Quality assurance in surgical practice

1993 ◽  
Vol 101 ◽  
pp. 183-191
Author(s):  
S. J. Nixon
Keyword(s):  
Critical Evaluation ◽  
Poor Performance ◽  
Late Complications ◽  
Surgical Practice ◽  
The Right ◽  
Discharge From Hospital ◽  
The Cost ◽  
First Time ◽  
Additional Therapy

Audit is the critical evaluation of medical practice to effect an improvement in quality of service. Quality has been described as ‘getting it right the first time’ and audit as asking ‘whether you are doing the right thing and you doing it right?’. Surgeons are acutely aware of the penalty paid by the patient when he ‘gets it wrong’. Immediate complications such as wound infection and anastomotic leakage may require additional therapy, delay discharge from hospital, necessitate further surgery or even lead to death. Late complications may result in recurrence of the presenting pathology or complications which cause more distress than the original disease. Surgery and audit seem to be closely linked and naturally associated. Surgical skills have developed immeasurably, no doubt accelerated by the realisation of the penalties of failure. Fortunately the cost of poor performance to the surgeon is no longer to have ones hand cut off as it was in 1750 BC under the rule of King Hammurabi of Babylonia.

scholarly journals The Effectiveness of Hospital Accreditation Implementation as a Protection Effort on Patient Information Rights

2018 ◽  
Vol 54 ◽  
pp. 03014
Author(s):  
Anggraeni Endah Kusumaningrum
Keyword(s):  
Improve Patient Safety ◽  
Legal Protection ◽  
Good Health ◽  
Hospital Services ◽  
Hospital Accreditation ◽  
Complex Organization ◽  
Right To Information ◽  
The Right ◽  
The Cost

This paper aims to analyze the effectiveness of the implementation of hospital accreditation in an attempt to provide legal protection of the right information of patients in hospital. The right to information stated on Article 7 and Article 8 of Law No. 36 of 2009 on Health as well as the shortcomings and advantages of health services. Along with the increasing awareness of the community to get good health service, raises the attitude of the critical patient. Patients no longer hesitate to ask the alternative treatment they will receive, whether in accordance with the cost incurred. The hospital is a complex organization because it is capital-intensive, energy, technology and various issues, covering the fields of law, economics, ethics, human rights, technology, and others with different principles and perspectives. The complexity of services in hospitals requires quality assurance and hospital service safety in the form of accreditation. Hospital accreditation is an acknowledgment given by an independent accrediting institution related to the assessment of the fulfillment of quality standards of hospital services on an ongoing basis. Therefore an accredited hospital is expected to effectively improve the quality of its services to their patients. The increased quality of hospital services will certainly improve patient safety and provide protection for patients.

scholarly journals Biogas purification technology to the quality of motor fuel

2018 ◽  
Author(s):  
Varvara Petrovna Druzianova ◽  
Ol'ga Panteleimonovna Semenova
Keyword(s):  
Agricultural Sector ◽  
Motor Fuel ◽  
The Road ◽  
Transfer Of Technology ◽  
Biogas Purification ◽  
Partial Transfer ◽  
The Cost ◽  
First Time ◽  
Petroleum Fuels

This paper describes the original technology of biogas purification to bring it to the optimal parameters of motor fuel. For the first time, as a filler in a purification filter the use of a natural mineral – zeolite – has been proposed. Biogas is obtained by processing organic animal waste, in this case cattle manure, in an anaerobic psychrophilic plant. In turn, the psychrophilic anaerobic technology was developed by the authors on the basis of the road department of the M. K. Ammosov North-Eastern Federal University. Even a partial transfer of technology to biogas would reduce the consumption of liquid petroleum fuels in the agricultural sector. As a result, a reduction in the cost of transporting of a liquid fuel would provide release of significant funds that can be spent on solving other problems. The manual is intended for students of motor and agro-feminine orientation, undergraduates, graduate students, teachers.

scholarly journals Comparative Analysis The Effect of Iodine, Ozone, and Peracetic Acid as A Disinfectant of Cantang Grouper Egg

2021 ◽  
Vol 5 (3) ◽  
pp. 95
Author(s):  
Putu Justika Nirmala Ardhiana Puspanjali ◽  
Gede Ari Yudasmara ◽  
Kadek Lila Antara
Keyword(s):  
Peracetic Acid ◽  
Hatching Rate ◽  
Research Subjects ◽  
Fish Eggs ◽  
Dose Time ◽  
Effectiveness And Efficiency ◽  
Hatching Eggs ◽  
The Right ◽  
The Cost

