Increasing resident utilization and recognition of the critical view of safety during laparoscopic cholecystectomy: a pilot study from an academic medical center

2016 ◽  
Vol 31 (4) ◽  
pp. 1627-1635 ◽  
Author(s):  
Crystal B. Chen ◽  
Francesco Palazzo ◽  
Stephen M. Doane ◽  
Jordan M. Winter ◽  
Harish Lavu ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Pilot Study ◽  
Medical Center ◽  
Academic Medical Center ◽  
Critical View ◽  
Critical View Of Safety ◽  
Academic Medical

scholarly journals Applying JIT Principles to Resident Education to Reduce Patient Delays: A Pilot Study in an Academic Medical Center Pain Clinic

Pain Medicine ◽  
2015 ◽  
Vol 16 (2) ◽  
pp. 312-318 ◽  
Author(s):  
Kayode A. Williams ◽  
Chester G. Chambers ◽  
Maqbool Dada ◽  
Paul J. Christo ◽  
Douglas Hough ◽  
...  
Keyword(s):  
Pilot Study ◽  
Resident Education ◽  
Medical Center ◽  
Academic Medical Center ◽  
Pain Clinic ◽  
Academic Medical

scholarly journals P-BN28 The Consistency of Operative Safety Markers and the Critical View of Safety During Laparoscopic Cholecystectomy: A Pilot Study

2021 ◽  
Vol 108 (Supplement_9) ◽  
Author(s):  
Ahmad H M Nassar ◽  
Mahmoud Sallam ◽  
Rhona Kilpatrick ◽  
Kiren Ali
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Pilot Study ◽  
Bile Duct ◽  
Target Identification ◽  
Consensus Conference ◽  
Critical View ◽  
Critical View Of Safety ◽  
Video Recordings ◽  
True Value ◽  
Dissection Technique

Abstract Background Safe laparoscopic cholecystectomy(LC) depends on surgeon's experience, operative difficulty, utilisation of traditional safety markers, adapting the dissection technique and, where possible, displaying the critical view of safety (CVS) to confirm cystic pedicle structures prior to division. The Safe Cholecystectomy Multi-Society Practice Guidelines and State of the Art Consensus Conference on Prevention of Bile Duct Injury During Cholecystectomy identified no direct comparative evidence to support the CVS over other methods of anatomic identification. The aim of this study, therefore, was to examine the consistency of safety markers guiding the dissection and to determine the value of displaying the CVS. Methods A pilot study was conducted, reviewing video recordings of 241 LCs (144 retrospective and 97 prospective). The consistency of the Rouvier Sulcus (RS), the cystic lymph node (CLN), identification of the common bile duct (CBD) and duodenum and a new marker; the “cystic duct fold” (CDF), the peritoneal fold stretching between the retracted Hartman's Pouch and the CBD guiding the dissection at its distal end over the gallbladder neck, was documented. Data on the safety marker used to commence dissection, gallbladder condition, the LC difficulty grade, the selected technique and whether the CVS was achieved was recorded and analysed. Results Although the CBD and duodenum were visualised in 77%, the CDF was identifiable in 56% (CLN in 52.3%, RS in 50.2%) and the most consistently used to commence dissection in 51.4% (CLN 17.4%, CBD in 11.6% and RS in 6.6%). 12.8% required access to the infundibulum using sub-serosal or trans-vesical dissection (41% had acute cholecystitis, empyema or gangrenous gallbladders). Infundibular dissection was used in 88%. CVS was achievable in 56.8%. The CDF dropped form 87% in difficulty grades 1 and 2 to 16.5% in grades 4 and 5 with the CLN used in 21% of these difficult LCs. Conclusions A new safety marker, the CDF is proposed, being more reliable and safer on account of starting the dissection away from the CBD and potentially aberrant ducts, contrary to the line of RS. The CLN is more reliable in difficult LC, especially with acute inflammation. Infundibular dissection remains the default approach to “target identification” required to display the CVS. The true value of the CVS, as an end product of the process of dissection, lies in “target confirmation” before dividing any structures and in clearing the cystic plate to avoid injury to Couinaud Types C, F and hepato-cystic ducts.

scholarly journals Optimizing Inpatient Urine Culture Ordering Practices Using the Electronic Medical Record: A Pilot Study

2016 ◽  
Vol 38 (4) ◽  
pp. 486-488 ◽  
Author(s):  
Daniel Shirley ◽  
Harry Scholtz ◽  
Kurt Osterby ◽  
Jackson Musuuza ◽  
Barry Fox ◽  
...  
Keyword(s):  
Pilot Study ◽  
Medical Record ◽  
Electronic Medical Record ◽  
Urine Culture ◽  
Medical Center ◽  
Academic Medical Center ◽  
Academic Medical ◽  
Before And After ◽  
Quasi Experimental ◽  
Before And After Study

A prospective quasi-experimental before-and-after study of an electronic medical record–anchored intervention of embedded education on appropriate urine culture indications and indication selection reduced the number of urine cultures ordered for catheterized patients at an academic medical center. This intervention could be a component of CAUTI-reduction bundles.Infect Control Hosp Epidemiol 2017;38:486–488

scholarly journals Clinical and Financial Impact of Pharmacist Involvement in Discharge Medication Reconciliation at an Academic Medical Center: A Prospective Pilot Study

2015 ◽  
Vol 50 (6) ◽  
pp. 505-513 ◽  
Author(s):  
Jamie Sebaaly ◽  
Laura Beth Parsons ◽  
Nicole A. (Weimert) Pilch ◽  
Wendy Bullington ◽  
Genevieve L. Hayes ◽  
...  
Keyword(s):  
Pilot Study ◽  
Medication Reconciliation ◽  
Medical Center ◽  
Academic Medical Center ◽  
Financial Impact ◽  
Prospective Pilot Study ◽  
Discharge Medication ◽  
Academic Medical

Availability of acupuncture in the hospitals of a major academic medical center: a pilot study

2003 ◽  
Vol 11 (3) ◽  
pp. 177-183 ◽  
Author(s):  
E.S. Highfield ◽  
T.J Kaptchuk ◽  
M.J Ott ◽  
L Barnes ◽  
K.J Kemper
Keyword(s):  
Pilot Study ◽  
Medical Center ◽  
Academic Medical Center ◽  
Academic Medical
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