Risk, Outcomes, and Costs in Neurosurgery

Risk, Outcomes, and Costs in Neurosurgery
Author: Andreea Seicean
Publisher:
Total Pages: 143
Release: 2013
Genre: Nervous system
ISBN:

Introduction: Health services research driven from within neurosurgery can be used to improve access to and quality of care, while helping to control costs. Aim: To answer clinically relevant questions that make a difference in patient care. Methods: We chose to use the American College of Surgeons National Safety and Quality Improvement Project as the database for all components of this dissertation, which contains prospective, blinded, multi-institutional information about patients undergoing surgery. Results: Hemostasis history was as predictive as laboratory testing for all outcomes, with higher sensitivity. Advanced age does not increase the risk of poor outcomes after surgical resection of primary or metastatic intracranial tumors, after controlling for other risk factors. We not find smoking to be associated with early (30-day) peri-operative morbidity or mortality. All levels of anemia were significantly associated with prolonged length of hospitalization and poorer operative or 30-day outcomes in patients undergoing elective spine surgery. Conclusions: Routine hemostatic laboratory screening appears to have limited utility. Testing limited to neurosurgical patients with a positive history would save an estimated $81,942,000 annually. Age should not be used, in isolation, as an a priori factor to discourage pursuing craniotomy. Smoking cessation can be considered prior to spine surgery for reasons other then early (30-day) peri-operative morbidity or mortality. Anemia should be regarded as an independent risk factor for peri-operative and post-operative complications that deserves attention prior to elective spine surgery.

Disease Control Priorities, Third Edition (Volume 1)

Disease Control Priorities, Third Edition (Volume 1)
Author: Haile T. Debas
Publisher: World Bank Publications
Total Pages: 445
Release: 2015-03-23
Genre: Medical
ISBN: 1464803676

Essential Surgery is part of a nine volume series for Disease Control Priorities which focuses on health interventions intended to reduce morbidity and mortality. The Essential Surgery volume focuses on four key aspects including global financial responsibility, emergency procedures, essential services organization and cost analysis.

Lung Volume Reduction Surgery

Lung Volume Reduction Surgery
Author: Michael Argenziano
Publisher: Springer Science & Business Media
Total Pages: 247
Release: 2001-10-15
Genre: Medical
ISBN: 1592591213

A panel of recognized authorities comprehensively review the medical, surgical, and pathophysiologic issues relevant to lung volume reduction surgery for emphysema. Topics range from the open technique and video-assisted thoracoscopic approaches to LVRS, to anesthetic management, to perioperative and nursing care of the patient. The experts also detail the selection of candidates for LVRS, the clinical results and clinical trials in LVRS, and the effects of LVRS on survival rates.

Ethics in Neurosurgical Practice

Ethics in Neurosurgical Practice
Author: Stephen Honeybul
Publisher: Cambridge University Press
Total Pages: 275
Release: 2020-06-18
Genre: Medical
ISBN: 110864046X

Neurosurgical interventions have the potential to change a person's concept of self, as well as affect their neurological and cognitive function to an unacceptable level for both patient and family. In an increasingly complex and evolving field, the ethical implications of treatments and their eventual outcomes must be carefully balanced. Ethics in Neurosurgical Practice is a comprehensive and practical guide for managing the treatment of patients with debilitating neurosurgical conditions. Chapters address specific conditions, such as traumatic brain injuries, ischemic stroke and spinal surgery, and the ethical challenges that each of these pose. Detailed case studies present potential scenarios that readers might encounter, and their outcomes. Future developments of this fast-paced field are expanded upon, including televised live surgery and the ethical aspects of innovation in neurosurgery. A broad variety of contributors in different fields, including neurosurgeons, intensivists and bioethicists, ensures comprehensive coverage from a range of views and experiences.

Revision Lumbar Spine Surgery

Revision Lumbar Spine Surgery
Author: Robert F. Heary
Publisher: Elsevier Health Sciences
Total Pages: 224
Release: 2021-03-03
Genre: Medical
ISBN: 0323712029

Offering in-depth coverage of an often-neglected topic, Revision Lumbar Spine Surgery identifies clinical problems and discusses recent major advances in this challenging area. Dr. Robert F. Heary and a team of international experts share their knowledge and experience with even the most difficult lumbar cases, helping you provide optimal outcomes for your patients. You’ll find authoritative guidance on indications, diagnosis, approaches, and follow-up, with a focus on the significant advances that have occurred over the past two decades in this fast-changing field. Identifies the clinical problems related to unsuccessful back spine surgery as well as indications, diagnosis, and new treatment options and advances in this complex area. Provides in-depth information on the multiple options that exist for most clinical situations: anterior, posterior, lateral, and combined anterior and posterior approaches. Covers methods of fixation, the use of interbody grafting, and surgical planning related to scar tissues, bleeding, and spinal fluid leaks. Discusses critical follow-up topics such as key clinical procedures, radiography, patient reported outcomes, and pain management. Includes timely chapters on robotics, bone density issues, medical fitness concerns, instrumentation options, imaging considerations, and much more.

