Anesthesiology clinics
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Multidisciplinary education (MDE) is perceived as the next means of implementing major improvements in the quality and cost-effectiveness of patient care. In this article, the authors discuss various definitions of MDE, evaluate how MDE might be implemented in clinical arenas relevant to the anesthesiologist, and describe several implementations of MDE within their hospital and the anesthesiology department.
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Anesthesiology clinics · Mar 2011
Review Meta AnalysisTeamwork and communication in the operating room: relationship to discrete outcomes and research challenges.
The literature defining and addressing teamwork and communication is abundant; however, few studies have analyzed the relationship between measures of teamwork and communication and quantifiable outcomes. The objectives of this review are: (1) to identify studies addressing teamwork and communication in the operating room in relation to discrete measures of outcome, (2) to create a classification of studies of the relationship between teamwork and communication and outcomes, (3) to assess the implications of these studies, (4) to explore the methodological challenges of teamwork and communication studies in the perioperative setting, and (5) to suggest future research directions.studies in the perioperative setting, and (5) to suggest future research directions.
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Postoperative complications are directly related to poor surgical outcomes in the elderly. This review outlines evidence based quality initiatives focused on decreasing neurologic, cardiac, and pulmonary complications in the elderly surgical patient. ⋯ However, some recommendations for adults can be applied to the geriatric surgical population. In the future, process measures may provide a more global assessment of quality in the elderly surgical population.
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Anesthesiology clinics · Mar 2011
ReviewOutcomes research using quality improvement databases: evolving opportunities and challenges.
The challenges to prospective randomized controlled trials have necessitated the exploration of observational data sets that support research into the predictors and modulators of preoperative adverse events. The primary purpose and design of quality improvement databases is quality assessment and improvement at the local, regional, or national level. However, these data can also provide the opportunity to robustly study specific questions related to patient outcomes with no additional clinical risk to the patient. The virtual explosion of anesthesia-related registries has opened seemingly limitless opportunities for outcomes research in addition to generating hypothesis for more rigorous prospective analysis.
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Anesthesiology clinics · Mar 2011
ReviewHealth care quality in end-of-life care: promoting palliative care in the intensive care unit.
Seminal articles published in the late 1990s instigated not only an intense interest in health care quality but also a new era of research into quality end-of-life care, particularly in intensive care units (ICUs). ICUs can improve health care quality at the end of life by better using palliative care services and palliative care-related principles. This article details how the interest in health care quality has spurred a similar interest in end-of-life and palliative care in ICUs, defines palliative care and describes how it improves health care quality, and highlights barriers to the incorporation of palliative care in ICUs.