Resident-Driven Holistic Lean Daily Management System to Enhance Care Experience at a Safety Net Hospital.

Abstract:

OBJECTIVE:To describe the use of Lean in urology at Zuckerberg San Francisco General, a community safety-net and trauma hospital that serves as a major teaching site for the University of California San Francisco. METHODS:We examined our process improvement activities from 2016 to 2018. Our Lean Daily Management System (DMS) includes a 15-minute team huddle ("urology Lean work") of service residents, faculty, clinic and operating room nursing staff, and anesthesia liaisons. Our DMS also includes a 5-minute preoperative huddle. Besides team-building, urology Lean work surfaces logistics, safety or equipment improvement ideas, and ensures progress and completion of initiated projects. RESULTS:Over a 2-year period we developed and completed 67 projects. Projects impacted the outpatient setting (57%), followed by the operating room (22%), the Urology service (12%), and inpatient setting (9%). We completed projects in the following domains: safety (26%), quality (22%), care experience (21%), workforce care and development (13%), equity (11%), and financial stewardship (7%). Urology Lean work reduced new patient clinic access time (119-21 days) and Bacillus Calmette-Guérin in clinic treatment time (180-105 minutes). The average proportion of urology on-time surgeries was better than the overall surgery on-time surgeries (71% v 61%). CONCLUSION:Urology Lean work successfully applied DMS in a service specific yet holistic approach. Urology Lean work improved resident engagement in quality and safety endeavors and served as a DMS model throughout perioperative and clinic areas.

journal_name

Urology

journal_title

Urology

authors

Tresh A,Cohen AJ,Mmonu NA,Berdy S,Barnas K,Krombach J,Breyer BN

doi

10.1016/j.urology.2020.01.038

subject

Has Abstract

pub_date

2020-06-01 00:00:00

pages

56-63

eissn

0090-4295

issn

1527-9995

pii

S0090-4295(20)30225-9

journal_volume

140

pub_type

杂志文章

相关文献

UROLOGY文献大全
  • Collection and storage of urine specimens for measurement of urolithiasis risk factors.

    abstract:OBJECTIVE:To evaluate how different methods for storage and preservation of urine samples affected the outcome of analysis of risk factors for stone formation. METHODS:Spot urine samples were collected from 21 healthy volunteers. Each fresh urine sample was divided into ten 10-mL aliquots: 2 without preservative, 2 wi...

    journal_title:Urology

    pub_type: 杂志文章

    doi:10.1016/j.urology.2014.10.030

    authors: Wu W,Yang D,Tiselius HG,Ou L,Mai Z,Chen K,Zhu H,Xu S,Zhao Z,Zeng G

    更新日期:2015-02-01 00:00:00

  • Surgical management of renal cell carcinoma invading into the liver: radical nephrectomy en bloc with right hepatic lateral sector.

    abstract::Renal cell carcinoma demonstrates expansive growth and invasion of adjacent structures. Direct liver extension, although uncommon, is a dismal prognostic sign. We propose radical nephrectomy en bloc with right lateral sector (segments 6 and 7) of the liver. The operative procedure was performed in 2 male patients, 61 ...

    journal_title:Urology

    pub_type: 杂志文章

    doi:10.1016/s0090-4295(01)00939-6

    authors: Johnin K,Nakai O,Kataoka A,Koizumi S,Dok An C,Okada Y,Makuuchi M

    更新日期:2001-05-01 00:00:00

  • Urinary diversion in hypospadias surgery 1987.

    abstract::To determine which form of urinary diversion is most effective for each type of hypospadias, we polled all full-time practicing pediatric urologists in the United States and Canada. Each was asked to complete a questionnaire, specifying the method of urinary diversion used, based on the severity of the hypospadias. Ni...

    journal_title:Urology

    pub_type: 杂志文章

    doi:10.1016/0090-4295(87)90041-0

    authors: Oesterling JE,Gearhart JP,Jeffs RD

    更新日期:1987-05-01 00:00:00

  • A review of contemporary data on surgically resected renal masses--benign or malignant?

    abstract:OBJECTIVE:To clearly define the proportions of benign vs malignant histologic findings in resected renal masses through an in-depth review of the contemporary medical data to assist in preoperative risk assessment. MATERIALS AND METHODS:PubMed and select oncology congresses were searched for publications that identify...

