scholarly journals Pre-habilitation in Enhanced Recovery After Surgery Programs: A New Potential for Balneology and Physical Medicine to Benefit Patients

2019 ◽  
Vol 61 (2) ◽  
pp. 78-80
Author(s):  
David Ferson
Keyword(s):  
Quality Of Care ◽  
21St Century ◽  
Enhanced Recovery ◽  
Enhanced Recovery After Surgery ◽  
Surgical Patient ◽  
Physical Medicine ◽  
Long Term Outcomes ◽  
Multidisciplinary Teamwork

Medicine in the 21st century is becoming more integrated and less episodic. The ERAS programs have demonstrated that developing an organized, multidisciplinary teamwork approach to surgical patient care can significantly improve the quality of care and reduce complications. The next step in further improving the ERAS programs and potentially positively influencing the long-term outcomes for the patients is optimal conditioning and preparation before the surgery.

scholarly journals Travel to a high volume hospital to undergo resection of gallbladder cancer: does it impact quality of care and long-term outcomes?

HPB ◽  
2020 ◽  
Vol 22 (1) ◽  
pp. 41-49 ◽  
Author(s):  
Eliza W. Beal ◽  
Rittal Mehta ◽  
Diamantis I. Tsilimigras ◽  
J. Madison Hyer ◽  
Anghela Z. Paredes ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Gallbladder Cancer ◽  
High Volume ◽  
Long Term Outcomes ◽  
High Volume Hospital ◽  
It Impact

scholarly journals Preliminary Results of first Belgian Cohort of Juvenile Idiopathic Arthritis: Where Do we Stand in Terms of Quality of Care and Remission?

2020 ◽  
Author(s):  
Céline La ◽  
Phu Quoc Lê ◽  
Alina Ferster ◽  
Laurence Goffin ◽  
Bernard Lauwerys ◽  
...  
Keyword(s):  
Juvenile Idiopathic Arthritis ◽  
Quality Of Care ◽  
Long Term Outcomes ◽  
Disease Characteristics ◽  
French Speaking ◽  
Das28 Remission ◽  
The Mean

Abstract BackgroundJuvenile idiopathic arthritis (JIA) represents a very heterogeneous disease, and our objectives were to describe the first Belgian cohort of children with JIA, assess their disease characteristics and outcome and identify potential markers of prognosis.MethodsThe CAP48 cohort is a multicentric observational study of children with a recent or well-established diagnosis of JIA (naïve or not to treatment at baseline), evaluated every 6 months during a follow-up of 5 to 10 years.ResultsThere were 125 children included in the cohort, composed of 25 naïve and 100 established patients. The patients had a median age of 6.2 and 4.2 years at onset in the naïve and established cohort respectively, with a predominance of female. All subtypes of JIA were represented in both cohorts. The mean DAS28-CRP and JADAS10-CRP at baseline in naïve patients was 2.52 and 6.0 respectively. Uveitis occurred in 19% of patients and was strongly associated with presence of antinuclear antibodies (odds ratio of 6). Fifty-five percent of naïve patients were in remission at 12 months of follow-up according to the ACR criteria and JADAS10 scores, in contrast with 100% achieving DAS28 remission. ConclusionThis first cohort study in Belgium allowed to compare its data to other existing cohorts and to evaluate quality of care in Belgian French-speaking hospitals. Additionally, it highlighted a superiority of JADAS10 over DAS28 to monitor and evaluate remission in JIA. This study also underlined a need for more accurate markers of prognosis to improve treatment and long-term outcomes.

scholarly journals Oncologic and long-term outcomes of enhanced recovery after surgery in cancer surgeries — a systematic review

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Qianyun Pang ◽  
Liping Duan ◽  
Yan Jiang ◽  
Hongliang Liu
Keyword(s):  
Systematic Review ◽  
Overall Survival ◽  
Enhanced Recovery ◽  
Enhanced Recovery After Surgery ◽  
Current Evidence ◽  
Cochrane Library ◽  
Long Term Outcomes ◽  
High Adherence ◽  
Eras Protocol

