[PDF] Safety In Spine Surgery Transforming Patient Care And Optimizing Outcomes eBook
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An indispensable resource for spine surgery professionals at all levels of experience, Safety in Spine Surgery: Transforming Patient Care and Optimizing Outcomes addresses today’s key issues in this complex field. Editor, Michael Vitale, MD, Chief Quality Officer in the Department of Orthopaedic Surgery at Columbia University Medical Center, leads an outstanding team of spine surgeons and other healthcare professionals who provide clear guidance in improving the care and safety of adult and pediatric patients undergoing surgery for disorders of the spine. Timely coverage includes using systems to improve safety and outcomes (such as adherence to process, open communication, team skills-building and training, creating urgency, and building consensus), with a focus on reducing infection, hemorrhage, and nerve injury.
Unsustainable healthcare costs and sophisticated predictive modeling based on large-scale medical data is rapidly changing models of healthcare delivery. The shift towards a value-based, consumer-driven industry has created an urgent need for validated tools to increase cost efficiency, reduce rates of adverse events, and improve patient outcomes. Value-based approaches to spine care will be presented, highlighting models for the future. These approaches stress cost effectiveness and sustainable approaches to spinal disease, where quality and safety are paramount. Beginning with a review of current trends in health care delivery leading to more value-based platforms, the discussion then focuses on how modern spine care is being shaped by the aging population, scientific and technological advancements, and the economic impact of various treatment modalities, providing insight into the seminal efforts surrounding sustainable spine care guideline development. The over-utilization of spine fusion surgery and adult spinal deformity are presented as examples that have led to a decline in the value of care delivered, as well as how a multidisciplinary evaluation by the range of clinicians involved in spine surgery can revise recommendations for management. The benefits and risks of LEAN methodology for streamlining and standardizing spine care approaches are discussed, and the specific approach of the Seattle Spine Team is presented as an example of successful system-wide improvement. Similar changes to outcome measurement, specifically for adult spinal deformity, are described. Last, the future of technology in spine care is presented, including robotics, nanotechnology, 3D printing, and the use of biologics and biomaterials. Given the broad scope of topics covered in this book, the intended audience includes not only orthopedic and spinal surgeons, neurosurgeons, physiatrists, and medical students, residents and fellows, but also hospital CEOs, CMOs, administrators, health services researchers, and health care policymakers, consultants and strategists.
Given the risks, physiologic tolls, and morbidity associated with spine surgery, it is imperative to optimize outcomes with appropriate interventions in the pre-, peri-, and postoperative period. There have been numerous publications in other surgical specialties and more recently in the spine literature describing various techniques to improve patients' outcomes. In the preoperative setting, surgical education, patients risk stratification and optimization of medical conditions, smoking cessation, and weight loss are critical. In the perioperative period, monitoring and minimization of blood loss, appropriate neuroanesthesia and analgesia, and metabolism management play a significant role. In the postoperative setting, early ambulation, wound care management and opioid-sparing analgesia, among others, play a role in recovery.
Quality reporting is a rapidly growing area. Each year, new regulations in the US from the Council of Medicare and Medicaid Services make quality reporting a larger factor in determining reimbursement practices. Quality metrics are common parts of European clinical practice. Value of care is a focus of all payers, with specific interest directed at assessing the quality of care provided by a given healthcare team. While there are many publications in this space, no text has sought to provide an overview of quality in spine care. Quality measurement and quality reporting are ever growing aspects of the healthcare environment. Quality assessment is valuable to all healthcare stakeholders: patients, physicians, facilities, and payers. Patients are drawn to facilities that provide high value care; public reporting systems and grading systems for hospitals offer one opinion with regard to “high quality care.” Most physicians email inboxes are inundated with offers of recognition for being a “Top Doc” for a nominal fee. Some payers offer incentives to patients who chose to be treated at “Centers of Excellence” or similar facilities; the definition of “Excellence” may be unclear. There is little consensus on how to measure quality, how to incorporate patient and procedure factors and achieve accurate risk adjustment, and how to define value of care. Regardless of these challenges, regulatory efforts in the US, as well as numerous international efforts, make quality assessment and quality reporting an important part of physician behaviour. Physician and facility reimbursement for procedures are often tied to quality metrics. Spine procedures are costly, elective, and are a focus of many payer-based programs. Hence, spine care is often a focus of quality reporting efforts. This text summarizes the state of the art with regard to quality measurement, reporting, and value assessment in spine care. We will review quality reporting in the US and internationally. Chapters will outline how quality improvement efforts have achieved success in hospital systems. The reader will be provided with insights in how to achieve success incorporating quality metrics into spine care. Features: 1. Illustrates the state of the art in spine quality reporting: There is no text that thoroughly addresses quality assessment and quality reporting in spine care; there are, however, numerous articles in this space. This book provides a definitive text covering the state of the art for quality reporting in spine care and will be of value to the international orthopedic and neurosurgical spine community. 2. Provides insight on quality reporting in different healthcare systems: The text will allow for comparison of different quality reporting systems from different health care systems. This will provide practitioners with insight into the strengths and weaknesses of different approaches to quality reporting, and may drive improvement in quality assessment and reporting systems. A single text that features review of US, European, and Australia/Asian health care systems’ quality reporting is novel and will be thought provoking for readers. 3. Describes the US and international Healthcare reimbursement systems: Practicing physicians are provided with little information and less insight into the vagaries of the US and other healthcare systems. The text will provide insight into code development, valuation, and how quality reporting affects physician reimbursement 4. Explains risk adjustment: Appropriate risk adjustment and assessing patient and procedure factors that may impact quality reporting are invaluable to accurate quality measurement. The text will review risk adjustment, different approaches to risk assessment/mitigation, and provide physicians with insights into appropriate measures to capture in their clinical practices 5. Provides a foundation for improved quality assessment in spine care: While there are many disparate elements and differing approaches to capturing spine quality metrics, no definitive text has attempted to summarize these efforts in a single volume. By synthesizing these variable approaches, the reader may be provided with insights into superior approaches to quality assessment and a foundation will be provided for improving healthcare systems.
