scholarly journals 1290 A Move to Magseed For Breast Conserving Surgery

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
B Chandrasekar ◽  
J Seward ◽  
J Ooi
Keyword(s):  
Patient Experience ◽  
Surgical Approach ◽  
Wide Local Excision ◽  
Breast Conserving Surgery ◽  
Endocrine Treatment ◽  
Retrospective Audit ◽  
Palpable Breast ◽  
Improve Patient ◽  
Preoperative Localisation ◽  
Excision Rate

Abstract Aim Wire guided localisation(WGL) to localise non-palpable breast tumours has been the standard for years. WGL has limitations; patient discomfort, fixed scheduling to facilitate insertion on the day of surgery and wire migration. A 2015 audit in our department found that 51% of patients undergoing wide local excision (WLE) used preoperative localisation techniques; of which 84% was WGL. The overall re-excision rate for WLE was 27%. We altered our practice to Magseed localisation from July 2019 to improve patient experience, and surgical efficiency, as there are similar outcomes between WGL and Magseed in the literature. This audit aims to examine if there are improvements in our re-excision rate. We aim to evaluate which is the best method for localisation in our department. Method A retrospective audit was conducted following registration with the local audit office. Patients who underwent breast conserving surgery between September 2019 and September 2020 were identified. The surgical approach, re-excision and complications were recorded and compared to the 2015 results. Results 100 patients underwent WLE in the study period. The percentage of patients undergoing therapeutic mammaplasty was 26% (14% in 2015). 63% underwent preoperative localisation; of which 71% used Magseed and 5% used wire. The overall re-excision rate was 20%. Conclusions Our re-audit has demonstrated an increase in patients requiring pre-operative localisation, probably due to the use of primary endocrine treatment during COVID-19. We gladly observed 26% improvement in re-excision rates suggesting success with Magseed.

A Modified CGM Algorithm Enhances Data Availability While Retaining iCGM Performance

2021 ◽  
pp. 193229682110075
Author(s):  
Rebecca A. Harvey Towers ◽  
Xiaohe Zhang ◽  
Rasoul Yousefi ◽  
Ghazaleh Esmaili ◽  
Liang Wang ◽  
...  
Keyword(s):  
Data Integration ◽  
Patient Experience ◽  
Real World ◽  
Data Availability ◽  
Post Processing ◽  
Sensor Error ◽  
The Mean ◽  
The Difference ◽  
Data Gap ◽  
Improve Patient

The algorithm for the Dexcom G6 CGM System was enhanced to retain accuracy while reducing the frequency and duration of sensor error. The new algorithm was evaluated by post-processing raw signals collected from G6 pivotal trials (NCT02880267) and by assessing the difference in data availability after a limited, real-world launch. Accuracy was comparable with the new algorithm—the overall %20/20 was 91.7% before and 91.8% after the algorithm modification; MARD was unchanged. The mean data gap due to sensor error nearly halved and total time spent in sensor error decreased by 59%. A limited field launch showed similar results, with a 43% decrease in total time spent in sensor error. Increased data availability may improve patient experience and CGM data integration into insulin delivery systems.

scholarly journals Categorizing and Rating Patient Complaints: An Innovative Approach to Improve Patient Experience

2021 ◽  
Vol 8 ◽  
pp. 237437352199862
Author(s):  
Stephanie Bayer ◽  
Paul Kuzmickas ◽  
Adrienne Boissy ◽  
Susannah L. Rose ◽  
Mary Beth Mercer
Keyword(s):  
Patient Experience ◽  
Medical Center ◽  
Academic Medical Center ◽  
Patient Experiences ◽  
Innovative Approach ◽  
Satisfaction Survey ◽  
Patient Complaints ◽  
Academic Medical ◽  
Survey Results ◽  
Improve Patient

The Ombudsman Office at a large academic medical center created a standardized approach to manage and measure unsolicited patient complaints, including methods to identify longitudinal improvements, accounting for volume variances, as well as incident severity to prioritize response needs. Data on patient complaints and grievances are collected and categorized by type of issue, unit location, severity, and individual employee involved. In addition to granular data, results are collated into meaningful monthly leadership reports to identify opportunities for improvement. An overall benchmark for improvement is also applied based on the number of complaints and grievances received for every 1000 patient encounters. Results are utilized in conjunction with satisfaction survey results to drive patient experience strategies. By applying benchmarks to patient grievances, targets can be created based on historical performance. The utilization of grievance and complaint benchmarking helps prioritize resources to improve patient experiences.