Problems in the fish hatchery sector often occur such as high egg mortality or low quality of fish eggs. Optimizing biosecurity is one of the efforts to improve the quality of fish eggs, for example by adding disinfectants such as iodine, ozone, and peracetic acid. The use of chemical disinfectants will produce good results if the right dose, time, and commodity are used. In this study. This research aims (1) to determine whether the use of chemicals including iodine, ozone, and peracetic acid had an effect as a disinfectant to increase the hatching rate of grouper fish, (2) to determine the level of effectiveness and efficiency of the use of chemicals as a disinfectant. This research is an experimental research type. The research subjects included in the study were cantang grouper fish eggs at PT. Pakarti Daksa Segara who used the exploratory sampling method. The conclusion of this study indicates that there is an influence on the growth rate of the use of iodine, ozone and, peracetic acid chemicals as disinfectants of cantang grouper eggs and there is a comparison of the effectiveness and efficiency of the use of the three chemicals which includes the percentage of the hatching rate, the cost of the disinfectant material and the time, which is needed in the use of the disinfectant. Iodine has the best level of effectiveness from the comparison of hatching eggs of cantang grouper and peracetic acid is the most efficient type of chemical.

Cost efficiency and service effectiveness for university e-libraries in Taiwan

2014 ◽  
Vol 32 (3) ◽  
pp. 308-321 ◽  
Author(s):  
Ling-Feng Hsieh ◽  
Jiung-Bin Chin ◽  
Mu-Chen Wu
Keyword(s):  
Cost Efficiency ◽  
Assessment Model ◽  
Content Type ◽  
Service Effectiveness ◽  
Related Data ◽  
The Cost ◽  
The University ◽  
Relationship Of ◽  
First Time

Purpose – The aim of this paper is to construct a model of cost efficiency and service effectiveness for a university e-library to allocate e-resources cost and to attain quality of service enhancement and cater to the needs of readers with existing e-resources. Design/methodology/approach – The paper establishes an assessment model for the cost efficiency and service effectiveness of a university e-library in Taiwan. It then proceeds with an empirical study and analysis of related data collected from e-libraries of 16 universities. A discussion of the results of the study and suggestions for the adjustment of the university e-libraries follows. Findings – The paper combines two models of cost efficiency and service effectiveness for the first time to analyze and consider the output results created by the input cost of university e-libraries in Taiwan and their utilization by readers. Originality/value – The paper builds a figure for the relationship of e-library cost efficiency and service effectiveness at 16 universities in Taiwan and then divides it into four types.

Economic Decision Model for First-Time Traumatic Patellar Dislocations in Adolescents

2017 ◽  
Vol 45 (10) ◽  
pp. 2267-2275 ◽  
Author(s):  
Benedict U. Nwachukwu ◽  
Conan So ◽  
William W. Schairer ◽  
Beth E. Shubin-Stein ◽  
Sabrina M. Strickland ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Surgical Treatment ◽  
Nonoperative Treatment ◽  
Cost Utility ◽  
Base Case ◽  
Delayed Surgery ◽  
Immediate Surgery ◽  
The Cost ◽  
First Time

Background: The surgical management of traumatic patellar dislocations in adolescents is associated with a lower rate of recurrent dislocations compared with nonoperative care. However, the attendant cost of surgery and the quality-of-life benefit of a surgical treatment strategy are unclear. Purpose: To compare the cost-utility of 3 management strategies for acute first-time patellar dislocations in adolescents: (1) nonoperative treatment only, (2) initial nonoperative treatment with surgery only for recurrent dislocations, and (3) immediate surgery. Study Design: Economic and decision analysis; Level of evidence, 2. Methods: A 10-year state-transition Markov model was constructed to compare the cost-utility of the 3 index treatment protocols. Utilities used to define health states were derived from a telephone interview of 60 adolescents with a history of acute patellar dislocations. The probability of transition between each health state was informed by the available literature. Direct costs were estimated using a statewide ambulatory surgery database, and indirect costs were estimated based on parental lost productivity. Effectiveness was expressed in quality-adjusted life years (QALYs). The principal outcome measure was the incremental cost-effectiveness ratio (ICER). Results: In the base case for our model, nonoperative treatment only was the least costly ($7300) but also the least effective (5.30 QALYs); initial nonoperative treatment with delayed surgery cost $10,500 for a 5.93 QALY benefit, while immediate surgical treatment cost $17,100 and provided 6.32 QALY benefits. Compared with nonoperative treatment only, initial nonoperative treatment with delayed surgery was associated with an ICER of $5100 per QALY. When immediate surgery was compared with a strategy of delayed surgery, immediate surgery provided incremental benefits at an ICER of $17,000 per QALY. The model was sensitive to the probability of surgical versus nonoperative treatment to achieve a full return to preinjury activity versus an intermediate lower state. When the probability of achieving a full return to preinjury activity with initial nonoperative treatment exceeds 47.5% (compared with 34.2% in the base case), then initial nonoperative treatment with delayed surgery is preferred to immediate surgery. Similarly, when the probability of achieving a full return to full preinjury activity with surgery falls below 51% (compared with 64% in the base case), then delayed surgery after initial nonoperative treatment is preferred. Conclusion: Immediate surgery and delayed surgical treatment are both cost-effective treatment options; however, immediate surgical treatment provides the highest QALY gains within a 10-year time horizon. Our model sensitivity analysis highlights the role of optimizing functional and quality-of-life benefits in the treatment of acute traumatic patellar dislocations. These findings have implications for clinical guidelines and policy decisions relating to adolescent patellar dislocations.

