Accreditation of specialized surgical units in general and digestive surgery: A step forward by the AEC for quality improvement and subspecialized Fellowship training

Author(s):  
Mónica Millan ◽  
Eduardo Targarona ◽  
Eduardo García-Granero ◽  
Xavier Serra-Aracil
2017 ◽  
Author(s):  
Kattie Bear-Pfaffendorf

AbstractNetwork graphs can provide a quantitative framework for identifying complications with significant volumes and strong relationships to other complications, as a method for prioritization of quality improvement work. Here we examine the application of network graphing techniques to acute care inpatient complications on acute care medical-surgical units of a quaternary care center. The 3M PPC software identified 66 complications among 106 unique patients with two or more complications during an inpatient hospital stay. The network graph highlighted renal failure without dialysis and septicemia and severe infections as highly connected complications in this population.


2020 ◽  
Vol 71 (10) ◽  
pp. e680-e685
Author(s):  
Jerome A Leis ◽  
Jeff E Powis ◽  
Allison McGeer ◽  
Daniel R Ricciuto ◽  
Tanya Agnihotri ◽  
...  

Abstract Background The current approach to measuring hand hygiene (HH) relies on human auditors who capture <1% of HH opportunities and rapidly become recognized by staff, resulting in inflation in performance. Group electronic monitoring is a validated method of measuring HH adherence, but data demonstrating the clinical impact of this technology are lacking. Methods A stepped-wedge cluster randomized quality improvement study was performed on 26 inpatient medical and surgical units across 5 acute care hospitals in Ontario, Canada. The intervention involved daily HH reporting as measured by group electronic monitoring to guide unit-led improvement strategies. The primary outcome was monthly HH adherence (percentage) between baseline and intervention. Secondary outcomes included transmission of antibiotic-resistant organisms such as methicillin-resistant Staphylococcus aureus (MRSA) and other healthcare-associated infections. Results After adjusting for the correlation within inpatient units and hospitals, there was a significant overall improvement in HH adherence associated with the intervention (incidence rate ratio [IRR], 1.73 [95% confidence interval {CI}, 1.47–1.99]; P < .0001). Monthly HH adherence relative to the intervention increased from 29% (1 395 450/4 544 144) to 37% (598 035/1 536 643) within 1 month, followed by consecutive incremental increases up to 53% (804 108/1 515 537) by 10 months (P < .0001). There was a trend toward reduced healthcare-associated transmission of MRSA (IRR, 0.74 [95% CI, .53–1.04]; P = .08). Conclusions The introduction of a system for group electronic monitoring led to rapid, significant improvements in HH performance within a 2-year period. This method offers significant advantages over direct observation for measurement and improvement of HH.


2020 ◽  
Vol 29 (2) ◽  
pp. 290-299
Author(s):  
Julie G. Arenberg ◽  
Ray H. Hull ◽  
Lisa Hunter

Purpose From the Audiology Education Summit held in 2017, several working groups were formed to explore ideas about improving the quality and consistency in graduate education in audiology and externship training. The results are described here from one of the working groups formed to examine postgraduate specialization fellowships. Method Over the course of a year, the committee designed and implemented two surveys: one directed toward faculty and one toward students. The rationale for the survey and the results are presented. Comparisons between faculty and student responses are made for similar questions. Results Overall, the results demonstrate that the majority of both students and faculty believe that postgraduation specialization fellowships are needed for either 1 year or a flexible length. There was a consensus of opinion that the fellowship should be paid, as these would be designed for licensed audiologists. Most believed that the fellowships should be “governed by a professional organization (e.g., American Speech-Language-Hearing Association, American Academy of Audiology, American Doctors of Audiology, etc.),” or less so, a “separate body for this specific purpose.” Potential topics for specialization identified were the following: tinnitus, vestibular, cochlear implants, pediatrics, and intraoperative monitoring. The highest priority attributes for a specialization site were “abundant access to patient populations,” “staff of clinical experts,” and “active research.” The weight put toward these attributes differed between faculty and students with faculty prioritizing “university/academic centers,” and “access to academic coursework in the fellowship area.” The faculty rated “caseload diversity,” “minimum hours,” “research,” and “academic affiliation” as requirements for a fellowship site, with less weight for “coursework” and “other.” Finally, the students valued “improved personal ability to provide exceptional patient care,” “the potential for increased job opportunities,” and the “potential for a higher salary” as benefits most important to them, with lower ratings for “recognition as a subject matter expert” or “potential pathway to Ph.D. program.” Conclusions As a result of the survey, further exploration of a postgraduate specialization fellowship is warranted, especially to determine funding opportunities to offset cost for the sites and to ensure that fellows are paid adequately.


2007 ◽  
Vol 177 (4S) ◽  
pp. 186-186
Author(s):  
Fernando J. Bianco ◽  
Andrew J. Vickers ◽  
Angel M. Serio ◽  
James A. Eastham ◽  
Eric A. Klein ◽  
...  

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