Abstract：
BACKGROUND:Efforts to improve surgical safety are limited by several factors and no consensus exists regarding the most effective way to improve surgical quality. The use of ISO 9001 quality standards within healthcare is recognized but has not been widely applied for improving surgical outcomes. METHODS:A surgical quality committee was created using ISO 9001:2015 standards. Quality objectives were assessed to understand how any suggested changes will be impacted due to risks and opportunities inherent in the system. RESULTS:The initial quality focus was on surgical site infections in 5 services. Change in surgical infection ratio from 2018 to 2019 showed significant improvement: coronary bypass 1.288 vs. 0.901; Colon 1.359 vs. 0.589; Hysterectomy 2.119 vs. 1.022; Knee 1.391 vs. 0.306; Hip 0 vs. 0.302. CONCLUSIONS:This is one of the first studies using ISO 9001 to improve surgical quality. The results indicate both acceptance and success of applying continual improvement strategies.
journal_name
Am J Surgjournal_title
American journal of surgeryauthors
Slakey DP,George JS,Anderson E,Willeumier D,Guglielmi Kdoi
10.1016/j.amjsurg.2020.11.014subject
Has Abstractpub_date
2020-11-09 00:00:00eissn
0002-9610issn
1879-1883pii
S0002-9610(20)30737-6pub_type
杂志文章abstract：BACKGROUND:In hepato-pancreato-biliary (HPB) surgery higher volumes are associated with improved outcomes; however, there are limitations to regionalization. Here we report our experience establishing multidisciplinary HPB program at a university-affiliated community hospital. METHODS:This is a retrospective review of...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2019.03.015
更新日期：2019-11-01 00:00:00
abstract：BACKGROUND:A method of augmenting host defenses against bacterial pathogens could result in a decrease in postoperative infections. Given its effects on leukocyte proliferation and function, it is possible that prophylactic granulocyte-macrophage colony-stimulating factor (GM-CSF) could reduce the incidence and severit...
journal_title：American journal of surgery
pub_type： 临床试验,杂志文章
doi：10.1016/s0002-9610(96)00106-7
更新日期：1996-09-01 00:00:00
abstract：BACKGROUND:The optimal management of cytologically indeterminate thyroid nodules is controversial given the variable malignancy rates reported in this patient population. We examined the prevalence of malignancy within cytologically indeterminate follicular thyroid lesions in an attempt to predict malignancy based on c...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2004.07.006
更新日期：2004-11-01 00:00:00
abstract：BACKGROUND:Professionalism and ethics are Accreditation Council for Graduate Medical Education (ACGME) core competencies, but there is little evidence regarding the effectiveness of ethics education. METHODS:General surgery residents at the University of Pittsburgh completed questionnaires measuring attitudes and know...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2010.08.002
更新日期：2010-11-01 00:00:00
abstract：BACKGROUND:The AAMC developed 13 Core Entrustable Professional Activities (EPAs) for graduating medical students. EPA 5 is: Document a clinical encounter in the patient record. Our goal was to develop an assessment rubric and gather evidence to support its validity in measuring progress towards entrustability. METHODS...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2018.12.055
更新日期：2020-02-01 00:00:00
abstract：:A plan is advocated for the management of the dominant breast mass with use of local anesthesia in the outpatient setting as the primary diagnostic tool, but with selection of certain patients for immediate general anesthesia biopsy in the "conventional" manner. Experience with this plan in 2,492 patients during a per...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(76)90030-1
更新日期：1976-05-01 00:00:00
abstract：:A discussion of congenital arteriovenous malformation of the head and neck based on five patients followed from three to twenty years is presented. Definition of the lesion and its progression as followed by angiography is described. The poor response to surgery is ascribed to the ischemic nature of the area of involv...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(78)90255-6
更新日期：1978-10-01 00:00:00
abstract：BACKGROUND:Platelet dysfunction associated with isolated traumatic brain injury (TBI) can be measured using thromboelastography-platelet mapping (TEG-PM). We hypothesized that platelet dysfunction can be detected after blunt TBI, and the degree of dysfunction is associated with increased TBI severity and in-hospital mo...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2019.09.024
更新日期：2019-12-01 00:00:00
abstract：:The results of transthoracic esophageal transection in 100 patients with esophageal varices are described. There were 11 operative deaths in this series, and the majority of patients died from hepatic failure. Esophageal varices disappeared completely in 81 percent of the patients and faded in 18 percent. Post-transec...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(80)90255-x
更新日期：1980-02-01 00:00:00
abstract：BACKGROUND:Hemoperfusion with PMX-F (polymyxin B covalently immobilized on fibers) has been reported to be safe and effective for patients with septic shock. However, the molecular mechanism of this usefulness is not yet clear. The purpose of this study was to evaluate whether the expression of CD14, human leukocyte an...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2003.12.067
更新日期：2004-08-01 00:00:00
abstract：:Thirteen published series concerning laparoscopic cholecystectomy performed in the United States were reviewed. The review was based on reports that included at least 100 patients. Three of the series are surveys of surgery chairpersons and multiple hospitals. The other 10 series are based on the experience of the inv...