scholarly journals Exceptional case of surgical treatment of huge inguinal hernia at the woman

2019 ◽  
Vol 21 (2) ◽  
pp. 52-57
Author(s):  
I A Solovyov ◽  
D V Cherkashin ◽  
M V Vasilchenko ◽  
B B Bromberg ◽  
O V Balyura ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Inguinal Hernia ◽  
Postoperative Period ◽  
Clinical Case ◽  
Exceptional Case ◽  
Self Service ◽  
Surgical Tactics ◽  
The Right ◽  
First Time

Despite significant progress in a health care system the started cases of huge inguinal hernias still meet. For successful treatment of such patients objective diagnostics, preoperative preparation, the choice of suitable tactics of surgery and treatment in the postoperative period is important. The clinical case of treatment by not reducible huge inguinal hernia at the patient of 73 years is presented in article. The patient showed complaints to presence of the big sizes of the hernia in the bottom of a stomach limiting movement of the patient and self-service reducing quality of life. For the first time hernial protrusion in inguinal area has appeared in 2008 which gradually increased in sizes. Since 2015 I have noted the intensive growth of hernia. I didn’t ask for medical care. To clinic it is brought by an ambulance crew with the diagnosis of The Restrained Inguinal Hernia direction. At the time of survey data for infringement weren’t. After comprehensive examination to the patient surgery in volume has been executed: a gryzhesecheniye on the right, plasticity across Liechtenstein. The postoperative period proceeded without complications. The patient is written out for the 13th days after operation. Extremely exceptional clinical case, the choice of adequate stage-by-stage preoperative inspection and treatment, optimum surgical tactics and postoperative kuration is shown. The chosen approach led to prevention of development of a cascade of the complications including a compartment syndrome, to elimination of cosmetic defect and restoration of quality of life.

High-Speed Computer Tomography: Pressure Die Casting

2019 ◽  
Author(s):  
Christian Heikel ◽  
Eberhard Ambos
Keyword(s):  
High Speed ◽  
Testing Methods ◽  
New Findings ◽  
Constructive Work ◽  
The Right ◽  
Die Castings ◽  
Pressure Die Casting ◽  
First Time ◽  
Speed Computer

For many years, molders have been trying to figure out the influence of diverse factors on the quality of die castings during molding. In 2010, the rapid computer tomograph became available for the first time. This system is derived from medical technology and offers new testing methods. The measures, which have been in progress for the past 5 years, were focused to point out the correlation between the major influences of pore expression in pressure die castings. These results are suggestive of the future technological and constructive work. Through continuous improvements in testing methods, the technology finally succeeded to work out major influences on pore expressions in pressure die castings. With these new findings, it is possible, and even proven by example, that through the right choice of process parameters strength-influencing pores can be reduced. In case of not preventing the formation of pores, they could be moved out of the areas, which are strength vulnerable. This is an appropriate concept to reduce the weight of components and therefore the implementation of lightweight constructions in the automotive industry.

scholarly journals Determination of influencing metricsin water fall model

2018 ◽  
Vol 7 (2.26) ◽  
pp. 7
Author(s):  
K David ◽  
R Anand
Keyword(s):  
Critical Role ◽  
Project Manager ◽  
Senior Management ◽  
Project Teams ◽  
Cycle Model ◽  
The Right ◽  
The Cost ◽  
The Relationship

You cannot control what you can’t measure - Tom DeMarco -Metrics plays a critical role in any industry. The metrics can tell the senior management the health of the activity in that organization. In the paper, we have studied the relationship between the metrics and the quality of deliverables. Once the right metrics are identified for a particular phasein the life cycle model it will help the project manager to proactive-ly detect the issues earlier and arrest the defects. This can help the project teams to deliver the product on time without defects. There by the cost of the projects can be reduced which in turn will have high customer satisfaction.  

