Best Practice & Research-Clinical Anaesthesiology最新文献

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Leadership in 2022: A perspective 2022年的领导力:展望
IF 4.8 3区 医学
Best Practice & Research-Clinical Anaesthesiology Pub Date : 2022-08-01 DOI: 10.1016/j.bpa.2022.04.002
Markus M. Luedi (Attending Anaesthesiologist)
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引用次数: 6
Perioperative leadership in the non-operating room and ambulatory setting 在非手术室和门诊环境围手术期的领导
IF 4.8 3区 医学
Best Practice & Research-Clinical Anaesthesiology Pub Date : 2022-08-01 DOI: 10.1016/j.bpa.2021.12.001
Cade Bourgeois (Medical Student) , Michael McDonald (Medical Student) , Fatima Iqbal (Medical Student) , Rayce Silva (Medical Student) , Alex D. Pham (Resident Physician) , Avery Bryan (Medical Student) , Gregory M. Tortorich (Resident Physician) , Elyse M. Cornett (Assistant Professor) , Alan D. Kaye (Provost & Vice Chancellor of Academic Affairs)
{"title":"Perioperative leadership in the non-operating room and ambulatory setting","authors":"Cade Bourgeois (Medical Student) ,&nbsp;Michael McDonald (Medical Student) ,&nbsp;Fatima Iqbal (Medical Student) ,&nbsp;Rayce Silva (Medical Student) ,&nbsp;Alex D. Pham (Resident Physician) ,&nbsp;Avery Bryan (Medical Student) ,&nbsp;Gregory M. Tortorich (Resident Physician) ,&nbsp;Elyse M. Cornett (Assistant Professor) ,&nbsp;Alan D. Kaye (Provost & Vice Chancellor of Academic Affairs)","doi":"10.1016/j.bpa.2021.12.001","DOIUrl":"10.1016/j.bpa.2021.12.001","url":null,"abstract":"<div><p>To create a successful ambulatory care center, healthcare systems need management that can understand and improve key ambulatory success factors such as quality of clinical care, clinical competence, regulatory compliance, financial management, and customer service. Effective leadership is a vital skill that can improve all these factors. This manuscript discusses successful perioperative leadership styles in the ambulatory setting and provides a framework for proven strategies that have improved patient care.</p></div>","PeriodicalId":48541,"journal":{"name":"Best Practice & Research-Clinical Anaesthesiology","volume":"36 2","pages":"Pages 275-282"},"PeriodicalIF":4.8,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40364934","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Perioperative leadership: Global perspectives in the year 2022 围手术期领导力:2022年的全球视野
IF 4.8 3区 医学
Best Practice & Research-Clinical Anaesthesiology Pub Date : 2022-08-01 DOI: 10.1016/j.bpa.2022.03.002
Markus M. Luedi, Richard D. Urman
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引用次数: 0
Technical skills in the operating room: Implications for perioperative leadership and patient outcomes 手术室的技术技能:对围手术期领导和患者预后的影响
IF 4.8 3区 医学
Best Practice & Research-Clinical Anaesthesiology Pub Date : 2022-08-01 DOI: 10.1016/j.bpa.2022.05.002
Lukas Andereggen (PD, Dr., MD) , Stefan Andereggen (Dr., sc., ETH, PhD) , Corina Bello (Dr., MD) , Richard D. Urman (Prof., Dr., MD, MBA) , Markus M. Luedi (Prof., Dr., MD, MBA)