Principles of Spinal Surgery

Principles of Spinal Surgery
Author: Arnold H. Menezes
Publisher: McGraw-Hill Companies Health Professions Division
Total Pages: 0
Release: 1996
Genre: Spinal Diseases
ISBN: 9780079120434

Surgical Care at the District Hospital

Surgical Care at the District Hospital
Author: World Health Organization
Publisher: World Health Organization
Total Pages: 515
Release: 2003-07-21
Genre: Medical
ISBN: 9241545755

Many patients who present to district (first-referral) level hospitals require surgical treatment for trauma, obstetric, abdominal or orthopedic emergencies. Often surgery cannot be safely postponed to allow their transfer to a secondary or tertiary-level hospital but many district hospitals in developing countries have no specialist surgical teams and are staffed by medical, nursing, and paramedical personnel who perform a wide range of surgical procedures often with inadequate training. The quality of surgical and acute care is often further constrained by poor facilities, inadequate low-technology apparatus and limited supplies of drugs, materials, and other essentials. The mission of the team responsible for Clinical Procedures in the World Health Organization Department of Essential Health Technologies (EHT) is to promote the quality of clinical care through the identification, promotion and standardization of appropriate procedures, equipment and materials, particularly at district hospital level. WHO/BCT has identified education and training as a particular priority, especially for non-specialist practitioners who practice surgery and anesthesia. It has therefore developed Surgical Care at the District Hospital as a practical resource for individual practitioners and for use in undergraduate and postgraduate programs in-service training and continuing medical education programs. The manual is a successor of three earlier publications that are widely used throughout the world and that remain important reference texts: General Surgery at the District Hospital (WHO 1988), Surgery at the District Hospital: Obstetrics Gynecology Orthopedics and Traumatology (WHO 1991), Anesthesia at the District Hospital (WHO 1988; second edition 2000). This new manual draws together material from these three publications into a single volume which includes new and updated material, as well as material from Managing Complications in Pregnancy and Childbirth: A Guide for Midwives and Doctors (WHO 2000).

Making Healthcare Safe

Making Healthcare Safe
Author: Lucian L. Leape
Publisher: Springer Nature
Total Pages: 450
Release: 2021-05-28
Genre: Medical
ISBN: 3030711234

This unique and engaging open access title provides a compelling and ground-breaking account of the patient safety movement in the United States, told from the perspective of one of its most prominent leaders, and arguably the movement’s founder, Lucian L. Leape, MD. Covering the growth of the field from the late 1980s to 2015, Dr. Leape details the developments, actors, organizations, research, and policy-making activities that marked the evolution and major advances of patient safety in this time span. In addition, and perhaps most importantly, this book not only comprehensively details how and why human and systems errors too often occur in the process of providing health care, it also promotes an in-depth understanding of the principles and practices of patient safety, including how they were influenced by today’s modern safety sciences and systems theory and design. Indeed, the book emphasizes how the growing awareness of systems-design thinking and the self-education and commitment to improving patient safety, by not only Dr. Leape but a wide range of other clinicians and health executives from both the private and public sectors, all converged to drive forward the patient safety movement in the US. Making Healthcare Safe is divided into four parts: I. In the Beginning describes the research and theory that defined patient safety and the early initiatives to enhance it. II. Institutional Responses tells the stories of the efforts of the major organizations that began to apply the new concepts and make patient safety a reality. Most of these stories have not been previously told, so this account becomes their histories as well. III. Getting to Work provides in-depth analyses of four key issues that cut across disciplinary lines impacting patient safety which required special attention. IV. Creating a Culture of Safety looks to the future, marshalling the best thinking about what it will take to achieve the safe care we all deserve. Captivatingly written with an “insider’s” tone and a major contribution to the clinical literature, this title will be of immense value to health care professionals, to students in a range of academic disciplines, to medical trainees, to health administrators, to policymakers and even to lay readers with an interest in patient safety and in the critical quest to create safe care.

Patient Safety and Quality

Patient Safety and Quality
Author: Ronda Hughes
Publisher: Department of Health and Human Services
Total Pages: 592
Release: 2008
Genre: Medical
ISBN:

"Nurses play a vital role in improving the safety and quality of patient car -- not only in the hospital or ambulatory treatment facility, but also of community-based care and the care performed by family members. Nurses need know what proven techniques and interventions they can use to enhance patient outcomes. To address this need, the Agency for Healthcare Research and Quality (AHRQ), with additional funding from the Robert Wood Johnson Foundation, has prepared this comprehensive, 1,400-page, handbook for nurses on patient safety and quality -- Patient Safety and Quality: An Evidence-Based Handbook for Nurses. (AHRQ Publication No. 08-0043)." - online AHRQ blurb, http://www.ahrq.gov/qual/nurseshdbk/