklist Computer decision support Patient education pamphlet Disincentive for lack of compliance Anesthesia preop clinic
33 Strategies & Tools Evidence Team
34 Conclusions There are multiple standardized clinical pathways that result in improved outcomes due to enhanced recovery after surgery (ERAS). Standardization should be tailored to the stakeholder team, the interpretation of the evidence, the context, and the desired goals.
35 Questions? Tweet
36 Tools & Strategies Evidence Context Team Goals/ Metrics
Enhanced Recovery in NSQIP (ERIN): an update on the collaborative. Julie Thacker, LianeFeldman, and Julia Berian ACS NSQIP National Conference 2015
Enhanced Recovery in NSQIP (ERIN): an update on the collaborative Julie Thacker, LianeFeldman, and Julia Berian ACS NSQIP National Conference 2015 No disclosures ERIN, ERAS, and ERP ERIN-Enhanced Recovery
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 informationPSI 12 - Perioperative Pulmonary Embolism or Deep Vein Thrombosis Rate Opportunity
MAY 2018 A MESSAGE FROM THE SAINT LUKE S CARE CMO Table of Contents PSI 12 - Perioperative Pulmonary Embolism or Deep Vein Thrombosis Rate Opportunity 1,2 NEW Order Sets & Documents 3 Saint Luke s Care
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 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 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 informationEnhanced Recovery Implementing Meaningful Change
Enhanced Recovery Implementing Meaningful Change Jeff Simmons MD Associate Professor UAB Department of Anesthesiology and Perioperative Medicine I have no relevant financial relationships to disclose.
More informationQuality Improvement Initiative (QII): 2018 Options
Quality Improvement Implementation, Option A: Increase Surgeon Engagement Outcome Measure: SSI Summary: Surgeon Engagement is essential for the success of quality improvement programs within hospitals.
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 informationOver the past decade, the number of quality measurement programs has grown
Performance improvement Surgeon sees standardization and data as keys to higher value healthcare Over the past decade, the number of quality measurement programs has grown exponentially as hospitals respond
More informationImplementing an Enhanced Recovery Program for Surgery. Michael F. McGee, MD, FACS, FASCRS September 21, 2017
Implementing an Enhanced Recovery Program for Surgery Michael F. McGee, MD, FACS, FASCRS September 21, 2017 Continuing Education Disclosures Commercial Support or Sponsorship None Speaker or planner relationships
More information2/13/2018. Enhanced Recovery after Surgery (ERAS) in Gynecology
Enhanced Recovery after Surgery (ERAS) in Gynecology J. Michael Straughn, Jr., MD Professor, Gynecologic Oncology University of Alabama at Birmingham Outline What is Enhanced Recovery after Surgery (ERAS)?
More informationToday medical providers are charged with delivering care
The Joint Commission Journal on Quality and Patient Safety 2017; 43:524 533 CARE PROCESSES Optimizing an Enhanced Recovery Pathway Program: Development of a Postimplementation Audit Strategy Michael C.
More informationEnhanced recovery after surgery: the role of the PACU & Pre-op
Enhanced recovery after surgery: the role of the PACU & Pre-op Magnus K. Teig BSc (Hons.) MBChB MRCP FRCA EDIC FFICM Assistant Professor Anesthesia & Neurosurgery Director UH PACU University of Michigan
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 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 informationEnhancing Recovery After Surgery: Better Teamwork for Better Outcomes 2017
MAYO SCHOOL OF CONTINUOUS PROFESSIONAL DEVELOPMENT Enhancing Recovery After Surgery: Better Teamwork for Better Outcomes 2017 Juanita Kious Waugh Auditorium Mayo Clinic Education Center Phoenix, Arizona
More informationEnhanced Recovery after Surgery Considerations for Pathway Development and Implementation
Enhanced Recovery after Surgery Considerations for Pathway Development and Implementation Table of Contents Purpose 2 Introduction 2 The Patient s Interdisciplinary Team 2 Culture and Leadership 3 Enhanced
More informationEnhanced Recovery After Surgery (ERAS) is a way to help you get better sooner after bowel surgery.
My Surgery Log Book This guide belongs to: Enhanced Recovery After Surgery (ERAS) is a way to help you get better sooner after bowel surgery. With ERAS, you play a big role in getting better sooner. You
More informationEnhanced Recovery After Surgery (ERAS) for Elective Colon Resection Surgery at Vancouver General Hospital. What is Possible?