Abstract Background Clinical evidence has proved that enhanced recovery after surgery (ERAS) can improve short-term clinical outcomes after various types of surgeries, but the long-term benefits have not yet been examined, especially with respect to cancer surgeries. Therefore, a systematic review of the current evidence was conducted. Methods The Pubmed, Cochrane Library, Embase, and Web of Science databases were searched using the following key words as search terms: “ERAS” or “enhanced recovery” or “fast track”, “oncologic outcome”, “recurrence”, “metastasis”, “long-term outcomes”, “survival”, and “cancer surgery”. The articles were screened using the inclusion and exclusion criteria, and the data from the included studies were extracted and analyzed. Results A total of twenty-six articles were included in this review. Eighteen articles compared ERAS and conventional care, of which, 12 studies reported long-term overall survival (OS), and only 4 found the improvement by ERAS. Four studies reported disease-free survival (DFS), and only 1 found the improvement by ERAS. Five studies reported the outcomes of return to intended oncologic treatment after surgery (RIOT), and 4 found improvements in the ERAS group. Seven studies compared high adherence to ERAS with low adherence, of which, 6 reported the long-term OS, and 3 showed improvements by high adherence. One study reported high adherence could reduce the interval from surgery to RIOT. Four studies reported the effect of altering one single item within the ERAS protocol, but the results of 2 studies were controversial regarding the long-term OS between laparoscopic and open surgery, and 1 study showed improvements in OS with restrictive fluid therapy. Conclusions The use of ERAS in cancer surgeries can improve the on-time initiation and completion of adjuvant chemotherapy after surgery, and the high adherence to ERAS can lead to better outcomes than low adherence. Based on the current evidence, it is difficult to determine whether the ERAS protocol is associated with long-term overall survival or cancer-specific survival.

Quality of care and short‐ and long‐term outcomes of laryngeal cancer care in the elderly

2015 ◽  
Vol 125 (10) ◽  
pp. 2323-2329 ◽  
Author(s):  
Christine G. Gourin ◽  
Heather M. Starmer ◽  
Robert J. Herbert ◽  
Kevin D. Frick ◽  
Arlene A. Forastiere ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Laryngeal Cancer ◽  
Cancer Care ◽  
The Elderly ◽  
Long Term Outcomes ◽  
Short And Long Term

Implementation of an Inpatient IBD Service Is Associated with Improvement in Quality of Care and Long-Term Outcomes

2021 ◽  
Author(s):  
Simon J. Hong ◽  
Janice Jang ◽  
Dana Berg ◽  
Tarik Kirat ◽  
Feza Remzi ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Long Term Outcomes

scholarly journals Enhancing Value and Uptake for Whole-Population Cohorts of Children and Parents: Methods to Integrate Registries into the Generation Victoria Cohort

Children ◽  
2021 ◽  
Vol 8 (4) ◽  
pp. 285
Author(s):  
Valerie Sung ◽  
Katrina Williams ◽  
Ella Perlow ◽  
Yanhong J. Hu ◽  
Susannah Ahern ◽  
...  
Keyword(s):  
Quality Of Care ◽  
High Risk ◽  
Long Term Outcomes ◽  
Children And Parents ◽  
Funding Bias ◽  
Almost All ◽  
Over Time ◽  
Morbid Conditions

Health registries are critical to understanding, benchmarking and improving quality of care for specific diseases and conditions, but face hurdles including funding, bias towards clinical rather than population samples, lack of pre-morbid and outcomes data, and absent cross-registry harmonisation and coordination. Children are particularly under-represented in registry research. This paper lays out novel principles, methods and governance to integrate diverse registries within or alongside a planned children’s mega-cohort to rapidly generate translatable evidence. GenV (Generation Victoria) will approach for recruitment parents of all newborns (estimated 150,000) over two years from mid-2021 in the state of Victoria (population 6.5 million), Australia. Its sample size and population denominator mean it will contain almost all children with uncommon or co-morbid conditions as they emerge over time. By design, it will include linked datasets, biosamples (including from pregnancy), phenotypes and participant-reported measures, all of which will span pre-morbid to long-term outcomes. We provide a vignette of a planned new registry for high-risk pregnancies to illustrate the possibilities. To our knowledge, this is the first paper to describe such a methodology designed prospectively to enhance both the clinical relevance of a large multipurpose cohort and the value and inclusivity of registries in a population.