journal_title：American journal of surgery
pub_type： 杂志文章,评审
doi：10.1016/s0002-9610(05)80939-0
更新日期：1993-04-01 00:00:00
abstract：INTRODUCTION:We sought to determine if lymph node harvesting and survival for CRC were comparable between laparoscopic and open resections in a community hospital setting. METHODS:A retrospective chart review of patients at two community hospitals who underwent open or laparoscopic resection for CRC between January 20...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2017.03.012
更新日期：2017-05-01 00:00:00
abstract：:Abnormal persistent of the embryonic axial blood supply to the leg, the sciatic artery, is a rare but often clinically important condition. The sciatic artery may vary from a small collateral in the upper thigh to a very large vessel that is the leg's sole arterial blood supply. The abnormal artery is prone to aneurys...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(83)90122-8
更新日期：1983-05-01 00:00:00
abstract：BACKGROUND:The need for mechanical ventilation (MV) after spinal cord injury (SCI) is a risk factor for prolonged critical care. The "purpose" of this study was to identify the level of cervical SCI that requires MV, thereby defining candidates for tracheostomy. METHODS:Patients with cervical SCI over a 15-year period...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2014.07.016
更新日期：2015-02-01 00:00:00
abstract：BACKGROUND:Phyllodes tumors (PTs) of the breast are rare, and their prognosis and treatment are still subject of discussion. The purpose of this study is to clarify therapeutic aspects and prognostic factors of this disease. PATIENTS AND METHODS:We retrospectively reviewed the medical records of 106 patients who had h...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2006.04.007
更新日期：2006-08-01 00:00:00
abstract：:During a fourteen year period, diagnostic peritoneal lavage was 98.5 per cent accurate in determining the presence or absence of blunt intraabdominal injuries among 2,586 patients. Of these, 69.4 per cent had a negative lavage and 29.2 per cent a positive lavage. Six patients (0.2 per cent) had a false-positive lavage...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(78)90339-2
更新日期：1978-12-01 00:00:00
abstract：BACKGROUND:Platelets are thought to participate in tumor metastasis. However, the relationship between platelet count and prognosis in pancreatic cancer remains unresolved. METHODS:A chart review of patients undergoing resection for pancreatic adenocarcinoma was undertaken. Demographic, perioperative, and outcome data...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2004.11.014
更新日期：2005-03-01 00:00:00
abstract：BACKGROUND:In the surgical management of lower gastrointestinal tract peritonitis (LGTP), drainage of the peritoneal cavity is often recommended. The objective of the study was to evaluate the impact of drainage of the abdominal cavity during management of LGTP. METHODS:From January 2009 to January 2012, patients unde...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2016.09.031
更新日期：2017-07-01 00:00:00
abstract：:Thirty-one patients with melanoma of the head and neck received split-course radiation therapy (5,000 to 6,000 rads/30 fractions) for loco-regional disease. There was no difference in survival in patients with gross tumors versus patients with no clinical evidence of disease at the start of radiation therapy. The prog...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(79)90428-8
更新日期：1979-10-01 00:00:00
abstract：BACKGROUND:Research has shown that pulsed electromagnetic fields (EMFs) promote wound healing in experimental colonic anastomosis; however, the effects of static EMFs in this setting have not been investigated to date. METHODS:Fifty male Wistar rats were used. Ten served as controls for mechanical strength testing, an...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2006.01.024
更新日期：2006-07-01 00:00:00