Enhanced Recovery After Surgery (ERAS) for Elective Colon Resection Surgery at Vancouver General Hospital What is Possible? BC Provincial Collaborative November 25, 2014 Disclosure Statement I do not have
More information? Prehab, immunonutrition. Safe surgical principles. Optimizing Preoperative Evaluation
Optimizing Preoperative Evaluation Timothy Geiger, MD, MMHC Associate Professor of Surgery Executive Medical Director, Surgery Patient Care Center Chief, Division of General Surgery Director, Colon and
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 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 informationColorectal Pathway: A Template for the Georgia Surgical Quality Collaborative
Colorectal Pathway: A Template for the Georgia Surgical Quality Collaborative Disclosure Bryant Wilson, MD Relevant Financial Relationships: I have no actual or potential conflict of interest in relation
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 informationWhy Focus on Perioperative Services?
1 Why Focus on Perioperative Services? 80% 60% 40% 20% 0% Perioperative Services are key to a hospital/system's success 68% % better performers revenue from perioperative services Perioperative Services
More informationEnhanced Recovery After. Colorectal Surgery. Your Path to Healing
Enhanced Recovery After Colorectal Surgery Your Path to Healing Your Colorectal Surgical Oncology Team This expert team works together to give you the best care available. Based on your situation, you
More informationNSQIP and Enhanced Recovery After Surgery (ERAS) for Colon Surgery. July252014
NSQIP and Enhanced Recovery After Surgery (ERAS) for Colon Surgery July252014 Outline for the Day Introduction to ERAS overview of ERAS putting a team together importance of education Preoperative and
More informationAdvisor Live Enhanced surgical recovery with perioperative goal-direcred therapy. October 16, #AdvisorLive
Advisor Live Enhanced surgical recovery with perioperative goal-direcred therapy October 16, 2015 @PremierHA #AdvisorLive Download today s slides at www.premierinc.com/events Logistics Audio Use your computer
More informationCLINICAL PATHWAY. Surgical Services. Recurring Ventral Hernia
CLINICAL PATHWAY Surgical Services Recurring Ventral Hernia Recurring Ventral Hernia Table of Contents (tap to jump to page) INTRODUCTION 1 Scope of this Pathway 1 Pathway Contacts 1 CLINICAL PATHWAY 3
More informationSurgical Technology Patient Care Skills Preop Routine Objectives:
Surgical Technology 8-Jul-09 Patient Care Skills Preop Routine Objectives: 1) Discuss why preop preparation of the patient is important a) Preparing the patient decreases impact and potential risks of
More informationCare of Patients Receiving Analgesia by Catheter Techniques Position Statement and Policy Considerations
Care of Patients Receiving Analgesia by Catheter Techniques Position Statement and Policy Considerations Position Statement Registered nurses (RNs) are valuable members of the patient care team who are
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 informationOptum Anesthesia. Completely integrated anesthesia information management system
Optum Anesthesia Completely integrated anesthesia information management system 2 Completely integrated anesthesia information management system Optum Anesthesia Information Management System (AIMS) helps
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 informationEP13EO Nurses participate in interprofessional groups that implement and evaluate coordinated patient education activities.
EP13EO Nurses participate in interprofessional groups that implement and evaluate coordinated patient education activities. Provide one example, with supporting evidence, of an interprofessional patient
More informationAHRQ Safety Program for Improving Surgical Care and Recovery. ACS Quality and Safety Conference New York City July 21, 2017
AHRQ Safety Program for Improving Surgical Care and Recovery ACS Quality and Safety Conference New York City July 21, 2017 1 Project goals To measurably improve patient outcomes in five surgical areas
More informationLaparoscopic Radical Prostatectomy
To learn about prostatectomy surgery, you will need to know what these words mean: The prostate is the sexual gland that makes a fluid that helps sperm move. It surrounds the urethra at the neck of the
More informationCreating Clinical Pathways
Creating Clinical Pathways Michael Stifelman, MD Professor and Chairman of Urology Director, Urologic Oncology & Courtney DiBona, MSN, RN-BC Nurse Manager: Urology Why create clinical pathways? Institute
More informationRIGHT HEMICOLECTOMY. Patient information Leaflet
RIGHT HEMICOLECTOMY Patient information Leaflet April 2017 WHAT IS A RIGHT HEMICOLECTOMY? This is an operation that is designed to remove the right side of your large bowel. Part of the large bowel is
More informationWhipple Procedure (Pancreaticoduodenectomy)
Enhanced Recovery After Whipple Procedure (Pancreaticoduodenectomy) Your Path to Healing Your Pancreatic Surgical Oncology Team This expert team is an important part of the Pancreatic Surgery Program at
More informationEnhanced Recovery After Surgery
Enhanced Recovery After Surgery Thomas Aloia, MD, FACS and Vijaya Gottumukkala, MB, BS, MD (Anes), FRCA The University of Texas MD Anderson Cancer Center March 7 8, 2017 Welcome Ask a question using the
More informationANTERIOR RESECTION WHAT ARE THE BENEFITS OF HAVING AN ANTERIOR RESECTION?
