Expanded surgical time out: A key to real-time data collection and quality improvement
Expanded surgical time out: A key to real-time data collection and quality improvement
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DOI：
10.1016/j.jamcollsurg.2007.01.009
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发表时间：
2007-04-01
影响因子：
5.2
通讯作者：
Polk, Hiram C., Jr.
中科院分区：
文献类型：
--
作者：
Altpeter, Terry;Luckhardt, Kitty;Polk, Hiram C., Jr.
这里包含的一些概念已在另一出版物中讨论并纳入，但数据完全是本文所独有的。(参见：将手术“暂停”转变为全面的“准备暂停”。Backster A, Teo A, Swift M， MD, Polk HC Jr， MD， FACS, Harken AH， MD， FACS。《心脏外科杂志》即将出版。)背景：对质量提高的不断推动与手术暂停（STO）的缓慢增长相一致，以减少错误部位手术的可能性。我们认为，使用STO作为反思暂停或术前简报具有更广泛的价值。本文的目的是描述一个机构使用该技术的经验，并验证其他机构使用该技术的潜力。研究设计：2006年在一家拥有400张床位的教学医院加强了STO的使用。对传导和构造前后进行了评级。结果：该机构认为该技术是有价值的，并在预防性抗生素选择和时机方面实质性地澄清和改进了其性能；适当维持术中体温和血糖；并提出次要问题，如维持β -阻断和适当的静脉血栓栓塞预防。外科医生的领导和实时数据收集成为必要和有用的组成部分。结论：及时反馈给外科医生是至关重要的；确定未来的绩效改进目标是可行的，尽管消除了无用的措施。由于外科医生努力解决按绩效付费的问题，STO是一个有用的安全、数据和质量改进工具。[J] .音乐学报，2007;04:527-532。(C) 2007年由美国外科医师学会发布)。
Some of the concepts contained here have been discussed and incorporated in another publication, but the data are entirely unique to this manuscript. (See: Transforming the Surgical "Time-Out" Into a Comprehensive "Preparatory Pause." Backster A, Teo A, Swift M, MD, Polk HC Jr, MD, FACS, Harken AH, MD, FACS. J Cardiac Surg, in press.)BACKGROUND:The increasing push for quality improvement coincides with the slowly growing use of surgical time out (STO) to lessen the likelihood of wrong-site operation. We believe that the use of STO as a reflective pause or a preoperative briefing has broader value. The purpose of this article is to describe one institution's experience with this technique and to validate its potential use by others.STUDY DESIGN:An enhanced use of STO was conducted in a 400-bed teaching hospital in calendar year 2006. Before and after conducts and constructs were rated.RESULTS:The institution found the technique to be of value, and substantially clarified and improved its performances with respect to prophylactic antibiotic choice and timing; appropriate maintenance of intraoperative temperature and glycemia; and institution of secondary issues, such as maintenance of beta-blockade and appropriate venous thromboembolism prophylaxis. Surgeon leadership and real-time data collection became essential and helpful components.CONCLUSIONS:Prompt feedback to surgeons is vital; identification of future targets for performance improvement is feasible, although useless measures are eliminated. Because surgeons grapple with pay-for-performance, STO is a useful safety, data, and quality improvement tool. (J Am Coll Sing 2007;204:527-532. (C) 2007 by the American College of Surgeons).