scholarly journals La concepción de lo básico en la determinación del ámbito subjetivo del derecho a la asistencia sanitaria

2018 ◽  
pp. 19-47
Author(s):  
Luis E. DELGADO DEL RINCÓN
Keyword(s):  
National Health System ◽  
The State ◽  
Constitutional Court ◽  
Court Ruling ◽  
Autonomous Region ◽  
The Right ◽  
First Time ◽  
Pais Vasco

LABURPENA: Lan honetan modu kritikoan aztertzen da Konstituzio Auzitegiaren jurisprudentzia, osasun esparruko sektore jakin batean oinarrizkotzat jotzen duenari dagokionez: osasun-laguntza jasotzeko eskubidearen esparrua zehaztea. Horretarako, bada, zehatz aztertzen da Konstituzio Auzitegiaren epai bat, azaroaren 16ko STC 134/2017 izenekoa. Epai horretan lehenengo aldiz jorratzen da gai hori; izan ere, Eusko Jaurlaritzak ekainaren 26ko 114/2012 Dekretua onetsi izanaren ondorioz Estatuaren eta Euskal Autonomia Erkidegoaren artean gertatu zen eskumen gatazka bat ebazten du epaiak. Dekretu horren bitartez Euskal Osasun Sistemaren prestazio sanitarioak zabaldu zitzaizkien apirilaren 20ko 16/2012 Lege Dekretuak aldatutako Nazio mailako osasun sistemaren kohesioa eta kalitateari buruzko maiatzaren 28ko 16/2003 Legean aseguratu eta onuradun gisa agertzen ez direnei. RESUMEN: El presente trabajo analiza críticamente la jurisprudencia del Tribunal Constitucional sobre lo que entiende por básico en un sector concreto de la materia sanitaria: la determinación del ámbito subjetivo del derecho a la asistencia sanitaria. Para ello se examina detalladamente una sentencia del Tribunal Constitucional, la STC 134/2017, de 16 de noviembre, que se ocupa por primera vez de esa cuestión, al resolver un conflicto de competencias suscitado entre el Estado y la Comunidad Autónoma del País Vasco, como consecuencia de la aprobación por el Gobierno vasco del Decreto 114/2012, de 26 de junio, que amplía las prestaciones sanitarias del Sistema Vasco de Salud a personas que no están definidas como asegurados ni beneficiarios en la Ley estatal 16/2003, de 28 de mayo, de Cohesión y calidad del Sistema Nacional de Salud, modificada por el Decreto-ley 16/2012, de 20 de abril. ABSTRACT: The present work critically analyzes what the jurisprudence of the Constitutional Court understands as basic in a specific sector of the sanitary matter: the determination of the subjective scope of the right to healthcare. To this end, the Constitutional Court ruling 134/2017, of November 16, which deals with this question for the first time, is examined in detail, by resolving a conflict of competences raised between the State and the Basque Autonomous Region, as a consequence of the approval by the Basque Government of Decree 114/2012, of June 26, which extends the health services of the Basque System of Health to people who are not defined as insured or beneficiaries in the State Act 16/2003, of May 28, on Cohesion and Quality of the National Health System, as amended by Decree-Law 16/2012, of April 20.

scholarly journals Are we ready for evidence-based prosthodontics? - A literature review

2021 ◽  
Vol 7 (4) ◽  
pp. 188-194
Author(s):  
Ayush Srivastava ◽  
Ranjoy Hazra ◽  
Dinesh Kumar ◽  
Amit Khattak ◽  
V S Legha ◽  
...  
Keyword(s):  
Case Reports ◽  
Meta Analysis ◽  
Scientific Evidence ◽  
Individual Preference ◽  
Current Evidence ◽  
Evidence Based ◽  
The Individual ◽  
The Right ◽  
The Cost

Traditional methods will be rendered obsolete, if not supplemented by current techniques and evidence. This requires a clinician to continuously recognize, scrutinize and consolidate the best available scientific literature in the field. Continuous improvement in the quality of research conducted, as well as reporting the findings should be encouraged to improve upon current and future treatments. This review showcases the most prominent controversies in prosthodontics and how the current evidence answers the questions. A PubMed, Met line and google scholar search with the keywords, Evidence-based dentistry and Evidence-based Prosthodontics was done from the year 1960-2021. Meta-analysis of randomized control trials and systematic reviews related to the evidence in complete dentures, fixed partial dentures, implants and prosthodontics were considered in the inclusion criteria. Literature reviews and case reports were excluded from the search. Evidence-based practice is a new level of sophistication in the practice of dentistry. Rather than considering the cost of material or the individual preference of the operator, choosing the right technique to maximize clinical efficiency should be based on scientific evidence.

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