WHAT IS AN ANTERIOR RESECTION? ANTERIOR RESECTION This is an operation that is designed to remove part of your lower large bowel and then join the bowel ends back together again. This is called an anastamosis.
More informationImplementation of Enhanced Recovery After Surgery: a strategy to transform surgical care across a health system
Gramlich et al. Implementation Science (2017) 12:67 DOI 10.1186/s13012-017-0597-5 RESEARCH Open Access Implementation of Enhanced Recovery After Surgery: a strategy to transform surgical care across a
More informationUniCare Professional Reimbursement Policy
UniCare Professional Reimbursement Policy Subject: Global Surgery Policy #: UniCare 0012 Adopted: 07/15/2008 Effective: 08/01/2017 Coverage is subject to the terms, conditions, and limitations of an individual
More informationTOTAL HIP REPLACEMENT FLOW SHEET
TOTAL HIP REPLACEMENT FLOW SHEET Before Surgery: Nothing to eat or drink after midnight the night before surgery. Make sure you have a bowel movement the day before surgery. Be sure to attend your pre-op
More informationEmpire BlueCross BlueShield Professional Reimbursement Policy
Subject: Global Surgery NY Policy: 0012 Effective: 02/01/2014 05/31/2014 Coverage is subject to the terms, conditions, and limitations of an individual member s programs or products and policy criteria
More informationEmpire BlueCross BlueShield Professional Commercial Reimbursement Policy
Subject: Global Surgery NY Policy: 0012 Effective: 10/01/2016 Coverage is subject to the terms, conditions, and limitations of an individual member s programs or products and policy criteria listed below.
More informationYour Anesthesiologist, Anesthesia and Pain Control
You can reduce your pain level after surgery by planning ahead. For example, if you know that you are going to be getting up to do your exercises with the therapist, ask for pain control medication in
More informationAssessment of Primary Care Resources and Supports for Chronic Disease Self management (PCRS) Quality Levels
To be filled in by your survey administrator: Site/ Location: Team: Focus of assessment or patient population under consideration (e.g., those with specific condition, those seen by certain patient care
More informationPreparing for Thoracic Surgery and Recovery
Division of Thoracic Surgery Preparing for Thoracic Surgery and Recovery A Guide for Patients and Families Brigham And Women s/faulkner Hospitals Important Phone Numbers Important Phone Numbers BWH NUMBERS
More informationImpact of Regional Anesthesia on Quality, Cost and Patient Satisfaction: Minor Changes, Immediate Impact. April 26, :15 p.m.
Impact of Regional Anesthesia on Quality, Cost and Patient Satisfaction: Minor Changes, Immediate Impact April 26, 2011 2:15 p.m. EST Hugh Morgan Director, Quality Assurance John LaFratta Corporate Training
More informationEnhanced 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
More informationAnthem Blue Cross and Blue Shield Commercial Professional Reimbursement Policy
Subject: Global Surgery IN, KY, MO, OH, WI Policy: 0012 Effective: 01/01/2018 Coverage is subject to the terms, conditions, and limitations of an individual member s programs or products and policy criteria
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 informationMeasure Abbreviation: TOC 02 (MIPS 426)*
Measure Abbreviation: TOC 02 (MIPS 426)* *TOC 02 is built to the specification outlined by the Merit Based Incentive Program (MIPS) 426: Post- Anesthetic Transfer of Care Measure: Procedure Room to a Post
More informationIntroduction. What Is Minilaparotomy?