    journal_title:Urology

    pub_type: 杂志文章,评审

    doi:10.1016/j.urology.2013.01.009

    authors: Corcoran AT,Russo P,Lowrance WT,Asnis-Alibozek A,Libertino JA,Pryma DA,Divgi CR,Uzzo RG

    更新日期:2013-04-01 00:00:00

  • Bilateral Ureterovaginal Fistulas and Vesicovaginal Fistula in Setting of Retained Pessary.

    abstract::Urogenital fistulas in the setting of foreign body are rare. Isolated vesicovaginal fistula is the most common and has been reported in the setting of retained intraureterine device,1,2 neglected pessary3,4 and atypical insertions related mostly to sexual activity or underlying psychiatric disorders.5-7 Combined vesic...

    journal_title:Urology

    pub_type: 杂志文章

    doi:10.1016/j.urology.2020.04.049

    authors: Rapp DE,Congleton JY,Boatman K,Karp N,Krupski T

    更新日期:2020-07-01 00:00:00

  • Pseudotumor of kidney.

    abstract::Hypertrophy of the renal columns of Bertin may present as a mass, at times difficult to distinguish from neoplasia or cyst. Herein, we present a case characterized by the inability of this lesion to absorb 99mTc DTPA (99mTechnetium diethylenetriaminepentaacetic acid) isotope on two separate renal studies. ...

    journal_title:Urology

    pub_type: 杂志文章

    doi:10.1016/0090-4295(79)90358-3

    authors: Katz AS,Landau SJ

    更新日期:1979-04-01 00:00:00

  • Right-sided intrathoracic renal ectopia with Bochdalek's hernia.

    abstract::A 23-year-old woman was evaluated for right flank pain of one year duration. Magnetic resonance imaging (MRI) revealed a 6 cm defect in the right hemidiaphragm with herniation of the right kidney, adrenal gland, and posterior right hepatic lobe consistent with a congenital right Bochdalek hernia. Computed tomography (...

    journal_title:Urology

    pub_type: 杂志文章

    doi:10.1016/j.urology.2008.05.012

    authors: Subramanian VS,Goldfarb DA

    更新日期:2008-11-01 00:00:00

  • Macronutrients, fatty acids, cholesterol, and risk of benign prostatic hyperplasia.

    abstract:OBJECTIVES:To better understand the role of specific macronutrients on the risk of benign prostatic hyperplasia (BPH), we used data from an Italian case-control study. Although BPH is extremely common among the elderly, its etiology-and, particularly, the role of diet and specific macronutrients-is still unclear. METH...

    journal_title:Urology

    pub_type: 杂志文章

    doi:10.1016/j.urology.2006.01.007

    authors: Bravi F,Bosetti C,Dal Maso L,Talamini R,Montella M,Negri E,Ramazzotti V,Franceschi S,La Vecchia C

    更新日期:2006-06-01 00:00:00

  • Laparoscopic partial nephrectomy: a matched-pair comparison of the transperitoneal versus the retroperitoneal approach.

    abstract:OBJECTIVES:To compare surgical and functional results of both surgical approaches to endoscopic partial nephrectomy. It is currently performed either by the transperitoneal (t) or the retroperitoneal (r) approach. METHODS:This was a retrospective, matched-pair comparison of 105 patients who underwent either transperit...

    journal_title:Urology

    pub_type: 杂志文章

    doi:10.1016/j.urology.2010.02.057

    authors: Marszalek M,Chromecki T,Al-Ali BM,Meixl H,Madersbacher S,Jeschke K,Pummer K,Zigeuner R

    更新日期:2011-01-01 00:00:00

  • Vesicoileal fistula via Meckel diverticulum.

    abstract::The presentation, diagnosis, and management of a patient with an ileovesical fistula is discussed, this being the second reported case in the literature. ...

    journal_title:Urology

    pub_type: 杂志文章

    doi:10.1016/0090-4295(89)90135-0

    authors: MacKenzie TM,Kisner CD,Murray J

    更新日期:1989-06-01 00:00:00

  • Extracorporeal shock wave lithotripsy monotherapy for renal stones >25 mm in children.