abstract：:Cytologic examination of peritoneal washings was performed in 40 patients with pancreatic ductal adenocarcinoma (35 head, 5 body) whose tumors had been selected as potentially resectable by computed tomographic (CT) findings. Saline (100 mL) was instilled and aspirated at laparoscopy in 27 patients and at laparotomy i...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(91)90356-i
更新日期：1991-01-01 00:00:00
abstract：:From 1972 to 1981, 430 patients were treated for bleeding peptic ulcer. Two hundred ten of the patients were treated surgically and 220 medically. In the surgically treated patients, mortality was high among those with posterior duodenal peptic ulcer and after gastrectomy rather than after vagotomy. Mortality after em...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(84)90170-3
更新日期：1984-03-01 00:00:00
abstract：BACKGROUND:While intussusception is relatively common in children, it is a rare clinical entity in adults, where the condition is almost always secondary to a definable lesion. DATA SOURCES:Thirteen cases of intussusception occurring in individuals older than 16 were encountered at our institute between 1981 and 1994....
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/S0002-9610(96)00419-9
更新日期：1997-02-01 00:00:00
abstract：:Intestinal infarction is a condition with a high rate of mortality. Progress in the fields of anesthesia, maintenance of electrolyte balance, and intensive postoperative care has made survival possible in a number of patients subjected to extensive resection of the small intestine. Many of these patients, however, lat...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(75)90322-0
更新日期：1975-05-01 00:00:00
abstract：BACKGROUND:Merkel cell carcinoma (MCC) is a cutaneous neuroendocrine tumor that may spread via lymphatics and can therefore be staged with sentinel lymph node biopsy (SLNB). MCC is radiosensitive and chemosensitive, although the role of adjuvant therapy is still unclear. We examined the impact of different treatments o...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2014.06.013
更新日期：2015-02-01 00:00:00
abstract：BACKGROUND:Vascular endothelial growth factor (VEGF) is a hypoxia-induced endothelial cell-specific mitogen, which is angiogenic in vivo and up-regulated in several malignancies. VEGF can be used as a prognostic marker, but the effect of surgical trauma on serum VEGF (S-VEGF) concentrations is unknown and might reduce ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(99)00253-6
更新日期：2000-01-01 00:00:00
abstract：BACKGROUND:Respiratory failure secondary to a variety of causes remains a significant cause of morbidity and mortality in the pediatric population. Newer therapies are appearing frequently in an attempt to decrease the number of deaths from this disease state. We briefly review the current literature on some of the new...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(96)00057-8
更新日期：1996-07-01 00:00:00
abstract：BACKGROUND:The presence of an "open abdomen" after a trauma laparotomy can complicate the nutritional management of injured patients. METHODS:The medical records of patients admitted to an American College of Surgeons-verified level 1 trauma center were evaluated. The timing of nutritional support was noted. The metho...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2009.08.033
更新日期：2010-03-01 00:00:00
abstract：BACKGROUND:The purpose of this study was to identify patients with rib injuries who were at risk for solid organ injury. METHODS:A retrospective chart review was performed of all blunt trauma patients with rib fractures during the period from July 2007 to July 2012. Data were analyzed for association of rib fractures ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2016.08.002
更新日期：2017-04-01 00:00:00
abstract：:We present a patient with pseudo-Meigs syndrome (PMS) secondary to sigmoid colon cancer metastasis to the ovary with elevated serum levels of carcinoembryonic antigen, CA19-9, and CA-125 who showed a marked change in pleural effusion before and after surgery. We have to consider PMS associated with colon cancer in pat...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2010.09.007
更新日期：2012-01-01 00:00:00
