Journal of critical care
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Journal of critical care · Jun 2008
Fewer intensive care unit refusals and a higher capacity utilization by using a cyclic surgical case schedule.
Mounting health care costs force hospital managers to maximize utilization of scarce resources and simultaneously improve access to hospital services. This article assesses the benefits of a cyclic case scheduling approach that exploits a master surgical schedule (MSS). An MSS maximizes operating room (OR) capacity and simultaneously levels the outflow of patients toward the intensive care unit (ICU) to reduce surgery cancellation. ⋯ Our findings show that the proposed cyclic OR planning policy may benefit OR utilization and reduce surgical case cancellation and peak demands on the ICU.
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Journal of critical care · Jun 2008
Role of simulators, educational programs, and nontechnical skills in anesthesia resident selection, education, and competency assessment.
Theoretical knowledge for anesthesia residents requires learning from a variety of sources. Technical skills are important and simulators are being used in many centers. ⋯ Training is evolving and higher standards in this field should create safer anesthesiologists. Simulator-based education and testing and assessment of nontechnical skills should be a priority in anesthesia residency programs.
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Journal of critical care · Jun 2008
The simulation theater: a theoretical discussion of concepts and constructs that enhance learning.
The increasing role of simulation in medical education has paralleled the advancement of this technology. Full environment simulation (FES) can be used to effectively replicate rare medical catastrophes with exacting realism. ⋯ Theoretically, the addition of emotional content to simulated crises during FES can be used to affect emotional changes in the participants and thus facilitate learning. Here, we discuss the theoretical benefit and the use of FES with emotional enhancement as it relates to improved memory and learning.
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Although rarely thought of as simulations by anesthesia educators, the use of standardized patients to simulate clinical encounters spans 4 decades (Mt Sinai J Med. 1996;63:241-249; J Am Med Assoc. 1997;278:790-791; Int J Dermatol. 1999;38:893-894). Although its efficacy for education and evaluation in the medical community has been well established through extensive research, there is a distinct dearth in the literature in its use for anesthesia trainee education and evaluation. In this article, we discuss this simulation modality via a historic review, its current application in competency assessment, and its use in anesthesiology education and evaluation. We conclude with a "how to guide" to facilitate those considering including standardized patient simulations into their anesthesia training or simulation curriculum.
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Journal of critical care · Jun 2008
Multicenter StudyImproving patient safety in intensive care units in Michigan.
The aim of this study was to describe the design and lessons learned from implementing a large-scale patient safety collaborative and the impact of an intervention on teamwork climate in intensive care units (ICUs) across the state of Michigan. ⋯ This study describes the first statewide effort to improve patient safety in ICUs. The use of the comprehensive unit-based safety program was associated with significant improvements in safety culture. This collaborative may serve as a model to implement feasible and methodologically rigorous methods to improve and sustain patient safety on a larger scale.