American journal of surgery
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The US military forces developed and implemented the Joint Theater Trauma System (JTTS) and Joint Theater Trauma Registry (JTTR) using US civilian trauma system models with the intent of improving outcomes after battlefield injury. ⋯ JTTS initiatives contributed to improved survival after battlefield injury. The JTTS has set the standard of trauma care for the modern battlefield using contemporary systems-based methodologies.
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The bispectral index (BIS) is a processed electroencephalographic value (awake = 100, isoelectric = 0). The relationship of BIS and brain death (BD) is assessed. ⋯ Distinguishing brain death and near brain death in severely comatose trauma patients is complex. By indicating the likelihood of brain death, BIS is an adjunct for efficient evaluation.
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From the legacy of Shukri Khuri, we have successfully implemented a regional quality collaborative in Michigan, the Michigan Surgical Quality Collaborative (MSQC). ⋯ The improved quality was likely the result of diverse process measures, many not yet recognized in the literature, which came together effectively in specific hospitals.
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Multicenter Study
Predictors of successful implementation of preoperative briefings and postoperative debriefings after medical team training.
The purpose of this study was to examine which factors at a medical team training learning session predict future success in the implementation of preoperative briefings and postoperative debriefings at health care facilities. ⋯ Full implementation of the patient safety tool preoperative briefings and postoperative debriefings is dependent on facility leadership support.
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In honor of the seminal contributions of Dr. Shukri Khuri to the foundation and development of the National Surgical Quality Improvement Program (NSQIP), a review of recent work and new directions within the American College of Surgeons (ACS) NSQIP is presented, according to the following outline: