Minimizing Retained Foreign Body in Hernia Repair Using a Novel Technique: Reinforced Biologic Augmented Repair (ReBAR)

2021 ◽  
Author(s):  
Paul Szotek
Keyword(s):  
Foreign Body ◽  
Hernia Repair ◽  
Care Delivery ◽  
Primary Repair ◽  
Synthetic Mesh ◽  
Patient Centered ◽  
Novel Technique ◽  
Retained Foreign Body ◽  
Centered Care

With the digital age in healthcare upon us, patients are more aware, educated, and concerned about their surgical options for hernia repair. As a result of exposure to the growing litigious environment surrounding synthetic mesh products, patients are demanding hernia repairs with minimal or no foreign body. In response to these pressures, we have developed a novel technique known as the Reinforced Biologic Augmented Repair (ReBAR) which incorporates the data-proven principles of (1) tissue defect closure and (2) primary repair reinforcement, while minimizing the amount of foreign body material exposure long-term. A cohort of 619 (1.2% recurrence) patients representing a variety of hernia types and using multiple methods underwent repair using the ReBAR technique:259 Robotic Inguinal (1.2%), 47 Open Inguinal (4.3%), 59 Robotic Ventral/Incisional (1.7%), 32 Stapled Retrorectus (0%), 54 Open Abdominal Wall Reconstructions (1.8%), and 48 Open Onlay Ventral/Incisional (2.0%) hernia repairs. Increasing consumer demand for alternatives to traditional synthetic mesh repairs has driven the development of the ReBAR technique. Outcomes to this point are equivalent or better using the ReBAR technique as compared to classical methodology, however further study will be required to determine if long-term outcomes are superior to traditional techniques. The easily adaptable ReBAR technique satisfies the patient-centered care goals of today’s healthcare and may drive enhanced overall value of hernia care delivery.

scholarly journals Building Better Clinical Relationships With Patients: An Argument for Digital Health Solutions With Black Men

2019 ◽  
Vol 12 ◽  
pp. 117863291983431
Author(s):  
Ledric D Sherman ◽  
Stuart W Grande
Keyword(s):  
Black Men ◽  
Information Exchange ◽  
Care Delivery ◽  
Digital Health ◽  
Rapid Evolution ◽  
Patient Centered ◽  
Health Technologies ◽  
Centered Care ◽  
The Impact

There is a rapid evolution of care delivery taking place across the globe in response to an explosion of novel health technologies. Growing in parallel to this expansion is the anticipation of mHealth technologies to drive patient-centered care into the future. Despite this hope, continuing reports of health inequities and lived experiences of substandard care fill national, state, and community health reports. The impact of these inequities is particularly pernicious on Black men and their long-term health status. As decades of robust evidence substantiates needed interventions, current progress is not seeing expected gains. In this commentary, we argue that at the heart of these inequities are issues of access, health literacy, institutional racism, and growing social distance between clinicians and Black men. To address these inequities, we suggest that digital interventions, designed to support decision-making, information exchange, and shared accountability have the best hope to overcome current inequities by promoting authentic relationships that ultimately drive better communication between Black men and their clinicians.

scholarly journals Unique Challenges for Otolaryngology Patients During the COVID-19 Pandemic

2020 ◽  
pp. 019459982095483
Author(s):  
Melissa Ghulam-Smith ◽  
Yeyoon Choi ◽  
Heather Edwards ◽  
Jessica R. Levi
Keyword(s):  
Health Care ◽  
Health Care Delivery ◽  
Care Delivery ◽  
Patient Centered Care ◽  
Patient Centered ◽  
Intimate Contact ◽  
Respiratory Mucosa ◽  
Increased Risk ◽  
Centered Care ◽  
Upper Respiratory

The coronavirus disease 2019 (COVID-19) pandemic has drastically altered health care delivery and utilization. The field of otolaryngology in particular has faced distinct challenges and an increased risk of transmission as day-to-day procedures involve intimate contact with a highly infectious upper respiratory mucosa. While the difficulties for physicians have been thoroughly discussed, the unique challenges of patients have yet to be considered. In this article, we present challenges for patients of otolaryngology that warrant thoughtful consideration and propose solutions to address these challenges to maintain patient-centered care both during and in the aftermath of the COVID-19 pandemic.