{"title":"Technical skills in the operating room: Implications for perioperative leadership and patient outcomes","authors":"Lukas Andereggen (PD, Dr., MD) ,&nbsp;Stefan Andereggen (Dr., sc., ETH, PhD) ,&nbsp;Corina Bello (Dr., MD) ,&nbsp;Richard D. Urman (Prof., Dr., MD, MBA) ,&nbsp;Markus M. Luedi (Prof., Dr., MD, MBA)","doi":"10.1016/j.bpa.2022.05.002","DOIUrl":"10.1016/j.bpa.2022.05.002","url":null,"abstract":"<div><p>Today's effective leaders create opportunities for their teams to develop both technical and non-technical skills. In the perioperative arena, the focus until now mainly has been on improving <em>non-technical skills</em>, with only few studies analyzing the relationship between <em>technical</em> skills and patient outcomes. Technical competence requires assessment of one's own strengths and weaknesses, inclusion of deliberate goal-oriented practice, objective structured feedback assessment, and a focus on best practice and improved patient outcomes. In this article, we address the prerequisites, assessment, and implications of technical skills for perioperative leadership, and provide key metrics impacting patient outcomes and leadership development.</p></div>","PeriodicalId":48541,"journal":{"name":"Best Practice & Research-Clinical Anaesthesiology","volume":"36 2","pages":"Pages 237-245"},"PeriodicalIF":4.8,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1521689622000313/pdfft?md5=0ee197496d1cdae26029fbb1db11b8c9&pid=1-s2.0-S1521689622000313-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40364930","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 3
Managing a perioperative medicine program 管理围手术期医学项目
IF 4.8 3区 医学
Best Practice & Research-Clinical Anaesthesiology Pub Date : 2022-08-01 DOI: 10.1016/j.bpa.2022.04.008
Thomas R. Vetter MD, MPH (Professor and Chief of Anesthesia and Perioperative Medicine)
{"title":"Managing a perioperative medicine program","authors":"Thomas R. Vetter MD, MPH (Professor and Chief of Anesthesia and Perioperative Medicine)","doi":"10.1016/j.bpa.2022.04.008","DOIUrl":"10.1016/j.bpa.2022.04.008","url":null,"abstract":"<div><p><span>Perioperative medicine is now a well-recognized albeit still evolving, interdisciplinary subspecialty, which encompasses a wide array of equally invested stakeholders and equally important contributors. The practice of perioperative medicine is fundamentally and optimally a collaborative effort, which aims to provide a comprehensive framework encompassing all aspects of the patient's surgical journey. Moving from a conceptual model of perioperative medicine to an operational perioperative medicine program and clinic requires a methodical management approach. This comprehensive management approach considers a variety of factors, such as defining the mission of a perioperative medicine program, expanding the role of the anesthesiologist and </span>internal medicine<span><span> hospitalist<span>, recognizing the role of the advanced practice provider, stratifying perioperative management of surgical patients, developing and implementing a program, undertaking a clinical proof-of-concept pilot of a program, scaling up and building out a program, maximizing the electronic health record, leveraging </span></span>telemedicine and virtual health, and providing adjunctive services.</span></p></div>","PeriodicalId":48541,"journal":{"name":"Best Practice & Research-Clinical Anaesthesiology","volume":"36 2","pages":"Pages 283-298"},"PeriodicalIF":4.8,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40366316","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 5
Managing bottlenecks in the perioperative setting: Optimizing patient care and reducing costs 围手术期瓶颈管理:优化患者护理和降低成本
IF 4.8 3区 医学
Best Practice & Research-Clinical Anaesthesiology Pub Date : 2022-08-01 DOI: 10.1016/j.bpa.2022.05.005
Maks Mihalj MD (Dr.) , Andrea Corona MD (Dr.) , Lukas Andereggen MD (PD Dr.) , Richard D. Urman MD, MBA (Prof. Dr.) , Markus M. Luedi MD, MBA (Prof. Dr.) , Corina Bello MD (Dr.)
