scholarly journals Discrepancy rates of preliminary and final reports for after-hours pediatric teleradiology interpretations

2021 ◽  
Vol 10 (2) ◽  
pp. 205846012198931
Author(s):  
Cory M Pfeifer ◽  
Mary L Dinh
Keyword(s):  
Patient Management ◽  
Normal Approximation ◽  
Standard Operating Procedure ◽  
Alter Patient ◽  
Standard Operating ◽  
Discrepancy Rate ◽  
After Hours ◽  
The Mean ◽  
Pediatric Subspecialty ◽  
Issue Reports

Background Children’s hospitals often do not have a high enough volume to justify providing radiologist staffing overnight, leading to hospitals employing teleradiology services to offer preliminary reports. There is limited literature related to discrepancies between preliminary teleradiology pediatric radiologists and final interpretations. Purpose The purpose of this study is to examine discrepancy rates for teleradiologists preliminarily interpreting pediatric exams at a children’s hospital. Material and Methods Eight thousand seven hundred seventy-eight consecutive preliminary reports issued by pediatric teleradiologists were reviewed. The hospital utilized a system in which local onsite radiologists rated the preliminary reports of teleradiologists following the interpretations as part of standard operating procedure. Discrepancies were also rated according to whether the discrepancy was actionable (judged to alter patient management by the final rater) or not. Rates were stratified by modality, preliminary teleradiologist reader, and final rater and compared to each using a normal approximation. The mean discrepancy rates were compared using a z test for proportions. Linear regression was applied to the effect of years of radiologist experience on the total and actionable discrepancy rates. Results The overall actionable discrepancy rate was 1.6%, similar to inter-observer discrepancy rates reported in other studies. There were no significant differences in the actionable discrepancy rates among teleradiologists. There was no correlation between years of experience and discrepancy rate for either the teleradiologists or the final raters. Conclusion Pediatric subspecialty teleradiologists issue reports that mirror discrepancy rates typical of radiologists who issue reports for emergent adult studies. Years of radiologist experience is not a predictor of discrepancy rate.

Does urgent cerebrospinal fluid (CSF) analysis After-Hours alter patient management?

Pathology ◽  
2014 ◽  
Vol 46 ◽  
pp. S100-S101
Author(s):  
Shobini Sivagnanam ◽  
Raymond Chan ◽  
Sebastian Van Hal
Keyword(s):  
Cerebrospinal Fluid ◽  
Patient Management ◽  
Alter Patient ◽  
Csf Analysis ◽  
After Hours

scholarly journals Ultrasonic bone scalpel for thoracic spinal decompression: case series and technical note

2020 ◽  
Author(s):  
Chuiguo Sun ◽  
Guanghui Chen ◽  
Tianqi Fan ◽  
Weishi Li ◽  
Zhaoqing Guo ◽  
...  
Keyword(s):  
Conservative Treatment ◽  
Blood Loss ◽  
Operating Procedure ◽  
Recovery Rate ◽  
Standard Operating Procedure ◽  
Decompression Surgery ◽  
Spinal Decompression ◽  
Thoracic Spinal ◽  
Standard Operating ◽  
The Mean

Abstract Background: Thoracic spinal stenosis (TSS) is a rare but intractable disease that fails to respond to conservative treatment. Thoracic spinal decompression, which is traditionally performed using high-speed drills and kerrison rongeurs, is a time-consuming and technically challenging task. Unfavorable outcomes and high incidence of complications are the major concerns. The development and adaptation of ultrasonic bone scalpel (UBS) has promoted its application in various spinal operations, but its application and standard operating procedure in thoracic decompression have not been fully clarified. Therefore, the purpose of this study is to describe our experience and technique note of using UBS, and come up with a standard surgical procedure for thoracic spinal decompression.Methods: A consecutive of 28 patients with TSS who underwent posterior thoracic spinal decompression surgery with UBS between December 2014 and May 2015 were enrolled in this study. The demographic data, perioperative complications, operation time, estimated blood loss, pre-and postoperative neurological statuses were recorded and analyzed. Neurological status was evaluated with a modified Japanese Orthopaedic Association (JOA) scale and the neurological recovery rate was calculated using the Hirabayashi’s Method.Results: Thoracic spinal decompression surgery was successfully carried out in all cases via a single posterior approach. The average age at surgery was 49.7±8.5 years. The mean operative time of single-segment laminectomy was 3.0±1.4min and the blood loss was 108.3±47.3ml. In circumferential decompression, the average blood loss was 513.8±217.0ml. Two cases of instrument-related nerve root injury occurred during operation and were cured by conservative treatment. Six patients experienced cerebrospinal fluid (CSF) leakage postoperatively, but no related complications were observed. The mean follow-up period was 39.7±8.9 months, the average JOA score increased from 4.7 before surgery to 10.1 postoperatively, and the average recovery rate was 85.8%.Conclusions: The UBS is an optimal instrument for thoracic spinal decompression, and its application enables surgeons to decompress the thoracic spinal cord safely and effectively. This standard operating procedure is expected to help achieve favorable outcomes, and can be used to treat various pathologies leading to TSS.

scholarly journals Ultrasonic bone scalpel for thoracic spinal decompression: case series and technical note

