Surgical innovation
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Surgical innovation · Jun 2006
ReviewAdvanced visualization platform for surgical operating room coordination: distributed video board system.
One of the major challenges for day-of-surgery operating room coordination is accurate and timely situation awareness. Distributed and secure real-time status information is key to addressing these challenges. This article reports on the design and implementation of a passive status monitoring system in a 19-room surgical suite of a major academic medical center. ⋯ Images were presented on a "need-to-know" basis, and access was controlled by identification badge authorization. The system delivered reliable real-time operating room images and status with acceptable network impact. Operating room status was visualized at 4 separate locations and was used continuously by clinicians and operating room service providers to coordinate operating room activities.
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Surgical innovation · Mar 2006
Surgical training and simulation laboratory at Baystate Medical Center.
The work hour restrictions imposed by the surgical residency review committee, without a curriculum change, essentially reduces training programs by 30%. The logical result of this is the risk that a higher percentage of surgeons beginning independent practice will fall below the competence level. We believe that simulation will play a vital role in the curriculum to enhance the clinical environment and make the learning environment better and more efficient. ⋯ Our center is rapidly becoming a multidisciplinary environment incorporating other residency and clinical programs within the health system and beyond. We are actively pursuing the development of novel assessment technology that will not only integrate the simulation center with the clinical arena but also link educational and clinical outcomes. This will allow us to automatically tailor the educational environment to the individual needs of the learner as they change over time, as well as look at quality improvement related to our educational and research endeavors.
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Most health-care costs are fixed and sunk. Fixed costs do not vary with the level of patient activity, and once sunk they cannot be easily reversed. We must rethink how we manage the expensive investments in our health care infrastructure, which is where most costs lie. ⋯ This rationing includes reducing the length of patients' hospital stays but this does not work as intended. A new paradigm advocates making more and better use of existing assets and by pursuing improvements incrementally and at the bedside. Elements include flexing intensive care unit beds, improving operating room efficiencies, and rationalizing health care capacity.
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Surgical innovation · Sep 2005
Review Comparative StudyMinimally invasive: minimally reimbursed? An examination of six laparoscopic surgical procedures.
It is generally believed that minimally invasive surgery (MIS) results in less postoperative pain, fewer complications, and shorter recovery periods compared with open procedures. Yet despite these benefits, the level of reimbursement assigned to the surgeon by United States health-care payers is often lower than that for open procedures. Furthermore, the cost of performing a MIS may be higher vs an open procedure because specialized equipment, increased surgical time, or both may be required. ⋯ The data demonstrate that these procedures result in reduced hospital stay, reduced hospital costs, and faster return to work or normal activities. Yet, the operating room time and costs are frequently higher for MIS. These findings suggest that as both the outcomes value and level of operating room resources are greater, MIS warrants reimbursement that meets or exceeds that of open procedures.
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Surgical innovation · Sep 2005
Comparative StudySmall intestinal submucosa intracardiac patch: an experimental study.
In this experimental study, small intestinal submucosa was implanted as an atrial prosthesis in calves. Echocardiography and histology showed this to be an impermeable prosthesis that develops a neointimal nonthrombogenic surface making it safe for repair of defects in a low-pressure system. Further study with small intestinal submucosa in an intracardiac position is warranted.