{"title":"Managing bottlenecks in the perioperative setting: Optimizing patient care and reducing costs","authors":"Maks Mihalj MD (Dr.) ,&nbsp;Andrea Corona MD (Dr.) ,&nbsp;Lukas Andereggen MD (PD Dr.) ,&nbsp;Richard D. Urman MD, MBA (Prof. Dr.) ,&nbsp;Markus M. Luedi MD, MBA (Prof. Dr.) ,&nbsp;Corina Bello MD (Dr.)","doi":"10.1016/j.bpa.2022.05.005","DOIUrl":"10.1016/j.bpa.2022.05.005","url":null,"abstract":"<div><p>Bottlenecks limit the maximum output of a system and indicate operational congestion points in process management. Bottlenecks also affect perioperative care and include dimensions such as infrastructure, architectural design and limitations, inefficient equipment and material supply chains, communication-related limitations on the flow of information, and patient- or staff-related factors. Improvement of workflow is, therefore, becoming a priority in most healthcare settings. We provide an overview of bottleneck management in the perioperative setting and introduce dimensions, including aligned strategic decision-making, tactical planning, and operational adjustments.</p></div>","PeriodicalId":48541,"journal":{"name":"Best Practice & Research-Clinical Anaesthesiology","volume":"36 2","pages":"Pages 299-310"},"PeriodicalIF":4.8,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1521689622000349/pdfft?md5=9c53b721575493aa6a12a6226936e7d2&pid=1-s2.0-S1521689622000349-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40366317","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 5
Administrative structures: Options for achieving success in perioperative medicine 管理结构:围手术期医学成功的选择
IF 4.8 3区 医学
Best Practice & Research-Clinical Anaesthesiology Pub Date : 2022-08-01 DOI: 10.1016/j.bpa.2022.05.004
Thomas J. Sieber MD, MBA (Head of Department, Chief Anaesthetist) , Markus M. Luedi MD, MBA (Attending Anaesthesiologist, Consultant Anaesthetist)
{"title":"Administrative structures: Options for achieving success in perioperative medicine","authors":"Thomas J. Sieber MD, MBA (Head of Department, Chief Anaesthetist) ,&nbsp;Markus M. Luedi MD, MBA (Attending Anaesthesiologist, Consultant Anaesthetist)","doi":"10.1016/j.bpa.2022.05.004","DOIUrl":"10.1016/j.bpa.2022.05.004","url":null,"abstract":"<div><p>Without the appropriate administrative structure, even well-thought-out strategic plans or detailed process improvement initiatives will fail. Developing a strong foundation for governance and leadership is a critical element of any high-functioning organization, and it applies just as well in the perioperative setting.</p><p>Yet, perioperative patient care teams and operating room (OR) management structures can be very complex, due to relationships both within the OR and between the OR and other departments. Frequently, reliable management of the perioperative process is lacking.</p><p>We aim to provide an overview of the structural and elemental components and roles of perioperative management teams, as well as the administrative structure that guides them, since effective perioperative care teams and OR leaders are of paramount importance for any successful hospital.</p></div>","PeriodicalId":48541,"journal":{"name":"Best Practice & Research-Clinical Anaesthesiology","volume":"36 2","pages":"Pages 257-263"},"PeriodicalIF":4.8,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1521689622000337/pdfft?md5=a7a5c00ef907eb68ec14a61ae6f594ec&pid=1-s2.0-S1521689622000337-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40364932","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Building a well-balanced culture in the perioperative setting 在围手术期环境中建立平衡的文化
IF 4.8 3区 医学
Best Practice & Research-Clinical Anaesthesiology Pub Date : 2022-08-01 DOI: 10.1016/j.bpa.2022.05.003
Corina Bello (Resident Physician) , Mark G. Filipovic (Resident Physician) , Lukas Andereggen (Attending Neurosurgeon) , Thomas Heidegger (Professor & Attending Anaesthesiologist) , Richard D. Urman (Professor & Attending Anaesthesiologist) , Markus M. Luedi (Professor & Attending Anaesthesiologist)
{"title":"Building a well-balanced culture in the perioperative setting","authors":"Corina Bello (Resident Physician) ,&nbsp;Mark G. Filipovic (Resident Physician) ,&nbsp;Lukas Andereggen (Attending Neurosurgeon) ,&nbsp;Thomas Heidegger (Professor & Attending Anaesthesiologist) ,&nbsp;Richard D. Urman (Professor & Attending Anaesthesiologist) ,&nbsp;Markus M. Luedi (Professor & Attending Anaesthesiologist)","doi":"10.1016/j.bpa.2022.05.003","DOIUrl":"10.1016/j.bpa.2022.05.003","url":null,"abstract":"<div><p>Healthcare institutions are currently under enormous financial, political and social pressure. Especially in the perioperative setting, various professional groups with differing agendas, dynamic teams, high-stress levels and diverging stakeholder interests are contributing to tension on a variety of levels. These players ask for guidance that goes beyond defined goals, clear structures or rules for process optimization. The impact of culture, which is influenced by core values, unspoken behaviours and practices, a shared purpose and implicit norms, has been often neglected. However, culture is a key factor in the search for optimal patient outcomes, quality of care, protection and long-time retention of staff, as well as economic success. In this review, we discuss important aspects to consider in building a great perioperative workplace, discuss indispensable adaptations in times of crisis and touch on urgently needed further investigations to optimize the art of developing, protecting, and cultivating a well-balanced culture.