From Minilaparotomy for Female Sterilization: An Illustrated Guide for Service Providers 2003 EngenderHealth 1 Introduction The purpose of this guide is to provide health care providers with an easy-to-use
More informationGoals and Objectives. Assessment Methods/Tools
CA-2 PEDIATRIC ANESTHESIA ROTATION Minneapolis Children s Hospital and Clinics (MCHC) Rotation Site Director: Dr. Chris Altman Rotation Duration: 6 weeks Introduction: In the CA-2 year residents have the
More informationYour Anesthesiologist, Anesthesia and Pain Control
You should avoid having pain after surgery by planning ahead. For example, if you know that you are going to be getting up to do your exercises with the therapist, ask for pain control medication in advance.
More informationEnhanced recovery after bowel surgery
Patient information - Bowel Pre-operative Surgery Enhanced Assessment Recovery - WLE Enhanced recovery after bowel surgery Introduction This leaflet will explain what will happen when you come to the hospital
More informationThe hospital s anesthesia services must be integrated into the hospital-wide QAPI program.
A-0416 482.52 Condition of Participation: Anesthesia Services If the hospital furnishes anesthesia services, they must be provided in a well-organized manner under the direction of a qualified doctor of
More informationA Patient s Guide to Surgery
A Patient s Guide to Surgery Welcome Welcome to Carolinas Medical Center-NorthEast. Our staff of skilled professionals look forward to providing the care you need. We want your stay to be pleasant and
More informationTotal Joint Partnership Program Identifies Areas to Improve Care and Decrease Costs Joseph Tomaro, PhD
WHITE PAPER Accelero Health Partners, 2013 Total Joint Partnership Program Identifies Areas to Improve Care and Decrease Costs Joseph Tomaro, PhD ABSTRACT The volume of total hip and knee replacements
More informationTotal Joint Arthroplasty Cost Savings With a Rapid Recovery Protocol in a Military Medical Center
MILITARY MEDICINE, 177, 1:64, 2012 Total Joint Arthroplasty Cost Savings With a Rapid Recovery Protocol in a Military Medical Center MAJ David M. Doman, MC USA ; COL Tad L. Gerlinger, MC USA ABSTRACT The
More informationEffect of Colon Bundle Implementation in a Community Hospital. Michael Barringer, MD, FACS CHS Cleveland
Effect of Colon Bundle Implementation in a Community Hospital Michael Barringer, MD, FACS CHS Cleveland Doug Hobson, MD, Surgeon Champion Mike Barringer, MD, Surgeon Champion No Disclosures Except for
More informationPatient Education and Informed Consent: The Role of the Plastic Surgical Nurse. Kathleen Mortl, RN, CPSN, CANS Amanda Genaw, BSN, RN, CPSN
Patient Education and Informed Consent: The Role of the Plastic Surgical Nurse Kathleen Mortl, RN, CPSN, CANS Amanda Genaw, BSN, RN, CPSN Overview Informed consent Role of MD Role of RN ASPS consideration
More informationBest Practices to Optimize Postoperative Recovery
The OR Management Series Best Practices to Optimize Postoperative Recovery First Edition A compilation of articles from OR Manager OR Manager Elizabeth Wood, Editor Judith M. Mathias, MA, RN, Clinical
More informationUW MEDICINE PATIENT EDUCATION. What is carotid artery dissection? DRAFT
UW MEDICINE PATIENT EDUCATION Stenting for Carotid Artery Dissection How to prepare and what to expect This handout explains stenting for carotid artery dissection, how to prepare for the procedure, what
More information25 Years Later: Improving the Quality of Pain Management: is Education Enough? Jean Guveyan Lecture Disclosures
25 Years Later: Improving the Quality of Pain Management: is Education Enough? Jean Guveyan Lecture 2015 Deb Gordon RN BC, DNP, ACNS BC FAAN Co Director Harborview Integrated Pain Care Program Anesthesiology
More informationTransforming Payment and Care Models for Total Joint Replacement. Stephen J. Zabinski, MD
Transforming Payment and Care Models for Total Joint Replacement Stephen J. Zabinski, MD Stephen John Zabinski, M.D. Director of the Division of Orthopaedic Surgery and Total Joint Replacement Services