What can a mobile App add to improve quality of care, with focus on ambulatory surgery?

2018 ◽  
Vol 6 (1) ◽  
pp. 20 ◽  
Author(s):  
Metha Brattwall ◽  
Magareta Warrén Stomberg ◽  
Pether Jildenstål ◽  
Irene Sellbrandt ◽  
Jan G Jakobsson
Keyword(s):  
Quality Of Care ◽  
Enhanced Recovery ◽  
Effective Means ◽  
Mobile App ◽  
Mobile Telephone ◽  
Hospital Length Of Stay ◽  
Surgical Patient ◽  
Operative Recovery

Rationale, aims and objectives: Many surgical procedures are nowadays performed as ambulatory or short stay procedures, reducing hospital length of stay. Patient safety and quality of care remain imperative especially when adopting enhanced recovery pathways. Patients should be adequately informed and prepared prior to admission. Recovery is to a major extent dependent after discharge on self-care and thus techniques to follow the post-operative course after leaving hospital are warranted. Telemedicine has grown tremendously over recent years and the incorporation of mobile telephone app technology for the pre- and post-operative coaching of the ambulatory surgical patient may represent an effective means of assisting patients. The present paper presents a feasibility study of a mobile telephone app providing pre-operative information and following the post-operative recovery following day surgery.Method: Patients scheduled for elective day surgery were asked to participate, testing the app and to assess its usefulness on visual analogue scales.Results: Sixty-nine patients aged 18 to 73 years tested the app. Patients aged 30 to 50 where the most frequent users and patients < 30 less frequent. The app was in general assessed as useful and most users expressed an interest in the option of having an app as a source of information before undergoing a scheduled procedure. General pre-operative information was assessed as the most important. A willingness to submit follow-up information decreased rapidly, only 26 and 16 responded at day 10 and 30, respectively.Conclusion: A mobile telephone app is a feasible and appreciated tool for pre-operative information and coaching as part of person-centered healthcare, but its use for follow-up after discharge is challenging and requires further investigation.

scholarly journals Preliminary Results of first Belgian Cohort of Juvenile Idiopathic Arthritis: Where Do we Stand in Terms of Quality of Care and Remission?

2021 ◽  
Author(s):  
Céline La ◽  
Phu Quoc Lê ◽  
Alina Ferster ◽  
Laurence Goffin ◽  
Bernard Lauwerys ◽  
...  
Keyword(s):  
Juvenile Idiopathic Arthritis ◽  
Quality Of Care ◽  
Age At Onset ◽  
Long Term Outcomes ◽  
Disease Characteristics ◽  
French Speaking ◽  
Das28 Remission

Abstract IntroductionJuvenile idiopathic arthritis (JIA) represents a very heterogeneous disease. As such, it has been a challenge to describe the disease activity of JIA cohorts. Our objective was to describe the first Belgian cohort of children with JIA by assessing their disease characteristics, outcomes, and potential markers of prognosis.MethodsThe CAP48 cohort is a multicentric observational study of children with recent or well-established diagnosis of JIA (naïve or not to treatment at baseline), evaluated every 3 to 6 months during a follow-up of 10 years.ResultsThere were 125 children included, composing of 25 naïve and 100 established patients. Their median age at onset was 6.2 and 4.2 years in the naïve and established cohort respectively, with a predominance of female. All subtypes of JIA were represented in both cohorts. The mean DAS28-CRP and JADAS10-CRP at baseline in naïve patients was 2.52 and 6.0 respectively. Uveitis occurred in 19% of patients and was strongly associated with presence of antinuclear antibodies (odds ratio of 6). Among naïve patients, 55% were in remission at 12 months according to ACR criteria and JADAS10 scores, in contrast with 100% achieving DAS28 remission. ConclusionThis first cohort study in Belgium allowed to compare its data to other existing cohorts and to evaluate quality of care in Belgian French-speaking hospitals. Additionally, it highlighted a superiority of JADAS10 over DAS28 to monitor and evaluate remission in JIA. This study also underlined a need for more accurate markers of prognosis to improve treatment and long-term outcomes.

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