scholarly journals Instilling the core concept of inter professional education

1970 ◽  
Vol 9 (3) ◽  
pp. 201-206
Author(s):  
S Bhattacharya ◽  
SK Bhattacharya ◽  
AP Gautam
Keyword(s):  
Health Care ◽  
Health Professional ◽  
Health Care Providers ◽  
Professional Education ◽  
Care Delivery ◽  
Care Providers ◽  
Patient Centered ◽  
Innovative Teaching ◽  
Centered Care ◽  
Teaching Learning

The Inter Professional Education (IPE) is an innovative teaching learning intervention in Health Professions’ Education during which members of more than one health profession learn interactively together to improve collaborative practice and/health of the patients. Thus this approach provides positive outcomes for students enhancing their awareness towards other professional groups, improving knowledge and understanding of how to work in an inter professional team and strengthening their communication and collaboration skills. Within the hierarchical nature of many clinical settings, the aims of IPE courses intersect with socialization of health professional (HP) students into roles of responsibility and authority. The IPE in HP courses emphasizes the practice of frequent high quality communication, strong relationships and partnerships among health care providers to maximize the quality of care thus improving the efficiency of care thereby improving clinical outcomes. Health Professional Schools are this motivated to opt for inter professional education to improve the learning of the students, health care delivery and patient outcomes. Keywords: Inter professional relations; patient centered care; education DOI: http://dx.doi.org/10.3126/hren.v9i3.5591   HR 2011; 9(3): 201-206

scholarly journals Open-Globe Injury With Intraocular Foreign Body

2020 ◽  
pp. 247412642096503
Author(s):  
Filippos Vingopoulos ◽  
Yvonne Wang ◽  
Seanna Grob ◽  
Chloe Yang Ling Li ◽  
Dean Eliott ◽  
...  
Keyword(s):  
Foreign Body ◽  
Primary Repair ◽  
Anterior Segment ◽  
Case Series ◽  
Visual Outcome ◽  
Posterior Segment ◽  
Open Globe ◽  
Time From Injury

Purpose: To investigate characteristics of Open Globe Injuries (OGI) that presented with Intra-Ocular Foreign Body (IOFB), along with their long-term visual outcomes and complications. Methods: Retrospective interventional consecutive case series of OGIs with IOFBs that presented at Massachusetts Eye and Ear from 2010 to 2015. Data collected included time from injury to OGI repair, location of IOFB, retinal detachment (RD) rate, presenting and final visual acuity and subsequent surgeries. Results: Fifty-seven consecutive cases of OGIs with IOFBs were included. Mean follow-up was 28 months and median time from injury to OGI repair was 0 days. Overall, 38/57 (66.7%) eyes achieved final vision of 20/40 or better and 43/57 (75.4%) 20/150 or better. Thirty-three cases had IOFBs in the anterior segment only, 24 cases had posterior segment involvement. Thirty percent of cases (17/57) were complicated by an RD, 58.3% (14/24) in the posterior versus 9.1% (3/33) in the anterior IOFB group ( P = .01). There were no cases of endophthalmitis. Posterior IOFB and higher zone of injury were risk factors for RD both at presentation (both P < .001) and post-primary repair (both P < .001). Posterior IOFB was associated with higher vitrectomy rates both at presentation ( P < .001) and post-primary repair ( P = .002) and worse long-term visual outcome ( P = .01). Conclusions: OGIs with IOFB involving the posterior segment are associated with higher complication and re-operation rates and worse visual prognosis compared to those involving the anterior segment only.

scholarly journals Telemedicine and the Interdisciplinary Clinic Model: During the COVID-19 Pandemic and Beyond

2020 ◽  
Vol 163 (4) ◽  
pp. 673-675 ◽  
Author(s):  
Lisa A. Zughni ◽  
Amanda I. Gillespie ◽  
Jeanne L. Hatcher ◽  
Adam D. Rubin ◽  
John Paul Giliberto
Keyword(s):  
Care Delivery ◽  
Upper Airway ◽  
The Novel ◽  
Speech Language Pathology ◽  
Patient Centered ◽  
Speech Language Pathologist ◽  
Centered Care ◽  
Language Pathology ◽  
Novel Coronavirus ◽  
Improve Access

The emergence of the novel coronavirus disease 2019 (COVID-19) and the subsequent need for physical distancing have necessitated a swift change in health care delivery. Prior to the COVID-19 outbreak, many institutions utilized an interdisciplinary clinic model including both a laryngologist and a speech-language pathologist for the evaluation of patients with voice, swallowing, and upper airway disorders. To improve access, many providers are pursuing the use of interdisciplinary telemedicine to provide individualized patient-centered care while allowing for physical distancing. The purpose of this commentary is to review the current literature regarding telemedicine in laryngology and speech-language pathology as well as the current and future states of practice for interdisciplinary tele-evaluations.