    abstract:OBJECTIVES:To determine the safety and efficacy of extracorporeal shock wave lithotripsy (ESWL) as monotherapy for renal stones >25 mm in children. METHODS:Our prospective study included 24 children <14 years old with radiopaque renal stones >25 mm treated by ESWL as first-line treatment using the electromagnetic Dorn...

    journal_title:Urology

    pub_type: 杂志文章

    doi:10.1016/j.urology.2008.09.083

    authors: Shouman AM,Ziada AM,Ghoneim IA,Morsi HA

    更新日期:2009-07-01 00:00:00

  • Half Fourier single-shot turbo spin-echo magnetic resonance urography for the evaluation of suspected renal colic in pregnancy.

    abstract:OBJECTIVE:To report our experience with magnetic resonance urography (MRU) in pregnant women suspected of having obstructing upper tract calculi. The diagnosis of an upper tract calculus in the pregnant woman can be challenging. Recent evidence suggests that MRU can be used to effectively evaluate renal colic. METHODS...

    journal_title:Urology

    pub_type: 杂志文章

    doi:10.1016/j.urology.2011.12.016

    authors: Mullins JK,Semins MJ,Hyams ES,Bohlman ME,Matlaga BR

    更新日期:2012-06-01 00:00:00

  • Retained Bullet in the Kidney: Imaging and Conservative Management.

    abstract::Renal gunshot wounds resulting in a grade IV injury (AAST) should be explored only if they involve the hilum or if there are signs of suspected renal pelvis or ureteral laceration, active hemorrhage, peritonitis, or hemodynamically unstable patients (Kitrey et al, 2017).1 However, because of the paucity of cases repor...

    journal_title:Urology

    pub_type: 杂志文章

    doi:10.1016/j.urology.2017.11.044

    authors: Mantica G,Kruger S,Ackermann H,Spies PV,Cassim F,Keyser Z,Terrone C,van der Merwe A

    更新日期:2018-03-01 00:00:00

  • Incontinence of urine due to instability of micturition reflexes: Part I. Detrusor reflex instability.

    abstract::Micturition reflex instability may result from malfunction of the detrusor reflex or instability of the pudendal nucleus which innervates the pelvic floor muscles and external sphincter. Detrusor instability is the result of sacral micturition reflex center (SMRC) hyperexcitability. This may be caused by underinhibiti...

    journal_title:Urology

    pub_type: 杂志文章

    doi:10.1016/0090-4295(80)90434-3

    authors: Mahony DT,Laferte RO,Blais DJ

    更新日期:1980-03-01 00:00:00

  • Tamsulosin: current clinical experience.

    abstract::During the past decade, our understanding of the epidemiology and natural history of benign prostatic hyperplasia (BPH) has improved considerably. Population-based studies confirm that lower urinary tract symptoms (LUTS) are very common among aging men. These studies have confirmed that men with moderate-to-severe sym...

    journal_title:Urology

    pub_type: 杂志文章,评审

    doi:10.1016/s0090-4295(01)01346-2

    authors: O'Leary MP

    更新日期:2001-12-01 00:00:00

  • Relationship of response to transurethral hyperthermia and prostate volume in BPH patients.

    abstract::A response to transurethral microwave hyperthermia (TUHT) at 915 MHz and its relationship to prostate volume was examined in 63 poor surgical risk benign prostatic hyperplasia (BPH) patients. All patients had moderate-to-severe obstructive signs and symptoms, and received > or = 5 TUHT one-hour sessions. Treatment tem...

    journal_title:Urology

    pub_type: 杂志文章

    doi:10.1016/0090-4295(92)90379-b

    authors: Petrovich Z,Ameye F,Pike M,Boyd S,Baert L

    更新日期:1992-10-01 00:00:00

  • New pharmacologic targets for the treatment of the overactive bladder: an update.

    abstract::Although currently available antimuscarinic agents are the standard of care for overactive bladder (OAB), they are limited by certain side effects, particularly dry mouth and constipation. Research aimed at discovering new therapies for OAB has resulted in the identification of some promising drugs. Investigations of ...

