Exploring Qualitative Perspectives on Surgical Resident Training, Well-Being, and Patient Care

Through a literary review of recent research, this paper examines the mixed impact of health information technology (HIT) on patient care, medical errors, and the quality of healthcare delivery in selected hospital settings such as emergency departments. Specific technologies examined include the electronic health record (EHR), medical devices, artificial intelligence, and robotics. The paper identifies that some healthcare technologies are increasingly valuable in reducing medical errors, improving healthcare quality, and in producing better patient-centered outcomes. It also determines that technologies have complicated the delivery of quality patient care, increased the incidences of clinician burnout, and made receiving quality healthcare in America's hospital systems possibly less sure. The paper concludes with some suggestions for improving HIT's implementations and confirms the need for further evaluation of the impact of HIT in increasing patient safety and clinician well-being.

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Attending Surgeon Variation in Operative Case Length: An Opportunity for Quality Improvement

The American Surgeon ◽

10.1177/000313481808401011 ◽

2018 ◽

Vol 84 (10) ◽

pp. 1595-1599

Author(s):

Kirollos S. Malek ◽

Jukes P. Namm ◽

Carlos A. Garberoglio ◽

Maheswari Senthil ◽

Naveen Solomon ◽

...

Keyword(s):

Operative Time ◽

Resident Training ◽

Careful Consideration ◽

Analysis Of Covariance ◽

Surgical Resident ◽

Or Efficiency ◽

American Society ◽

Case Logs ◽

American Society Of Anesthesiologists ◽

The Impact

Balancing resident education with operating room (OR) efficiency, while accommodating different styles of surgical educators and learners, is a challenging task. We sought to evaluate variability in operative time for breast surgery cases. Accreditation Council for Graduate Medical Education case logs of breast operations from 2011 to 2017 for current surgical residents at Loma Linda University were correlated with patient records. The main outcome measure was operative time. Breast cases were assessed as these operations are performed during all postgraduate years (PGY). Breast procedures were grouped according to similarity. Variables analyzed included attending surgeon, PGY level, procedure type, month of operation, and American Society of Anesthesiologists class. Of 606 breast cases reviewed, median overall operative time was 150 minutes (interquartile range 187–927). One-way analysis of covariance demonstrated statistically significant variation in operative time by attending surgeon controlling for covariates (PGY level, procedure, American Society of Anesthesiologists class, and month) ( P = 0.04). With institutional OR costs of $30 per minute, the average difference between slowest and fastest surgeon was $2400 per case [(218–138) minutes 3 $30/min]. Minimizing variability for common procedures performed by surgical educators may enhance OR efficiency. However, the impact of case length on surgical resident training requires careful consideration.

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Is there disparity between regions and facilities in surgical resident training in Japan? Insights from a national survey

Surgery Today ◽

10.1007/s00595-020-02037-z ◽

2020 ◽

Vol 50 (12) ◽

pp. 1585-1593

Author(s):

Daisuke Hashimoto ◽

◽

Saseem Poudel ◽

Satoshi Hirano ◽

Yo Kurashima ◽

...

Keyword(s):

National Survey ◽

Resident Training ◽

Surgical Resident

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Seeing and Being Seen: The Impact of Art Making on the Experience of Isolation and Fear in Patient Care

Journal of Patient Experience ◽

10.1177/2374373520957172 ◽

2020 ◽

Vol 7 (6) ◽

pp. 839-841

Author(s):

Libby Byrne

Keyword(s):

Mental Health ◽

Adverse Effect ◽

Patient Care ◽

Well Being ◽

Art Making ◽

Incurable Illness ◽

The World ◽

Health Burdens ◽

The Impact

A positive diagnosis for COVID-19 is a threat not only to the health of an individual but also to the community where the disease manifests. Rather than being the discreet experience of a few or some, many people now appreciate our shared vulnerability with the threat of uncontained and incurable illness in our midst. “In this era of unspecified isolation, contagious disease, and with no sign of returning to normal life soon, coronavirus is putting an adverse effect on people’s mental health” (1). While managing the spread of COVID-19 has necessitated the use of social distancing and isolation a means of expressing care, equating care with the experience of fear and isolation can place unseen mental health burdens on inner resources for supporting the well-being of patients and those who care for them. Art can offer a remedy for this experience, lending the quality of durability to our fragile human experience and inviting us to extend the ways in which we see, think, and make sense of the world.