Our bodies are programmed to heal, but too often we are unaware that we are working against our own healing. The damaging effects of incisions, anesthesia, antibiotics and opioids demand that you Optimize before and after surgery for your best recovery. No matter how perfect the surgery, your surgeon needs your commitment and help to achieve your goal of a pain-free life. The Optimized Patient offers insights from a team of six spine patients, two physical therapists, a chiropractor and a nutritionist all dedicated to helping you prepare to be an Optimized Patient. In the time it takes to read this book, you will have gained the insights from all those patients, surgeons, and experts as if you were in a small group setting where you could ask all the questions you wanted.What you end up with is the ability to make a well-informed decision about whether or not spine surgery is right for you. And, should you make that decision, you will have the best information possible to achieve what every spine patient wants: to be you again.No matter how perfect the surgery, your surgeon needs your commitment and help to achieve your goal of a pain-free life."Three times Mr. Warren has made the commitment to optimize in order to support his clinical recovery phase. What he has learned is critically important to anyone facing the challenge of spine surgery. The Optimized Patient is a straight-forward, super-informative and enjoyable book written to help you achieve your best possible surgical outcome." -Dr. Sanjay Khurana, MD, Spine Surgeon
Now in its Third Edition, this popular volume in the Master Techniques in Orthopaedic Surgery Series combines the step-by-step procedural guidance that readers have come to trust with new and updated discussions of specific procedures. The text’s how-to format helps readers face the challenges of spinal surgery with confidence.
Author : National Academy of Engineering Publisher : National Academies Press Page : 340 pages File Size : 42,2 MB Release : 2011-07-14 Category : Medical ISBN : 0309120640
Improving our nation's healthcare system is a challenge which, because of its scale and complexity, requires a creative approach and input from many different fields of expertise. Lessons from engineering have the potential to improve both the efficiency and quality of healthcare delivery. The fundamental notion of a high-performing healthcare system-one that increasingly is more effective, more efficient, safer, and higher quality-is rooted in continuous improvement principles that medicine shares with engineering. As part of its Learning Health System series of workshops, the Institute of Medicine's Roundtable on Value and Science-Driven Health Care and the National Academy of Engineering, hosted a workshop on lessons from systems and operations engineering that could be applied to health care. Building on previous work done in this area the workshop convened leading engineering practitioners, health professionals, and scholars to explore how the field might learn from and apply systems engineering principles in the design of a learning healthcare system. Engineering a Learning Healthcare System: A Look at the Future: Workshop Summary focuses on current major healthcare system challenges and what the field of engineering has to offer in the redesign of the system toward a learning healthcare system.
A comprehensive guide to anesthesia specifically for spine surgery, explaining procedures from the point of view of both anesthesiologists and surgeons.
The New Era of Precision Medicine: What it Means for Patients and the Future of Healthcare highlights aspects of precision medicine in different specialties and offers an understanding of how a biological background integrates into clinical guidelines, the therapeutic efficacy of interventions and disease prevention. The book explains how precision healthcare differs among countries, as well as how there is a collaboration among many labs to share resources and knowledge to advance the field across the globe. The book also discusses the cultural differences and cultural sensitivity that may be involved in the precision medicine approach. Finally, with regard to safety and quality outcomes, the book presents a range of current and possible future concerns related to those outcomes. Precision medicine is the new standard of quality healthcare delivery. It aims to optimize patient safety and clinical outcomes, enhance the efficacy of therapeutic interventions, and facilitate disease prevention, offering a way to customize patient care, decision-making, and clinical practice. Highlights the characteristics of precision medicine in different areas Offers an understanding of how a biological background integrates into clinical guidelines, the therapeutic efficacy of interventions, and disease prevention Emphasizes how medicine has transformed from a “one-size-fits-all approach to personalized medicine influenced by individual characteristics Introduces complex topics delivered in terms that target a broad range of audiences
Author : Institute of Medicine Publisher : National Academies Press Page : 226 pages File Size : 40,12 MB Release : 2015-08-24 Category : Medical ISBN : 0309339227
According to Transforming Health Care Scheduling and Access, long waits for treatment are a function of the disjointed manner in which most health systems have evolved to accommodate the needs and the desires of doctors and administrators, rather than those of patients. The result is a health care system that deploys its most valuable resource-highly trained personnel-inefficiently, leading to an unnecessary imbalance between the demand for appointments and the supply of open appointments. This study makes the case that by using the techniques of systems engineering, new approaches to management, and increased patient and family involvement, the current health care system can move forward to one with greater focus on the preferences of patients to provide convenient, efficient, and excellent health care without the need for costly investment. Transforming Health Care Scheduling and Access identifies best practices for making significant improvements in access and system-level change. This report makes recommendations for principles and practices to improve access by promoting efficient scheduling. This study will be a valuable resource for practitioners to progress toward a more patient-focused "How can we help you today?" culture.