Broadening the concept of patient safety culture through value-based healthcare

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Viktor Dombrádi ◽  
Klára Bíró ◽  
Guenther Jonitz ◽  
Muir Gray ◽  
Anant Jani
Keyword(s):  
Patient Safety ◽  
Patient Experience ◽  
Safety Culture ◽  
Improve Patient Safety ◽  
Cost Benefit ◽  
Population Level ◽  
Patient Safety Culture ◽  
Content Type ◽  
Experience Of Care ◽  
Improve Patient

PurposeDecision-makers are looking for innovative approaches to improve patient experience and outcomes with the finite resources available in healthcare. The concept of value-based healthcare has been proposed as one such approach. Since unsafe care hinders patient experience and contributes to waste, the purpose of this paper is to investigate how the value-based approach can help broaden the existing concept of patient safety culture and thus, improve patient safety and healthcare value.Design/methodology/approachIn the arguments, the authors use the triple value model which consists of personal, technical and allocative value. These three aspects together promote healthcare in which the experience of care is improved through the involvement of patients, while also considering the optimal utilisation and allocation of finite healthcare resources.FindingsWhile the idea that patient involvement should be integrated into patient safety culture has already been suggested, there is a lack of emphasis that economic considerations can play an important role as well. Patient safety should be perceived as an investment, thus, relevant questions need to be addressed such as how much resources should be invested into patient safety, how the finite resources should be allocated to maximise health benefits at a population level and how resources should be utilised to get the best cost-benefit ratio.Originality/valueThus far, both the importance of patient safety culture and value-based healthcare have been advocated; this paper emphasizes the need to consider these two approaches together.

A Comparison Between Oncoplastic Breast Conserving Surgery andStandard Wide Local Excision: A UK Experience

2016 ◽  
Vol 01 (01) ◽  
Author(s):  
Saira Khawaja ◽  
Abrar Saiyed ◽  
Darmiga Thayabaran ◽  
Sujatha Udayasankar ◽  
Joel Dias ◽  
...  
Keyword(s):  
Local Excision ◽  
Wide Local Excision ◽  
Breast Conserving Surgery

scholarly journals Many small steps to reducing length of stay: A visit to the DH pilot enhanced recovery scheme

2010 ◽  
Vol 92 (8) ◽  
pp. 266-268
Author(s):  
Matthew Worrall
Keyword(s):  
Length Of Stay ◽  
Health Service ◽  
Patient Experience ◽  
Enhanced Recovery ◽  
Enhanced Recovery Programme ◽  
Department Of Health ◽  
Recovery Scheme ◽  
Hospital Stays ◽  
Improve Patient

Enhanced recovery (ER) is one of the current buzz terms in the health service but it seems to mean a different thing depending on to whom you speak. The Department of Health (DH) invited applications from acute trusts across England to become 'innovation sites' for the enhanced recovery programme. These sites are supported by DH as they implement a defined programme that aims to improve patient experience through shorter hospital stays. The Bulletin spent a day at one of them, West Hertfordshire Hospitals NHS Trust, to witness the changes made.

Axillary Metastasis with Occult Primary Breast Cancer

2017 ◽  
Author(s):  
Anne Kuritzky ◽  
Laila Khazai ◽  
Roberto Diaz ◽  
Christine Laronga
Keyword(s):  
Breast Cancer ◽  
Primary Breast Cancer ◽  
Breast Conservation ◽  
Radical Mastectomy ◽  
Clinical Trial Data ◽  
Breast Conserving Surgery ◽  
Endocrine Treatment ◽  
Axillary Lymph ◽  
Axillary Metastasis ◽  
Cancer Breast

The identification of an axillary metastasis in the absence of a primary breast cancer can pose a diagnostic and therapeutic dilemma. The clinician should first use more sensitive imaging modalities, such as breast magnetic resonance imaging, to attempt to find the primary index lesion. If the primary cancer remains occult and the molecular markers are consistent with a breast origin, then the recommended treatment includes multimodality therapy including surgery, chemotherapy/endocrine treatment, and radiation. Historically, the modified radical mastectomy was the standard of practice. Recently, in the era of improved adjuvant therapies, breast-conserving surgery with irradiation is also being considered. Multiple retrospective reviews have shown no difference in survival or recurrence with these two surgical pathways. However, due to the rare nature of this clinical presentation, no multiinstitutional or prospective clinical trial data are available.  Key words: axillary lymph node dissection, axillary metastasis, breast cancer, breast conservation, local recurrence, occult primary tumor, radiotherapy 

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