Improving Patient Throughput by Streamlining the Surgical Care-Pathway Process

The referral surgeon-first opinion practitioner interaction is a source of communication breakdown in the surgical care pathway – a review of 112 questionnaire responses from first opinion practitioners

BSAVA Congress Proceedings 2019 ◽

10.22233/9781910443699.71.4 ◽

2019 ◽

pp. 465-465

Author(s):

Barnaby Dean ◽

Danny Chambers

Keyword(s):

Care Pathway ◽

Surgical Care ◽

Communication Breakdown

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Outcomes of day case shoulder replacement surgery in a stand-alone day care unit in the United Kingdom

Shoulder & Elbow ◽

10.1177/17585732211070822 ◽

2022 ◽

pp. 175857322110708

Author(s):

Mosab Elgalli ◽

Jamie Hind ◽

Ian Lahart ◽

Gur Aziz Singh Sidhu ◽

Sajjad Athar ◽

...

Keyword(s):

Shoulder Arthroplasty ◽

Care Pathway ◽

Surgical Care ◽

Operation Time ◽

District General Hospital ◽

Shoulder Replacement ◽

Day Case ◽

Replacement Surgery ◽

Post Surgery ◽

Significant Difference

Background: This review aims to compare the outcomes for day case shoulder replacement with in-patient shoulder replacement surgery in a district general hospital. Methods: Seventy-three patients had 82 shoulder arthroplasty procedures. Forty-six procedures were undertaken in a dedicated stand-alone day-case unit and 36 were undertaken as in-patient cases. Patient were followed up at 6 weeks, 6 months and annually. Results: There was no significant difference between the outcomes of shoulder arthroplasty procedures performed in the day case or in-patient settings making this a safe option for surgical care in a unit with an appropriate care pathway. Six complications in total were observed, three in each group. Operation time was statistically shorter for day cases by 25.1 min (95% CI - 36.5 to −13.7; d = −0.95, 95% CI −1.42 to 0.48). Estimated marginal means (EMM) revealed lower post-surgery oxford pain scores in day cases (EMM = 3.25, 95% CI 2.35, 4.16) compared with inpatients (EMM = 4.65, 95% CI 3.64 to 5.67). Constant shoulder scores were higher in day cases versus inpatients. Conclusion: Day case shoulder replacement is safe with comparable outcomes to routine inpatient care for patients up to ASA 3 classification with high satisfaction and excellent functional outcomes.

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Surgical data science: the new knowledge domain

Innovative Surgical Sciences ◽

10.1515/iss-2017-0004 ◽

2017 ◽

Vol 2 (3) ◽

pp. 109-121 ◽

Cited By ~ 8

Author(s):

S. Swaroop Vedula ◽

Gregory D. Hager

Keyword(s):

Decision Making ◽

Data Science ◽

Care Pathway ◽

Surgical Care ◽

Care Providers ◽

Knowledge Domain ◽

New Knowledge ◽

Surgical Data ◽

And Training

AbstractHealthcare in general, and surgery/interventional care in particular, is evolving through rapid advances in technology and increasing complexity of care, with the goal of maximizing the quality and value of care. Whereas innovations in diagnostic and therapeutic technologies have driven past improvements in the quality of surgical care, future transformation in care will be enabled by data. Conventional methodologies, such as registry studies, are limited in their scope for discovery and research, extent and complexity of data, breadth of analytical techniques, and translation or integration of research findings into patient care. We foresee the emergence of surgical/interventional data science (SDS) as a key element to addressing these limitations and creating a sustainable path toward evidence-based improvement of interventional healthcare pathways. SDS will create tools to measure, model, and quantify the pathways or processes within the context of patient health states or outcomes and use information gained to inform healthcare decisions, guidelines, best practices, policy, and training, thereby improving the safety and quality of healthcare and its value. Data are pervasive throughout the surgical care pathway; thus, SDS can impact various aspects of care, including prevention, diagnosis, intervention, or postoperative recovery. The existing literature already provides preliminary results, suggesting how a data science approach to surgical decision-making could more accurately predict severe complications using complex data from preoperative, intraoperative, and postoperative contexts, how it could support intraoperative decision-making using both existing knowledge and continuous data streams throughout the surgical care pathway, and how it could enable effective collaboration between human care providers and intelligent technologies. In addition, SDS is poised to play a central role in surgical education, for example, through objective assessments, automated virtual coaching, and robot-assisted active learning of surgical skill. However, the potential for transforming surgical care and training through SDS may only be realized through a cultural shift that not only institutionalizes technology to seamlessly capture data but also assimilates individuals with expertise in data science into clinical research teams. Furthermore, collaboration with industry partners from the inception of the discovery process promotes optimal design of data products as well as their efficient translation and commercialization. As surgery continues to evolve through advances in technology that enhance delivery of care, SDS represents a new knowledge domain to engineer surgical care of the future.

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Failures in communication and information transfer across the surgical care pathway: interview study

BMJ Quality & Safety ◽

10.1136/bmjqs-2012-000886 ◽

2012 ◽

Vol 21 (10) ◽

pp. 843-849 ◽

Cited By ~ 74

Author(s):

Kamal Nagpal ◽

Sonal Arora ◽

Amit Vats ◽

Helen W Wong ◽

Nick Sevdalis ◽

...

Keyword(s):

Information Transfer ◽

Care Pathway ◽

Surgical Care ◽

Interview Study

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The surgical care practitioner seeking consent: An appropriate delegate?

Journal of Perioperative Practice ◽

10.1177/1750458918780156 ◽

2018 ◽

Vol 28 (10) ◽

pp. 273-277

Author(s):

Michael Nicholas

Keyword(s):

Decision Making ◽

Informed Consent ◽

Shared Decision Making ◽

Care Pathway ◽

Surgical Care ◽

Recent Case ◽

Health Board ◽

Shared Decision ◽

Surgical Team ◽

Surgical Practice

Surgical care practitioners (SCPs) have become recognised as integral members of the surgical team in many healthcare establishments. Seeking informed consent either as the operating practitioner or on behalf of the surgeon, as their delegate, has becoming routine for many SCPs. Informed consent is a critical step in the patient’s care pathway and fundamental in fostering shared decision making and safer surgical practice. The relatively recent case of Montgomery v Lanarkshire Health Board has highlighted a need for those practitioners seeking informed consent to critically examine their practice and revisit the founding principles of the process.

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