</p></div>","PeriodicalId":48541,"journal":{"name":"Best Practice & Research-Clinical Anaesthesiology","volume":"36 2","pages":"Pages 247-256"},"PeriodicalIF":4.8,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1521689622000325/pdfft?md5=297a4d29038bcd00e43b41af0bbd98f5&pid=1-s2.0-S1521689622000325-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40364931","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Optimal uterotonic management 最佳子宫张力管理。
IF 4.8 3区 医学
Best Practice & Research-Clinical Anaesthesiology Pub Date : 2022-05-01 DOI: 10.1016/j.bpa.2022.02.002
Michael Heesen Dr (Professor), Sharon Orbach-Zinger MD
{"title":"Optimal uterotonic management","authors":"Michael Heesen Dr (Professor),&nbsp;Sharon Orbach-Zinger MD","doi":"10.1016/j.bpa.2022.02.002","DOIUrl":"10.1016/j.bpa.2022.02.002","url":null,"abstract":"<div><p>Uterotonics play an important role in the management of postpartum haemorrhage (PPH), often caused by uterine atony. The World Health Organization (WHO) recommends the application of uterotonics for all births. Oxytocin, considered the first-line uterotonic, binds to a G protein-coupled receptor which is subject to down sensitization upon repeated or prolonged administration of oxytocin. Consequently, a uterotonic with a different mechanism of action should be chosen early when oxytocin does not restore uterine tone. Choice of the second-line uterotonic is determined by institutional preferences as well as by maternal co-morbidities since most uterotonics have cardiovascular side effects. Slow injection of all uterotonics is strongly recommended to blunt these reactions. Methylergometrine and carboprost should, therefore, be avoided in many cardiovascular pathologies. Carbetocin is a chemical modification of oxytocin with a longer half-time, and therefore one bolus of carbetocin is usually sufficient. Its heat stability makes it an ideal candidate in resource-restricted settings.</p></div>","PeriodicalId":48541,"journal":{"name":"Best Practice & Research-Clinical Anaesthesiology","volume":"36 1","pages":"Pages 135-155"},"PeriodicalIF":4.8,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74190087","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Critical care in obstetrics 产科重症监护。
IF 4.8 3区 医学
Best Practice & Research-Clinical Anaesthesiology Pub Date : 2022-05-01 DOI: 10.1016/j.bpa.2022.02.001
Cesar R. Padilla MD (Clinical Assistant Professor) , Amir Shamshirsaz MD (Assistant Professor)
{"title":"Critical care in obstetrics","authors":"Cesar R. Padilla MD (Clinical Assistant Professor) ,&nbsp;Amir Shamshirsaz MD (Assistant Professor)","doi":"10.1016/j.bpa.2022.02.001","DOIUrl":"10.1016/j.bpa.2022.02.001","url":null,"abstract":"<div><p>Leading causes of intensive care unit<span><span> (ICU) admission include hemorrhage, hypertensive disorders of pregnancy, and sepsis. Although the incidence of ICU admission in pregnancy may be low, this does not account for critical illness in labor and delivery or </span>maternity<span><span> unit suites, which is as high as 1–3%. Most admissions, for example, to an ICU unit occur in the postpartum period<span>, where studies have shown a range from 62 to 92% of admissions occurring during this period. A total of 60% of maternal deaths have been reported as preventable, with a delay in diagnosis and prompt medical treatment cited as primary factors, prompting for early recognition of high-risk obstetric patients. Recently, comorbidity-based screening tools, which quantify a patient's medical comorbidity burden, have been developed and validated in predicting ICU admission and death. Noninvasive ultrasonography such as point-of-care ultrasonography becomes essential in determining </span></span>hemodynamic status, guides resuscitation, and manages cardiovascular dysfunction.</span></span></p></div>","PeriodicalId":48541,"journal":{"name":"Best Practice & Research-Clinical Anaesthesiology","volume":"36 1","pages":"Pages 209-225"},"PeriodicalIF":4.8,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84021955","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 2
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