Articles: outcome.
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Ahead of Print article withdrawn by publisher Although anesthesia has become increasingly safe, there remain significant differences among countries in terms of training standards and practice regulations. There is evidence and widespread consensus that the occasional practice of pediatric anesthesia should be avoided, and there is a trend towards the centralization of pediatric surgical activity. ⋯ In recent years, focus has been directed at validating the efficacy of simulation training and at its cost-effectiveness for improving learning and patient outcomes. Future challenges will include the best way to integrate simulation into the existing pediatric anesthesia training curricula, the determination of better evidence of its impact on clinical performance and the design and validation of assessment tools for technical and non-technical skills.
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World J Pediatr Congenit Heart Surg · Oct 2011
Outcomes analysis and quality improvement for the treatment of patients with pediatric and congenital cardiac disease.
Tremendous progress has been made in the science of assessing the outcomes of the treatments of patients with pediatric and congenital cardiac disease. Multi-institutional databases have been developed that span subspecialty, geographic, and temporal boundaries. Linking of different databases enables additional analyses not possible using the individual data sets alone and can facilitate quality improvement initiatives. ⋯ Parents are an integral part of the health care team and are key partners with regard to quality improvement. The role of the parent in the process of health care delivery can be facilitated by enhancing the organizational culture and creating methods of transparency, empowering parents, and implementing effective strategies of communication. The professionals caring for patients with pediatric and congenital cardiac disease, in collaboration with the patients and their families, now have the opportunity to capitalize on the power of our databases and move beyond outcome assessment and benchmarking, to collaborative quality improvement.
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Open Access J Clin Trials · Sep 2011
Critical Illness Outcome Study: An Observational Study on Protocols and Mortality in Intensive Care Units.
Many individual Intensive Care Unit (ICU) characteristics have been associated with patient outcomes, including staffing, expertise, continuity and team structure. Separately, many aspects of clinical care in ICUs have been operationalized through the development of complex treatment protocols. The United State Critical Illness and Injury Trials Group-Critical Illness Outcomes Study (USCIITG-CIOS) was designed to determine whether the extent of protocol availability and use in ICUs is associated with hospital survival in a large cohort of United States ICUs. Here, we describe the study protocol and analysis plan approved by the USCIITG-CIOS Steering Committee. ⋯ USCIITG-CIOS is a large multicentric study examining the effect of ICU protocol use on patient outcomes. The primary results of this study will inform our understanding of the relationship between protocol availability, use, and patient outcomes in the ICU. Moreover, given the shortage of intensivists worldwide, the results of USCIITG-CIOS can be used to promote more effective ICU and care team design and will impact the delivery of intensive care services beyond individual practitioners.