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Impact of COVID-19 Pandemic on Neurosurgical Practice in a Tertiary Care Center in India

Journal of Neurosciences in Rural Practice ◽

10.1055/s-0040-1716455 ◽

2020 ◽

Author(s):

Rahul Singh ◽

Anurag Sahu ◽

Kulwant Singh ◽

Ravi Shankar Prasad ◽

Nityanand Pandey ◽

...

Keyword(s):

Negative Impact ◽

Health Care Systems ◽

Care Center ◽

Tertiary Care ◽

Admission Rate ◽

Virtual Learning ◽

Well Being ◽

Resident Training ◽

Management Approach ◽

Tertiary Care Center

Abstract Objectives The aim of the study is to determine the magnitude of repercussions of coronavirus disease 2019 (COVID-19) pandemic on neurosurgical specialty and formulate a management approach. Materials and Methods This combined retrospective and prospective study was done in neurosurgical specialty of IMS–BHU, Varanasi, India, a tertiary care center, between January 1, 2020 and May 31, 2020. Analysis of impact on neurosurgical emergency and electives was done over before pandemic, during lockdown 1 and 2 and during lockdown 3 and 4 timelines. Effects of COVID-19 pandemic on psychology of neurosurgical team (50 members) and on patient party (88) were also evaluated. Virtual learning and webinars as a substitute to residential neurosurgical training were analyzed by a questionnaire given to 13 neurosurgeons of our department. Statistical Analysis Ordinary one-way ANOVA (analysis of variance) and unpaired t-test were used according to data analyzed. p < 0.05 was considered statistically significant. GraphPad Prism software was used for this analysis. Results On an average 8.22 admissions per day were done in neurosurgical emergency before pandemic. After lockdown these figures reduced to 3.2 admissions per day during lockdown 1 and 2 and to 5.36 admissions per day during lockdown 3 and 4. There was significant reduction in neurotrauma admission rate during lockdown (p < 0.0001) at our center. There was 76% reduction in emergency neurosurgical operated cases during pandemic. There was significant reduction in outpatient department (OPD) attendance per day, OPD admissions per day (p < 0.0001), and total elective surgeries (p < 0.0001) during lockdown. Of 50 neurosurgical team members (neurosurgeons, nursing, and ground staff) interviewed, 90% of them had the fear of contacting the COVID-19 disease, fear of well-being of family and children, and difficulty in transport. Three out of 13 neurosurgeons (23.1%) agreed on change in practice based on what they learned from virtual teaching and webinars and only two of them (15.4%) accepted improvement of skills based on virtual learning. Conclusion The COVID-19 pandemic is causing a significant impact on health care systems worldwide. For conserving resources elective surgical procedures should be limited. This pandemic has a negative impact on neurosurgical resident training program and psychology of both neurosurgical unit and patients.

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Endoscopy in Canada: Proceedings of the National Roundtable

Canadian Journal of Gastroenterology and Hepatology ◽

10.1155/2015/643463 ◽

2015 ◽

Vol 29 (5) ◽

pp. 259-265

Author(s):

Noah Switzer ◽

Elijah Dixon ◽

Jill Tinmouth ◽

Nori Bradley ◽

Melina Vassiliou ◽

...

Keyword(s):

Quality Assurance ◽

Resident Training ◽

The State ◽

Roundtable Discussion ◽

High Quality ◽

Surgical Resident ◽

Canadian Association ◽

The Future ◽

General Surgeons ◽

And Training

This 2014 roundtable discussion, hosted by the Canadian Association of General Surgeons, brought together general surgeons and gastroenterologists with expertise in endoscopy from across Canada to discuss the state of endoscopy in Canada. The focus of the roundtable was the evaluation of the competence of general surgeons at endoscopy, reviewing quality assurance parameters for high-quality endoscopy, measuring and assessing surgical resident preparedness for endoscopy practice, evaluating credentialing programs for the endosuite and predicting the future of endoscopic services in Canada. The roundtable noted several important observations. There exist inadequacies in both resident training and the assessment of competency in endoscopy. From these observations, several collaborative recommendations were then stated. These included the need for a formal and standardized system of both accreditation and training endoscopists.

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