More informationSurgical Weight Loss at Eastern Maine Medical Center Your Inpatient Nursing Stay
Surgical Weight Loss at Eastern Maine Medical Center Your Inpatient Nursing Stay Dear Prospective Patient: I have recently been informed that you are considering weight loss surgery at EMMC. As you know
More informationThe Colorado ALTO Project
Using Alternatives to Opioids (ALTOs) in Hospital Emergency Departments PRE-LAUNCH CHECKLIST Based on the 2017 Opioid Prescribing & Treatment Guidelines Colorado ALTO Project Champion Sets the direction
More informationA PARENT S GUIDE TO PEDIATRIC DAY SURGERY PROVIDENCE MEDICAL CENTER ALASKA PEDIATRIC SURGERY 4100 LAKE OTIS PARKWAY SUITE
ALASKA PEDIATRIC SURGERY 4100 LAKE OTIS PARKWAY SUITE 206 929-7337 A PARENT S GUIDE TO PEDIATRIC DAY SURGERY AT PROVIDENCE MEDICAL CENTER Pre- Admission Appointment, Tours and Pre- Registration If pre-
More informationPOST OPERATIVE MANAGEMENT FOR PEDIATRIC HOSPITALISTS
After the Operating Room: POST OPERATIVE MANAGEMENT FOR PEDIATRIC HOSPITALISTS Presenters: Sonaly McClymont, MD Anjna Melwani, MD David Rappaport, MD Rebecca Rosenberg, MD Sarah Denniston, MD Moises Auron,
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 informationManagement of the Surgical Patient Preoperative, Intraoperative and Postoperative
NURS 143 Nursing in Health Alterations II Management of the Surgical Patient Preoperative, Intraoperative and Postoperative Upon completion of the O.R., PACU, or SDS experience, the student will be able
More informationUnderstanding The Rapid Recovery Program
Understanding The Rapid Recovery Program Rapid Recovery Understanding The Rapid Recovery Program Efficiency and Quality of Care in Joint Replacement Objectives and Principles Health care systems increasingly
More information2018 OPTIONS FOR INDIVIDUAL MEASURES: REGISTRY ONLY. MEASURE TYPE: Process
Quality ID #426: Post-Anesthetic Transfer of Care Measure: Procedure Room to a Post Anesthesia Care Unit (PACU) National Quality Strategy Domain: Communication and Care Coordination 2018 OPTIONS FOR INDIVIDUAL
More informationWhat s next? Joint Commission Center for Transforming Healthcare Colorectal Surgical Site Infections (SSIs) Copyright, The Joint Commission
What s next? Joint Commission for Transforming Healthcare Colorectal Surgical Site Infections (SSIs) 1 Public Launch SSI Storyboard 2 COLORECTAL SURGICAL SITE INFECTIONS: CHARACTERISTICS OF THE PROJECT
More information1. Introduction. 1 CMS section
1. Introduction Anesthesiology is the practice of medicine including, but not limited to, preoperative patient evaluation, anesthetic planning, intraoperative and postoperative care and the management
More informationSeptember 6, RE: CY 2017 Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems Proposed Rule
September 6, 2016 VIA E-MAIL FILING Centers for Medicare & Medicaid Services Department of Health and Human Services Attention: CMS-1656-P P.O. Box 8013 Baltimore, MD 21244-1850 RE: CY 2017 Hospital Outpatient
More informationPeri-operative Pain Management - a multi-disciplinary team-based approach
Peri-operative Pain Management - a multi-disciplinary team-based approach Dr Steven Wong Chief of Service Department of Anaesthesiology & OT Services Queen Elizabeth Hospital Outline Development of postoperative
More informationStrategy/Driver Prevention Strategies Action Strategies
I. Hospital executive leadership commitment to prevention of surgical site infections 1. Establish Surgical Site Infection prevention as a strategic priority 2. Develop and implement business/strategic
More informationThe How to Guide for Reducing Surgical Complications
The How to Guide for Reducing Surgical Complications Post operative wound (surgical site) infections Maintaining perioperative normothermia Main contacts for Reducing Surgical Complications Campaign Director:
More informationOrganizational Culture Change Results in Improvement in Outcomes, Value and Experience. Elizabeth C. Wick, M.D.