scholarly journals Patient-centered care, collaboration, communication, and coordination: a report from AMIA's 2013 Policy Meeting

2014 ◽  
Vol 22 (e1) ◽  
pp. e2-e6 ◽  
Author(s):  
Patti Flatley Brennan ◽  
Rupa Valdez ◽  
Greg Alexander ◽  
Shifali Arora ◽  
Elmer V Bernstam ◽  
...  
Keyword(s):  
Research Agenda ◽  
Care Delivery ◽  
Data Access ◽  
Patient Centered Care ◽  
Policy Framework ◽  
Patient Centered ◽  
Research Perspectives ◽  
Centered Care ◽  
Major Shift ◽  
Communication And Coordination

Abstract In alignment with a major shift toward patient-centered care as the model for improving care in our health system, informatics is transforming patient–provider relationships and overall care delivery. AMIA's 2013 Health Policy Invitational was focused on examining existing challenges surrounding full engagement of the patient and crafting a research agenda and policy framework encouraging the use of informatics solutions to achieve this goal. The group tackled this challenge from educational, technical, and research perspectives. Recommendations include the need for consumer education regarding rights to data access, the need for consumers to access their health information in real time, and further research on effective methods to engage patients. This paper summarizes the meeting as well as the research agenda and policy recommendations prioritized among the invited experts and stakeholders.

scholarly journals Patient-centered care pathways: what does it mean? An integrative conceptual framework to meet the need of an international consensus: a qualitative systematic review protocol

2021 ◽  
Author(s):  
Jean-Baptiste Gartner ◽  
Kassim Said Abasse ◽  
Ghita Ben Zagguou ◽  
Frédéric Bergeron ◽  
Paolo Landa ◽  
...  
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Care Delivery ◽  
Care Pathway ◽  
Patient Centered Care ◽  
Patient Centered ◽  
International Consensus ◽  
Patient Journey ◽  
Centered Care ◽  
Health Care Delivery Systems

Background: Faced with increased expectations regarding the quality and safety of health care delivery systems, a number of stakeholders are increasingly looking for more qualitative and efficient ways to deliver care. This study is conducted to provide a clear definition of the patient-centered care pathway and its characteristics to meet the need for an international consensus. Methods: This qualitative systematic review aims to perform a systematic synthesis of published evidence concerning (1) the definition of the patient trajectory, patient pathway or patient journey and (2) their characteristics. With a consulting librarian, a comprehensive and systematic search in three databases was conducted (PUBMED, Embase, ABI/Inform), from 1995 to 2020 without language criteria. Eligibility criteria guiding data selection will follow the PICo mnemonic criteria consisting of (1) Population : all types of patients managed by health care delivery systems for an acute or chronic condition regardless of age or condition, (2) Phenomena : studies that contribute to the definition and conceptualization of the concepts of care trajectory, care pathway and patient journey resulting in a theoretical and conceptual contribution, and (3) Context : health care providers include all providers of primary, secondary, tertiary, and quaternary care in any geographic area. Two reviewers will independently screen, select, extract data and make a critical assessment of the methodology used with the JBI Qualitative Assessment and Review Instrument (JBI QARI).Discussion: This systematic review will provide much-needed knowledge regarding patient-centered pathways. The results will benefit clinicians, decision makers, and researchers by giving them a clear and integrated definition and understanding of the patient-centered care pathways and their characteristics to finally meet the need for an international consensus.

Models of Care

2017 ◽  
Author(s):  
Tyson Sawchuk ◽  
Joan K. Austin ◽  
Debbie Terry
Keyword(s):  
Health Care ◽  
Health Care Services ◽  
Care Delivery ◽  
Hospital Setting ◽  
Models Of Care ◽  
Stepped Care ◽  
Patient Centered ◽  
Care Approach ◽  
Centered Care ◽  
Care Models

This chapter addresses common barriers to care delivery in psychogenic nonepileptic seizures (PNES) and limitations of current approaches. Theoretical and practical considerations in delivering PNES care are discussed. These include a stepped-care approach, which offers a strategy for efficiently managing health care resources and has promise in treatment of PNES. Patient-centered care, a general approach to providing health care services in a manner that takes into consideration the patients’ expressed needs, desires, and preferences, is also considered. Examples of care models are presented, including a pediatric model for PNES recently developed and being tested in a Canadian hospital setting. Future directions for the development of care models in PNES are discussed and a list of recommendations is provided.

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