Mount Sinai Journal of Medicine最新文献_第9页

Anesthesia information management systems: past, present, and future of anesthesia records. 麻醉信息管理系统:麻醉记录的过去、现在和未来。

Mount Sinai Journal of Medicine Pub Date : 2012-01-01 DOI: 10.1002/msj.21281

Bassam Kadry, William W Feaster, Alex Macario, Jesse M Ehrenfeld

{"title":"Anesthesia information management systems: past, present, and future of anesthesia records.","authors":"Bassam Kadry, William W Feaster, Alex Macario, Jesse M Ehrenfeld","doi":"10.1002/msj.21281","DOIUrl":"https://doi.org/10.1002/msj.21281","url":null,"abstract":"Documenting a patient's anesthetic in the medical record is quite different from summarizing an office visit, writing a surgical procedure note, or recording other clinical encounters. Some of the biggest differences are the frequent sampling of physiologic data, volume of data, and diversity of data collected. The goal of the anesthesia record is to accurately and comprehensively capture a patient's anesthetic experience in a succinct format. Having ready access to physiologic trends is essential to allowing anesthesiologists to make proper diagnoses and treatment decisions. Although the value provided by anesthesia information management systems and their functions may be different than other electronic health records, the real benefits of an anesthesia information management system depend on having it fully integrated with the other health information technologies. An anesthesia information management system is built around the electronic anesthesia record and incorporates anesthesia-relevant data pulled from disparate systems such as laboratory, billing, imaging, communication, pharmacy, and scheduling. The ability of an anesthesia information management system to collect data automatically enables anesthesiologists to reliably create an accurate record at all times, regardless of other concurrent demands. These systems also have the potential to convert large volumes of data into actionable information for outcomes research and quality-improvement initiatives. Developing a system to validate the data is crucial in conducting outcomes research using large datasets. Technology innovations outside of healthcare, such as multitouch interfaces, near-instant software response times, powerful but simple search capabilities, and intuitive designs, have raised the bar for users' expectations of health information technology.","PeriodicalId":51137,"journal":{"name":"Mount Sinai Journal of Medicine","volume":"79 1","pages":"154-65"},"PeriodicalIF":0.0,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/msj.21281","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30380183","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 66

Role of simulation in U.S. physician licensure and certification. 模拟在美国医师执照和认证中的作用。

Mount Sinai Journal of Medicine Pub Date : 2012-01-01 DOI: 10.1002/msj.21291

Adam I Levine, Andrew D Schwartz, Ethan O Bryson, Samuel Demaria

引用次数: 61

Integrating perioperative information from divergent sources. 整合来自不同来源的围手术期信息。

Mount Sinai Journal of Medicine Pub Date : 2012-01-01 DOI: 10.1002/msj.21282

Elizabeth A M Frost

引用次数: 9

Managing chronic pain with spinal cord stimulation. 脊髓刺激治疗慢性疼痛。

Mount Sinai Journal of Medicine Pub Date : 2012-01-01 DOI: 10.1002/msj.21289

Lawrence J Epstein, Marco Palmieri

{"title":"Managing chronic pain with spinal cord stimulation.","authors":"Lawrence J Epstein, Marco Palmieri","doi":"10.1002/msj.21289","DOIUrl":"https://doi.org/10.1002/msj.21289","url":null,"abstract":"Since its introduction as a procedure of last resort in a terminally ill patient with intractable cancer-related pain, spinal cord stimulation has been used to effectively treat chronic pain of varied origins. Spinal cord stimulation is commonly used for control of pain secondary to failed back surgery syndrome and complex regional pain syndrome, as well as pain from angina pectoris, peripheral vascular disease, and other causes. By stimulating one or more electrodes implanted in the posterior epidural space, the patient feels paresthesias in their areas of pain, which reduces the level of pain. Pain is reduced without the side effects associated with analgesic medications. Patients have improved quality of life and improved function, with many returning to work. Spinal cord stimulation has been shown to be cost effective as compared with conservative management alone. There is strong evidence for efficacy and cost effectiveness of spinal cord stimulation in the treatment of pain associated with intractable angina, failed back surgery syndrome, and complex regional pain syndrome. In this article, we review the history and pathophysiology of spinal cord stimulation, and the evidence (or lack thereof) for efficacy in common clinical practice.","PeriodicalId":51137,"journal":{"name":"Mount Sinai Journal of Medicine","volume":"79 1","pages":"123-32"},"PeriodicalIF":0.0,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/msj.21289","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30380178","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 63

Preventing post-thoracotomy pain syndrome. 预防开胸后疼痛综合征。

Mount Sinai Journal of Medicine Pub Date : 2012-01-01 DOI: 10.1002/msj.21286

Yury Khelemsky, Christopher J Noto

引用次数: 37

Prediction of rate and severity of adverse perioperative outcomes: "normal accidents" revisited. 预测围手术期不良结果的发生率和严重程度:“正常事故”的重新审视。