    journal_title:Urology

    pub_type: 杂志文章,评审

    doi:10.1016/j.urology.2003.10.005

    authors: Andersson KE

    更新日期:2004-03-01 00:00:00

  • Roentgenographic evaluation of nephroptosis.

    abstract::Vertical and medial nephroptosis was assessed on 60 consecutive excretory urographic examinations. Ptosis, both vertical and medial, was seen more commonly in females, and vertical ptosis was more frequent than medial ptosis. In our series there was no significant evidence of predominance on the right side. Dietl cris...

    journal_title:Urology

    pub_type: 杂志文章

    doi:10.1016/0090-4295(78)90026-2

    authors: Moschetti GA,Miller HL,Ney C,Finby N

    更新日期:1978-06-01 00:00:00

  • Congenital multicystic dysplastic kidney in the adult.

    abstract::Unilateral multicystic kidneys are not infrequent during infancy. However, few cases in adults are reported. A case is presented in which a unilateral multicystic kidney with atresia of the ureter was found as an incidental finding in an asymptomatic elderly patient. The literature is reviewed, and a nonoperative diag...

    journal_title:Urology

    pub_type: 杂志文章

    doi:10.1016/0090-4295(80)90609-3

    authors: Marsidi PJ,Lin WI,Pilloff B

    更新日期:1980-11-01 00:00:00

  • Testicular calcifications and neoplasia in patient treated for subfertility.

    abstract::A subfertile male with a history of left cryptorchism underwent scrotal ultrasound that revealed stippled calcifications, without associated mass, in the right testicle. Six months later, while on a regimen of clomiphene citrate, a testicular tumor became palpable. This was sonographically confirmed to be surrounding ...

    journal_title:Urology

    pub_type: 杂志文章

    doi:10.1016/0090-4295(90)80202-x

    authors: Salisz JA,Goldman KA

    更新日期:1990-12-01 00:00:00

  • Patterns of inheritance and outcome in patients treated with external beam radiation for prostate cancer.

    abstract:OBJECTIVES:To evaluate biochemical outcome after definitive radiotherapy as a function of family history groupings. METHODS:Biochemical freedom from disease for 920 men treated for prostate cancer with external beam radiation alone between March 1987 and December 1997 was compared according to hereditary/familial hist...

    journal_title:Urology

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1016/s0090-4295(98)00398-7

    authors: Hanlon AL,Hanks GE

    更新日期:1998-11-01 00:00:00

  • Limitations to ultrasound in the detection and measurement of urinary tract calculi.

    abstract:OBJECTIVES:To evaluate differences in stone measurement using computed tomography (CT) and ultrasound (US). Axial unenhanced helical CT is the reference-standard imaging modality for the assessment of urinary tract calculi; however, US is also commonly used. Differences in stone measurement using these techniques are p...

    journal_title:Urology

    pub_type: 杂志文章

    doi:10.1016/j.urology.2009.12.015

    authors: Ray AA,Ghiculete D,Pace KT,Honey RJ

    更新日期:2010-08-01 00:00:00

  • Bone alterations in patients with idiopathic hypercalciuria and calcium nephrolithiasis.

    abstract:OBJECTIVES:To verify whether alterations in bone density and turnover in patients with calcium nephrolithiasis and hypercalciuria are observable in various subgroups of patients divided according to the pathogenesis of the hypercalciuria. METHODS:Seventy patients with calcium nephrolithiasis and idiopathic hypercalciu...

    journal_title:Urology

    pub_type: 杂志文章

    doi:10.1016/s0090-4295(02)01626-6

    authors: Tasca A,Cacciola A,Ferrarese P,Ioverno E,Visonà E,Bernardi C,Nobile M,Giannini S

    更新日期:2002-06-01 00:00:00

  • Clinical Proof-of-concept of a Novel Platform Utilizing Biopsy-derived Live Single Cells, Phenotypic Biomarkers, and Machine Learning Toward a Precision Risk Stratification Test for Prostate Cancer Grade Groups 1 and 2 (Gleason 3 + 3 and 3 + 4).

