The Journal of medical practice management : MPM
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When an unexpected perioperative crisis arises, simulation studies have suggested that the use of an emergency manual (EM) may offset the large cognitive load involved in crisis management, facilitating the efficient performance of key steps in treatment. However, little is known about how well EMs will translate into actual practice and what is required to use them optimally. ⋯ In the interim, cautious use of these cognitive aids is recommended, especially when the diagnosis is not straightforward, falls "in between" sections of the EM, or falls outside of the EM itself. Further research should focus on the efficacy of EMs as measured by the percentage of critical steps correctly performed by their users in scenarios that do not closely mirror one of the listed EM scenarios from the beginning or as the situation evolves.
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Traditionally, the operating room (OR) in an academic medical center has faced numerous challenges to effective clinical productivity, including additional missions of teaching and research. Level 1 trauma poses more challenges related to the need for additional specialized personnel in anesthesia, surgery, and nursing. The present investigation explores lessons learned in efficiency, teamwork, and data evaluation at a level 1 academic teaching facility. ⋯ These results are remarkable in comparison to the greater-than 20% cancellation rate recorded in 2005 when the current OR leadership team first assessed OR efficiency. An increase in the number of cases completed per month likely can be attributed to a reduction in the number of case cancellations. Increased efficiency allows for more operations to be performed, leading to increased profitability and an increased ability of hospitals to continue caring for patients. We advocate the implementation of a comprehensive multidisciplinary strategy for sustained improvement in OR efficiency and utilization.
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Medicare's fee-for-service (FFS) payment model may contribute to unsustainable spending growth. Payers are turning to alternative payment methods. ⋯ The CMS's Center for Medicare and Medicaid Innovation developed four models of bundled payments and 48 discrete clinical condition episodes. Many surgical care procedures are included in the 48 different clinical condition episodes.
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Do you believe that the roles your employees play on your medical practice team are identical to their job titles or job descriptions? Do you believe that team roles are determined by personality type? This article suggests that a more effective way to build and manage your medical practice team is to define team roles through employee behaviors. It provides 10 rules of behavioral team roles that can help practice managers to select and build high-performing teams, build more productive team relationships, improve the employee recruitment process, build greater team trust and understanding; and increase their own effectiveness. ⋯ Finally, this article offers an easy-to-implement method for assessing current team roles. It provides a simple four-question checklist that will help practice managers balance an imbalanced medical practice team.
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Performing a peer review of an article under consideration for publication requires not only an understanding of the subject matter, but also a systematic approach that includes screening for conflicts of interest; determining whether the manuscript is within or outside the reviewer's area of expertise; properly classifying the manuscript; and writing a detailed, organized review. Although some journals may provide guidelines for the reviewers, the guidelines usually are not detailed and do not take into consideration the variability in reviewer experience. This article is meant to serve as a guideline for peer reviewers and provide concrete information on how to write a comprehensive, unbiased review that will serve both the author and the journal well.