2020 ◽  
Author(s):  
Chuiguo Sun ◽  
Guanghui Chen ◽  
Tianqi Fan ◽  
Weishi Li ◽  
Zhaoqing Guo ◽  
...  
Keyword(s):  
Conservative Treatment ◽  
Blood Loss ◽  
Operating Procedure ◽  
Recovery Rate ◽  
Standard Operating Procedure ◽  
Decompression Surgery ◽  
Spinal Decompression ◽  
Thoracic Spinal ◽  
Standard Operating ◽  
The Mean

Abstract Background: Thoracic spinal stenosis (TSS) is a rare but intractable disease that fails to respond to conservative treatment. Thoracic spinal decompression, which is traditionally performed using high-speed drills and kerrison rongeurs, is a time-consuming and technically challenging task. Unfavorable outcomes and high incidence of complications are the major concerns. The development and adaptation of ultrasonic bone scalpel (UBS) has promoted its application in various spinal operations, but its application and standard operating procedure in thoracic decompression have not been fully clarified. Therefore, the purpose of this study is to describe our experience and technique note of using UBS, and come up with a standard surgical procedure for thoracic spinal decompression.Methods: A consecutive of 28 patients with TSS who underwent posterior thoracic spinal decompression surgery with UBS between December 2014 and May 2015 were enrolled in this study. The demographic data, perioperative complications, operation time, estimated blood loss, pre-and postoperative neurological statuses were recorded and analyzed. Neurological status was evaluated with a modified Japanese Orthopaedic Association (JOA) scale and the neurological recovery rate was calculated using the Hirabayashi’s Method.Results: Thoracic spinal decompression surgery was successfully carried out in all cases via a single posterior approach. The average age at surgery was 49.7±8.5 years. The mean operative time of single-segment laminectomy was 3.0±1.4min and the blood loss was 108.3±47.3ml. In circumferential decompression, the average blood loss was 513.8±217.0ml. Two cases of instrument-related nerve root injury occurred during operation and were cured by conservative treatment. Six patients experienced cerebrospinal fluid (CSF) leakage postoperatively, but no related complications were observed. The mean follow-up period was 39.7±8.9 months, the average JOA score increased from 4.7 before surgery to 10.1 postoperatively, and the average recovery rate was 85.8%. Conclusions: The UBS is an optimal instrument for thoracic spinal decompression, and its application enables surgeons to decompress the thoracic spinal cord safely and effectively. This standard operating procedure is expected to help achieve favorable outcomes, and can be used to treat various pathologies leading to TSS.

IMPLEMENTASI SISTEM PENGENDALIAN INTERNAL PADA PERUSAHAAN JASA

2019 ◽  
Vol 2 (2) ◽  
pp. 110
Author(s):  
Wahyu Wahyu Wahyu ◽  
Marliyati Marliyati Marliyati ◽  
I. Nyoman Romangsi
Keyword(s):  
Risk Assessment ◽  
Operating Procedure ◽  
Internal Control ◽  
Standard Operating Procedure ◽  
Control Environment ◽  
Service Company ◽  
Standard Operating ◽  
Information And Communication

The aim of this article is to analyze internal control in service company. The analyze used the components of internal control according to COSO: control environment, risk assessment, control activities, information and communication, monitoring. Analysis of internal control used the data obtained through observation, questionnaires, interview, and documentary. Based on this analysis results can be concluded, that the dual positions refer with company SOP (Standard Operating Procedure). Separation of task does not work because that the dual positions. Therefore, the component of control activities applied at company is not in accordance with the component of control activities according to COSO. Nonconformity components still results in very effective internal control because the purpose of the internal control still remains to be achieved even though there are components that are not in accordance with the internal control components according to COSO.

PENENTUAN STANDARD OPERATING PROCEDURE (SOP) PADA DODOL JEWAWUT

2018 ◽  
Vol 7 (2) ◽  
pp. 95
Author(s):  
Indrastuti Indrastuti ◽  
Fatmawaty Damrah
Keyword(s):  
Operating Procedure ◽  
Standard Operating Procedure ◽  
Standard Operating

Description of the standard operating procedure «Operating procedures for a nurse when interviewing patients within the regular medical examination of certain groups of adult population»

2020 ◽  
pp. 33-38
Author(s):  
N. Katkasova ◽  
L. Pudovinnikova
Keyword(s):  
Operating Procedure ◽  
Nursing Staff ◽  
Adult Population ◽  
Standard Operating Procedure ◽  
Medical Examination ◽  
Standard Process ◽  
Standard Operating

This standard operating procedure (SOP) determines the standard process of filling out questionnaire by a nurse, it is introduced into the practice of nursing staff of the Samara City Clinical Polyclinic No. 15.

Contents of standard operating procedure «Hygienic processing of hands»

2020 ◽  
pp. 64-66
Author(s):  
Svetlana Dashuk
Keyword(s):  
Operating Procedure ◽  
Standard Operating Procedure ◽  
Standard Operating

This standard operating procedure (SOP) defines the establishment of uniform requirements to compliance with the procedure for carrying out hygienic treatment of hands, has been introduced into the practical activities of medical workers of Tolyattin dental polyclinic No. 3.

Description of the standard operating procedure «Order of routine and comprehensive cleaning in premises»

2020 ◽  
pp. 71-74
Author(s):  
Svetlana Dashuk
Keyword(s):  
Operating Procedure ◽  
Standard Operating Procedure ◽  
Standard Operating

This standard operating procedure (DIS) defines the establishment of uniform requirements for compliance with the procedure for carrying out current and general cleaning in the premises, has been put into practice by cleaners of the office premises of Tolyattin dental polyclinic No. 3.

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