    abstract:OBJECTIVE:To examine the ability of a novel live primary-cell phenotypic (LPCP) test to predict postsurgical adverse pathology (P-SAP) features and risk stratify patients based on SAP features in a blinded study utilizing radical prostatectomy (RP) surgical specimens. METHODS:Two hundred fifty-one men undergoing RP we...

    journal_title:Urology

    pub_type: 杂志文章,多中心研究

    doi:10.1016/j.urology.2018.09.032

    authors: Albala D,Manak MS,Varsanik JS,Rashid HH,Mouraviev V,Zappala SM,Ette E,Kella N,Rieger-Christ KM,Sant GR,Chander AC

    更新日期:2019-02-01 00:00:00

  • Inflammatory myofibroblastic tumor of the epididymis: case report and review of the literature.

    abstract::The inflammatory myofibroblastic tumor (IMT) is a rare benign tumor, known by several names and found in several locations throughout the body, including the lungs and genitourinary system (mostly the bladder). We report a case of a paratesticular IMT in a 17-year-old boy. Although the initial clinical diagnosis was r...

    journal_title:Urology

    pub_type: 杂志文章,评审

    doi:10.1016/j.urology.2010.09.027

    authors: Tunuguntla H,Mishra A,Jorda M,Gosalbez R

    更新日期:2011-07-01 00:00:00

  • Evaluation of Sacks solution for hypothermic preservation of kidneys.

    abstract::The efficacy of Sacks solution for hypothermic preservation of dog kidneys was determined. Complete ischemia was produced in one kidney for thirty minutes by clamping the renal pedicle in situ, followed by excision and immediate washout with the cold preservation fluid. Kidneys were stored in Sacks solution at 2 degre...

    journal_title:Urology

    pub_type: 杂志文章

    doi:10.1016/0090-4295(75)90502-6

    authors: Welch LT,Redman JF,Seager LD

    更新日期:1975-11-01 00:00:00

  • Occult stress urinary incontinence and the effect of vaginal vault prolapse on abdominal leak point pressures.

    abstract:OBJECTIVES:To compare the difference in abdominal leak point pressures (ALPPs) between patients with large cystoceles and severe vaginal vault prolapse and to assess the frequency of occult stress urinary incontinence (SUI) in these groups. METHODS:A total of 24 adult female patients with pelvic prolapse underwent pro...

    journal_title:Urology

    pub_type: 杂志文章

    doi:10.1016/s0090-4295(00)00856-6

    authors: Gallentine ML,Cespedes RD

    更新日期:2001-01-01 00:00:00

  • Transurethral resection in saline vaporization: evaluation of clinical efficacy and prostate volume.

    abstract:OBJECTIVE:To assess the efficacy and safety of transurethral resection in saline vaporization for symptomatic bladder outlet obstruction and the change in prostate volume. METHODS:A total of 106 patients with symptomatic bladder outlet obstruction underwent transurethral resection in saline vaporization. The effective...

    journal_title:Urology

    pub_type: 杂志文章

    doi:10.1016/j.urology.2011.09.044

    authors: Otsuki H,Kuwahara Y,Kosaka T,Tsukamoto T,Nakamura K,Shiroki R,Hoshinaga K

    更新日期:2012-03-01 00:00:00

  • Occult megarectum--a commonly unrecognized cause of enuresis.

    abstract:OBJECTIVE:To determine whether occult megarectum remains a commonly unrecognized cause of enuresis and whether treating it will cure enuresis in most children. A landmark study proved constipation was a commonly unrecognized cause of enuresis in 1986 in which constipation was defined as abnormal rectal distension. Howe...

    journal_title:Urology

    pub_type: 杂志文章

    doi:10.1016/j.urology.2011.10.015

    authors: Hodges SJ,Anthony EY

    更新日期:2012-02-01 00:00:00

  • Surgery for crural venous leakage.

    abstract::A procedure for congenital or acquired crural venous leakage is described. A 3-in.-long inguinoscrotal incision is made about 1 in. lateral to the penis. The suspensory ligament is incised, and the penis is detached from the pubic bone. The deep dorsal vein is resected to expose the hilum of the penis. The entrance of...

    journal_title:Urology

    pub_type: 杂志文章

    doi:10.1016/s0090-4295(99)00244-7

    authors: Lue TF

    更新日期:1999-10-01 00:00:00