Abstract:
BACKGROUND:Preprocedural briefings have been adopted in many high consequence environments, but have not been widely accepted in medicine. We sought to develop, implement, and evaluate a preoperative briefing for cardiovascular surgery. STUDY DESIGN:The briefing was developed by using a combined questionnaire and semistructured focus group approach involving five subspecialties of surgical staff (n=55). The results were used to design and implement a preoperative briefing protocol. The briefing was evaluated by monitoring surgical flow disruptions, circulating nurse trips to the core, time spent in the core, and cost-waste reports before and after implementation of the briefing across 16 cardiac surgery cases. RESULTS:Focus group data indicated consensus among surgical staff concerning briefing benefits, duration, location, content, and potential barriers. Disagreement arose concerning timing of the brief and the roles of key participants. After implementation of the briefing, there was a reduction in total surgical flow disruptions per case (5.4 preimplementation versus 2.8 postimplementation, p=0.004) and reductions in per case average of procedural knowledge disruptions (4.1 versus 2.17, p=0.004) and miscommunication events (2.5 versus 1.17, p=0.03). There was no significant reduction in disruptions because of equipment preparation or disruptions from patient-related issues. On average, briefed teams experienced fewer trips to the core (10 versus 4.7, p=0.004) and spent less time in the core (397.4 seconds versus 172.3 seconds, p=0.006), and there was a trend toward decreased waste (30% versus 17%, p=0.15). CONCLUSIONS:These findings demonstrate the feasibility of creating a specialty-specific preoperative briefing to decrease surgical flow disruptions and improve patient safety in the operating room.
journal_name
J Am Coll Surgjournal_title
Journal of the American College of Surgeonsauthors
Henrickson SE,Wadhera RK,Elbardissi AW,Wiegmann DA,Sundt TM 3rddoi
10.1016/j.jamcollsurg.2009.01.037subject
Has Abstractpub_date
2009-06-01 00:00:00pages
1115-23issue
6eissn
1072-7515issn
1879-1190pii
S1072-7515(09)00131-8journal_volume
208pub_type
杂志文章abstract:BACKGROUND:The management of dysplasia arising in Barrett's esophagus is controversial. STUDY DESIGN:Twenty patients (group 1, prompt attitude) underwent operation as soon as high-grade dysplasia (HGD) was discovered (n = 8) or just after either the presence of HGD was confirmed (n = 9) or invasive carcinoma (IC) was ...
journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章
doi:10.1016/S1072-7515(03)00417-4
更新日期:2003-09-01 00:00:00
abstract:BACKGROUND:The clinicopathologic characteristics and the expression of apomucin (MUC) in intrahepatic cholangiocarcinoma (ICC) with respect to gross morphology have not been comprehensively examined. STUDY DESIGN:We reviewed the clinical data of 98 patients with ICC who underwent resection at Seoul National University...
journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章
doi:10.1016/s1072-7515(02)01343-1
更新日期:2002-12-01 00:00:00
abstract:BACKGROUND:Since 1993, the American College of Surgeons has sponsored an annual 6-day course entitled the Surgeons as Educators. The course was designed to provide academic surgeons with the knowledge and skills necessary to enhance the surgical education curriculum, teaching strategies, educational program administrat...
journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章
doi:
更新日期:1996-11-01 00:00:00
abstract:BACKGROUND:The robotic platform has been used increasingly to perform colorectal surgery. The benefits of robotic colectomy when compared with laparoscopic colectomy have not been definitively established. STUDY DESIGN:A retrospective review of the NSQIP database was performed on patients undergoing elective laparosco...
journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章
doi:10.1016/j.jamcollsurg.2016.03.041
更新日期:2016-08-01 00:00:00
abstract:BACKGROUND:Effective use of ultrasonography (US) by surgeons was demonstrated a decade ago. Major surgical organizations now require its incorporation into surgical training and practice. But little information about the teaching of US to surgical residents exists. This study assesses the current status of US training ...
journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章
doi:10.1016/j.jamcollsurg.2005.10.023
更新日期:2006-03-01 00:00:00
abstract:BACKGROUND:We examine the technique of combining percutaneous transluminal angioplasty and secondary intravascular stent deployment with femorofemoral bypass graft in patients with bilateral aortoiliac occlusive disease. STUDY DESIGN:Retrospective review. RESULTS:During the 5-year period from June 1988 to October 199...
journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章
doi:
更新日期:1997-03-01 00:00:00
abstract:BACKGROUND:Cecal leak or disruption after appendectomy for complicated appendicitis is a consequence of severity of disease and is related to residual abscess cavity, inflammation, phlegmon, and nonviable intestine. In an attempt to improve results, we have begun to resect the cecum and other localized infected tissue ...
journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章
doi:
更新日期:1994-08-01 00:00:00
abstract:BACKGROUND:Abdominal wall reconstruction for complex ventral and incisional hernias is associated with significant complications. Commonly, the peritoneal cavity is opened and adhesiolysis is performed with the potential for enterotomy. A totally extraperitoneal (TE) approach to abdominal wall reconstruction is feasibl...
journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章
doi:10.1016/j.jamcollsurg.2015.11.012
更新日期:2016-02-01 00:00:00
abstract:BACKGROUND:Recent population-based studies have demonstrated that the use of intraoperative cholangiography (IOC) during laparoscopic cholecystectomy (LC) is associated with a decrease in the rate of common bile duct (CBD) injury. The cost implications of a management strategy involving routine IOC use have not been ad...
journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章
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更新日期:2003-03-01 00:00:00
abstract:BACKGROUND:Disconnected pancreatic duct syndrome (DPDS) typically complicates acute necrotizing pancreatitis (ANP) and presents as a pseudocyst months after the initial episode of pancreatitis. However, our experience suggests that the presentation of DPDS may be quite varied and might require significant evaluation an...
journal_title:Journal of the American College of Surgeons
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doi:10.1016/j.jamcollsurg.2014.03.055
更新日期:2014-10-01 00:00:00
abstract:BACKGROUND:Pediatric liver transplantation (pLTx) has been the standard of care for children with liver failure since the 1980s. This study examined the world's largest single-center experience and aimed to identify unique preoperative predictors of early graft and patient survival for primary transplantation (1°-pLTx)...
journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章
doi:10.1016/j.jamcollsurg.2017.12.042
更新日期:2018-04-01 00:00:00
abstract:BACKGROUND:General surgery (GS) resident vascular surgery (VS) operations have declined significantly in the last 15 years. We hypothesized that initiation of VS fellowship programs (VSFPs) contributes to that decline. This study examined the effect of establishing new VSFPs on VS case volumes of residents in associate...
journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章
doi:10.1016/j.jamcollsurg.2018.12.010
更新日期:2019-04-01 00:00:00
abstract:BACKGROUND:Use of Enhanced Recovery After Surgery (ERAS) pathways have evidenced improved outcomes in several surgical specialties. The effectiveness of ERAS pathways specific to hernia surgery, however, has not yet been investigated. We hypothesized that our ERAS pathway would accelerate functional recovery and shorte...
journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章
doi:10.1016/j.jamcollsurg.2016.02.015
更新日期:2016-06-01 00:00:00
abstract:INTRODUCTION:An effective strategy to manage acute pain while minimizing opioid exposure is needed for injured patients. In this trial, we aimed to compare two multimodal pain regimens (MMPR) in minimizing opioid exposure and relieving acute pain in a busy, urban trauma center. METHODS:This was an unblinded, pragmatic...
journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章
doi:10.1016/j.jamcollsurg.2020.12.014
更新日期:2020-12-29 00:00:00
abstract:BACKGROUND:The association of acute pancreatitis with fulminant hepatic failure (FHF) was first recognized in 1973. Since then, few studies have described the clinical profile of the FHF patient with acute pancreatitis. Identification of the distinguishing attributes of pancreatitis in combination with FHF will provide...
journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章
doi:10.1016/s1072-7515(98)00222-1
更新日期:1998-11-01 00:00:00
abstract:BACKGROUND:The National Surgical Quality Improvement Program-Pediatrics (NSQIP-P) collects data for institutional quality benchmarking of surgery performed on children using a sampling algorithm. The Pediatric and Infant Case Log and Outcomes (PICaLO) is a database of all general and thoracic pediatric surgery (GTPS) p...
journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章
doi:10.1016/j.jamcollsurg.2015.07.014
更新日期:2015-10-01 00:00:00
abstract:BACKGROUND:Triage decision correctness for children in motor vehicle crashes can be affected by occult injuries. There is a need to develop a transfer score (TS) metric for children that can help quantify the likelihood that an injury is present that would require transfer to a trauma center (TC) from a non-TC, and imp...
journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章
doi:10.1016/j.jamcollsurg.2017.09.018
更新日期:2018-01-01 00:00:00
abstract:BACKGROUND:Splenectomy at the time of resection of esophageal, gastric, or colon cancer has been correlated with inferior longterm survival. No such effect has yet been demonstrated for pancreatic cancer. STUDY DESIGN:Patients undergoing resection of pancreatic adenocarcinoma with curative intent at Memorial Sloan-Ket...
journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章
doi:10.1016/s1072-7515(99)00041-1
更新日期:1999-05-01 00:00:00
abstract:BACKGROUND:Frequently, patients present with symptoms after cholecystectomy (pain or discomfort in the upper part of the abdomen, postprandial fullness, bile vomiting, among others). Duodenogastric reflux has been associated with these symptoms in some patients. Therefore, this study was done to investigate this relati...
journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章
doi:
更新日期:1994-08-01 00:00:00
abstract:BACKGROUND:Acute appendicitis remains the most common cause of acute abdominal pain necessitating operative intervention. Although postoperative antibiotics are universally used for perforated appendicitis, no consensus exists on whether postoperative antibiotics are beneficial for preventing surgical site infections (...
journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章
doi:10.1016/j.jamcollsurg.2011.08.018
更新日期:2011-12-01 00:00:00
abstract:BACKGROUND:Development of infectious complications after high volume elective surgical procedures imposes a significant clinical burden to the United States population. This study evaluated the association of in-hospital delay of elective procedures and the subsequent impact on infectious complications after coronary a...
journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章
doi:10.1016/j.jamcollsurg.2010.08.009
更新日期:2010-12-01 00:00:00
abstract:BACKGROUND:Transfusion practice among surgeons varies despite several trials supporting the restrictive use of blood products. We sought to define the variation in surgeon transfusion hemoglobin (Hb) triggers and targets among patients undergoing hepatopancreaticobiliary (HPB) procedures, as well as assess perioperativ...
journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章
doi:10.1016/j.jamcollsurg.2014.02.033
更新日期:2014-08-01 00:00:00
abstract:BACKGROUND:Until recently, in the United Kingdom, borderline resectable pancreatic cancer with invasion into the portomesenteric veins often resulted in surgical bypass because of the presumed high risk for complications and the uncertainty of a survival benefit associated with a vascular resection. Portomesenteric vei...
journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章,多中心研究
doi:10.1016/j.jamcollsurg.2013.11.017
更新日期:2014-03-01 00:00:00
abstract::Portal vein thrombosis was considered to be a major contraindication to liver transplantation before the introduction of vessel grafts from the recipient's area of confluence of the splenic and superior mesenteric veins, behind the neck of the pancreas, to the graft's portal vein. Refinement in surgical technique has ...
journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章
doi:10.1016/s1072-7515(99)00299-9
更新日期:2000-04-01 00:00:00
abstract:BACKGROUND:The technique of lymphatic mapping and sentinel lymph node (SLN) biopsy is rapidly becoming the preferred method of staging the axilla of the breast cancer patient. This report describes the impact of postinjection massage on the sensitivity of this surgical technique. STUDY DESIGN:Lymphatic mapping at the ...
journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章
doi:10.1016/s1072-7515(00)00771-7
更新日期:2001-01-01 00:00:00
abstract:BACKGROUND:The Affordable Care Act (ACA)'s Medicaid expansion has increased access to surgical care overall. Whether it was associated with reduced disparities in use of regionalized surgery at high-volume hospitals (HVH) remains unknown. Quasi-experimental evaluations of this expansion were performed to examine the us...
journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章
doi:10.1016/j.jamcollsurg.2018.08.693
更新日期:2018-11-01 00:00:00
abstract:BACKGROUND:Classic emergency surgical management of complicated perforated sigmoid diverticulitis is based on the principle of a two-stage operation, with colon resection and temporary stoma (Hartmann's procedure). But the later second-stage operation can be technically difficult and can be associated with a significan...
journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章
doi:10.1016/j.jamcollsurg.2007.11.018
更新日期:2008-04-01 00:00:00
abstract:BACKGROUND:Academic medical centers are faced with increasing volumes, higher acuity, and, as a consequence, capacity issues. These affect operating room (OR) use and patient throughput, with negative impact on finances and patient and physician satisfaction. We evaluated our experiences in dealing with OR efficiency a...
journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章
doi:10.1016/j.jamcollsurg.2007.01.052
更新日期:2007-05-01 00:00:00
abstract:BACKGROUND:Several national initiatives are aimed at training citizens to assist bleeding victims. The purpose of this study was to evaluate an effort to quickly and efficiently teach basic bleeding control techniques to a clinical and nonclinical workforce. STUDY DESIGN:The research study was conducted at 4 hospitals...
journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章
doi:10.1016/j.jamcollsurg.2017.11.003
更新日期:2018-02-01 00:00:00
abstract:BACKGROUND:Neuroendocrine tumors commonly metastasize to the liver. Although surgical resection is considered a treatment option for patients with localized metastases confined to the liver, the longterm survival benefit of liver resection has not been clearly demonstrated. We examined the survival of patients undergoi...
journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章
doi:10.1016/s1072-7515(98)00099-4
更新日期:1998-07-01 00:00:00