Journal of critical care
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Journal of critical care · Jun 2008
Fewer intensive care unit refusals and a higher capacity utilization by using a cyclic surgical case schedule.
Mounting health care costs force hospital managers to maximize utilization of scarce resources and simultaneously improve access to hospital services. This article assesses the benefits of a cyclic case scheduling approach that exploits a master surgical schedule (MSS). An MSS maximizes operating room (OR) capacity and simultaneously levels the outflow of patients toward the intensive care unit (ICU) to reduce surgery cancellation. ⋯ Our findings show that the proposed cyclic OR planning policy may benefit OR utilization and reduce surgical case cancellation and peak demands on the ICU.
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Journal of critical care · Jun 2008
Role of simulators, educational programs, and nontechnical skills in anesthesia resident selection, education, and competency assessment.
Theoretical knowledge for anesthesia residents requires learning from a variety of sources. Technical skills are important and simulators are being used in many centers. ⋯ Training is evolving and higher standards in this field should create safer anesthesiologists. Simulator-based education and testing and assessment of nontechnical skills should be a priority in anesthesia residency programs.
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Although rarely thought of as simulations by anesthesia educators, the use of standardized patients to simulate clinical encounters spans 4 decades (Mt Sinai J Med. 1996;63:241-249; J Am Med Assoc. 1997;278:790-791; Int J Dermatol. 1999;38:893-894). Although its efficacy for education and evaluation in the medical community has been well established through extensive research, there is a distinct dearth in the literature in its use for anesthesia trainee education and evaluation. In this article, we discuss this simulation modality via a historic review, its current application in competency assessment, and its use in anesthesiology education and evaluation. We conclude with a "how to guide" to facilitate those considering including standardized patient simulations into their anesthesia training or simulation curriculum.
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Journal of critical care · Jun 2008
Multicenter StudyImproving patient safety in intensive care units in Michigan.
The aim of this study was to describe the design and lessons learned from implementing a large-scale patient safety collaborative and the impact of an intervention on teamwork climate in intensive care units (ICUs) across the state of Michigan. ⋯ This study describes the first statewide effort to improve patient safety in ICUs. The use of the comprehensive unit-based safety program was associated with significant improvements in safety culture. This collaborative may serve as a model to implement feasible and methodologically rigorous methods to improve and sustain patient safety on a larger scale.
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Journal of critical care · Jun 2008
Multicenter StudyAssessing organizational performance in intensive care units: a French experience.
The objective of the study was to assess and to explain variation of organizational performance in intensive care units (ICUs). ⋯ A benchmarking approach can be used by ICU managers to assess the organizational performance of their ICU based on a validated questionnaire. Differences are mainly explained by cultural values and individual well-being factors, introducing new requirements for managing human resources in ICUs.