Mount Sinai Journal of Medicine Pub Date : 2012-01-01 DOI: 10.1002/msj.21295

Albert J Saubermann, Robert S Lagasse

{"title":"Prediction of rate and severity of adverse perioperative outcomes: \"normal accidents\" revisited.","authors":"Albert J Saubermann, Robert S Lagasse","doi":"10.1002/msj.21295","DOIUrl":"https://doi.org/10.1002/msj.21295","url":null,"abstract":"The American Society of Anesthesiologists Physical Status classification system has been shown to predict the frequency of perioperative morbidity and mortality despite known subjectivity, inconsistent application, and exclusion of many perioperative confounding variables. The authors examined the relationship between the American Society of Anesthesiologists Physical Status and both the frequency and the severity of adverse events over a 10-year period in an academic anesthesiology practice. The American Society of Anesthesiologists Physical Status is predictive of not only the frequency of adverse perioperative events, but also the severity of adverse events. These nonlinear mathematical relationships can provide meaningful information on performance and risk. Calculated odds ratios allow discussion about individualized anesthesia risks based on the American Society of Anesthesiologists Physical Status because the added complexity of the surgical or diagnostic procedure, and other perioperative confounding variables, is indirectly factored into the Physical Status classification. The ability of the American Society of Anesthesiologists Physical Status to predict adverse outcome frequency and severity in a nonlinear relationship can be fully explained by applying the Normal Accident Theory, a well-known theory of system failure that relates the interactive complexity of system components to the frequency and the severity of system failures or adverse events.","PeriodicalId":51137,"journal":{"name":"Mount Sinai Journal of Medicine","volume":"79 1","pages":"46-55"},"PeriodicalIF":0.0,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/msj.21295","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30380220","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 12

Perioperative assessment of patients with cardiac implantable electronic devices. 心脏植入式电子装置患者围手术期评估。

Mount Sinai Journal of Medicine Pub Date : 2012-01-01 DOI: 10.1002/msj.21287

Javier G Castillo, George Silvay, Juan Viles-González

引用次数: 7

Role of effective teamwork and communication in delivering safe, high-quality care. 有效的团队合作和沟通在提供安全、高质量护理中的作用。

Mount Sinai Journal of Medicine Pub Date : 2011-11-01 DOI: 10.1002/msj.20295

Michael W Leonard, Allan S Frankel

引用次数: 84

Patient safety training simulations based on competency criteria of the Accreditation Council for Graduate Medical Education. 基于研究生医学教育认证委员会能力标准的患者安全培训模拟。

Mount Sinai Journal of Medicine Pub Date : 2011-11-01 DOI: 10.1002/msj.20301

S Barry Issenberg, Hyun Soo Chung, Luke Adam Devine

{"title":"Patient safety training simulations based on competency criteria of the Accreditation Council for Graduate Medical Education.","authors":"S Barry Issenberg, Hyun Soo Chung, Luke Adam Devine","doi":"10.1002/msj.20301","DOIUrl":"https://doi.org/10.1002/msj.20301","url":null,"abstract":"This report reviews and critically evaluates the development of 3 movements in healthcare that have had a profound impact on changes occurring at all levels of medical education: patient safety, healthcare simulation, and competency-based education (exemplified by the Accreditation Council for Graduate Medical Education). The authors performed a critical and selective review of the literature from 1999 to 2011 to identify uses of simulation to address patient-safety issues aligned according to the Accreditation Council for Graduate Medical Education 6 core competencies: (1) patient care; (2) medical knowledge; (3) interpersonal and communication skills; (4) professionalism; (5) practice-based learning; and (6) systems-based practice. The research synthesis is reported to inform and provide evidence about how simulation is used to train and evaluate learners on a range of patient-safety issues for each of the core competencies: There is emerging evidence that simulation can be used in training efforts to reduce medical errors related to medical knowledge and patient care (particular invasive procedures as well as improved communication and teamwork skills). There remains limited evidence on its impact to improve patient safety related to more complex competencies of practice-based learning and systems-based practice. Simulation-based learning can lead to positive patient outcomes and reduction of medical errors particularly when used for individual skills. However, particular attention needs to be placed on the organizational context in which it is implemented if improvements in practice-based learning and systems-based practice are to be realized.","PeriodicalId":51137,"journal":{"name":"Mount Sinai Journal of Medicine","volume":"78 6","pages":"842-53"},"PeriodicalIF":0.0,"publicationDate":"2011-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/msj.20301","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30242185","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 30

Prevention of retained surgical items. 防止手术物品残留。

Mount Sinai Journal of Medicine Pub Date : 2011-11-01 DOI: 10.1002/msj.20299

David L Feldman

引用次数: 22