Paediatric anaesthesia
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Paediatric anaesthesia · Jul 2013
Using quality improvement methods to optimize resources and maximize productivity in an anesthesia screening and consultation clinic.
The anesthesia preoperative screening and evaluation of a patient prior to surgery is a critical element in the safe and effective delivery of anesthesia care. In this era of increased focus on cost containment, many anesthesia practices are looking for ways to maximize productivity while maintaining the quality of the preoperative evaluation process by harnessing and optimizing all available resources. We sought to develop a Nurse Practitioner-assisted Preoperative Anesthesia Screening process using quality improvement methods with the goal of maintaining the quality of the screening process, while at the same time redirecting anesthesiologists time for the provision of nonoperating room (OR) anesthesia. The Nurse practitioner (NP) time (approximately 10 h per week) directed to this project was gained as a result of an earlier resource utilization improvement project within the Department of Anesthesia. The goal of this improvement project was to increase the proportion of patient anesthesia screens conducted by NPs to 50% within 6 months. ⋯ By applying quality improvement methods, we identified key drivers for the institution of an NP-assisted preoperative screening process and successfully implemented this process while redirecting anesthesiologists' time for the provision of non-OR anesthesia. This project was instrumental in improving the matching of provider skills with clinical need while maintaining superior outcomes at the lowest possible cost.
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Paediatric anaesthesia · Jul 2013
Striving for a zero-error patient surgical journey through adoption of aviation-style challenge and response flow checklists: a quality improvement project.
We describe our aim to create a zero-error system in our pediatric ambulatory surgery center by employing effective teamwork and aviation-style challenge and response 'flow checklists' at key stages of the patient surgical journey. These are used in addition to the existing World Health Organization Surgical Safety Checklists (Ann Surg, 255, 2012 and 44). ⋯ We have created a reproducible model of care involving multiple checklists at high-risk points in the patient surgical journey. The model is reliable and has a high degree of staff engagement. It promotes patient safety by ensuring the patient, team and equipment are correctly configured at every key transition stage in the surgical journey. We have been able to achieve this with no measurable increase in turnover times or reduction in operating room efficiency.
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Paediatric anaesthesia · Jul 2013
Handoff checklists improve the reliability of patient handoffs in the operating room and postanesthesia care unit.
Ineffective communications among healthcare providers are common and increases the risk of medical errors. During the perioperative period, multiple handoffs occur within a short period of time, and failure to convey important patient information can compromise safety. We used quality improvement methodology to improve the reliability of our handoffs in the operating room and postanesthesia care unit (PACU). ⋯ We utilized quality improvement methodology to develop and implement standardized checklists for handoffs of care in the operating room and PACU. Acceptance of and adherence to the standardized handoff protocols dramatically increased the quality and reliability of our handoff process.
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Paediatric anaesthesia · Jul 2013
Improving on-time starts for patients scheduled with general anesthesia in a MRI suite.
We applied quality improvement methodology to identify unnecessary, redundant parts of processes that can lead to delayed on-time starts for patients scheduled with general anesthesia (GA) in the radiology department. ⋯ Process improvement projects in anesthesia can yield positive results, using small incremental standardized changes. We used a quality improvement methods to successfully improve on-time start for patients scheduled with GA in high-volume MRI suite.
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Paediatric anaesthesia · Jul 2013
Biography Historical ArticleAlan Conn; his role in the development of the anesthesia department at Toronto SickKids.