Organizational Culture Change Results in Improvement in Outcomes, Value and Experience Elizabeth C. Wick, M.D. Objectives To describe the burden and complexity of surgical site infections To outline the
More informationCombined SSI Bundles and ERAS in Colorectal Surgeries
Combined SSI Bundles and ERAS in Colorectal Surgeries Joy Lanfranchi BSN, RN, CNOR, CMLSO Richard Bollin Jr. M.D. Kevin Kinzinger M.D. MBA, FACS, FASCRS Joanne Bonnot MSN, RN, BBA, NE-BC Claudia Skinner
More informationHip Replacement Modern Total Hip Replacement in an Ambulatory Surgery Center. A Brief History of Total Hip Replacement
Modern Total Hip Replacement in an Ambulatory Surgery Center James T. Caillouette, M.D. Chairman Newport Orthopedic Institute 1 A Brief History of Total Hip Replacement Hip replacement 1990: LOS 7 Days
More informationGlobal Surgery Package
Private Property of Florida Blue. This payment policy is Copyright 2017 Florida Blue. All Rights Reserved. You may not copy or use this document or disclose its contents without the express written permission
More informationCONSENT FOR SURGERY OR SPECIAL PROCEDURES
Admission Date THE VALLEY HOSPITAL CONSENT FOR SURGERY OR SPECIAL PROCEDURES - Colonoscopy 1. Authorization. I hereby authorize Dr. (" my Doctor") and any such assistants or designees as may be selected
More informationA Guide to Your Hospital Stay When Having Gynecology Surgery
Patient/Family Material A Guide to Your Hospital Stay When Having Gynecology Surgery For all your visits and on the day of your surgery, please bring with you: Manitoba Health Registration Card Any other
More informationWhat to Expect: Vaginoplasty at Michigan Medicine. Department of Surgery
What to Expect: Vaginoplasty at Michigan Medicine Table of Contents: What should I expect during my consultation appointment? 3 How can I prepare for surgery and plan for my recovery period?...5 How do
More informationGuidelines for patients undergoing surgery as part of an Enhanced Recovery Programme (ERP)
Guidelines for patients undergoing surgery as part of an Enhanced Recovery Programme (ERP) Summary Helping you to get better sooner after surgery June 2012 Foreword These guidelines have been produced
More informationThe Use Of Guidelines And Clinical Pathways
The Use Of Guidelines And Clinical Pathways Quality & Safety In Healthcare First Congress Lebanese Society for Quality & Safety in Healthcare 15-16 November 2013 Ashraf Ismail, MD, MPH, CPHQ Managing Director,
More informationNational Quality Strategy (NQS) Domain: Communication and Care Coordination. Measure Type: Composite; Process
Surgical Phase of Care Measure 6 ACS20 Optimal Postoperative Communication Plan and Patient Care Coordination Composite National Quality Strategy (NQS) Domain: Communication and Care Coordination Measure
More informationVolume to Value Transition in the USA
Volume to Value Transition in the USA Lee A. Fleisher, M.D. Robert D. Dripps Professor and Chair of Anesthesiology Perelman School of Medicine at the University of Pennsylvania Email: lee.fleisher@uphs.upenn.edu
More informationEnhanced Recovery Programme
Cancer Action Team Enhanced Recovery Programme Andy McMeeking National Cancer Action Team Andy.McMeeking@gstt.nhs.uk 18 th November 2009 Upper GI Lead Clinicians 1 Enhanced recovery Is a novel approach
More informationColorectal PGY3 Tuesday, February 02, 2016
Stanford University General Surgery Residency Program Colon and Rectal Surgery Service Goals and Objectives for Residents: R-3 Rotation Director: Andrew Shelton, MD Description The Colon and Rectal Surgery
More informationAssessment of Primary Care Resources and Supports for Chronic Disease Self Management (PCRS) 1,2,3
Assessment of Primary Care Resources and Supports for Chronic Disease Self Management (PCRS),2,3 Individuals interested in using the PCRS in quality improvement work or research are free to do so. We request
More information2018 DOM HealthCare Quality Symposium Poster Session
Winner - Outstanding Faculty Project Author Hillary Lum, MD, Faculty Division/Department Geriatric Medicine / Department of Medicine UCHealth Patient use of a Medical Power of Attorney via My Health Connection
More informationUW MEDICINE PATIENT EDUCATION. atherosclerosis? DRAFT
UW MEDICINE PATIENT EDUCATION Carotid Angioplasty and Stenting for Atherosclerosis How to prepare and what to expect This handout explains carotid angioplasty and stenting for atherosclerosis. It includes
More information