Emergency department use and hospital admission in children following ambulatory surgery: a retrospective population-based cohort study.

Introduction: Paediatric ambulatory surgery (same day surgery and planned same day discharge) is more frequently being performed more in Canada and around the world; however, after surgery children may return to hospital, either through the emergency department (ED) or through a hospital admission (HA). The aim of this study was to determine the patient characteristics associated with ED visits and HA in the 3 days following paediatric ambulatory surgery.

Methods: This population-based retrospective cohort study used de-identified health administrative database housed at ICES and included residents of Ontario, younger than 18 years of age, who underwent ambulatory surgery between 2014 and 2018.

Pain and haemorrhage are the most common reasons for emergency department use and hospital admission in adults following ambulatory surgery: results of a population-based cohort study.

Background: Advances in healthcare delivery have allowed for the increase in the number of ambulatory surgery procedures performed in Canada. Despite these advances, patients return to hospital following discharge. However, the reason for unplanned healthcare use after ambulatory surgery in Canada is not well understood.

Barriers and facilitators to postoperative pain management in Rwanda from the perspective of health care providers: A contextualization of the theory of planned behavior.

Aims: Identify opportunities to improve knowledge translation for post-operative pain management in Rwanda by exploring clinician and environmental factors affecting this practice.

Methods: The theory of planned behavior (TPB) guided development of a questionnaire to measure intent to assess and treat postoperative pain. Focus groups and individual interviews were used to contextualize the final questionnaire and generate questions related to pain management practice.

Self-reported patient safety competence among Canadian medical students and postgraduate trainees: a cross-sectional survey.

Background: Quality and patient safety (PS) are critical components of medical education. This study reports on the self-reported PS competence of medical students and postgraduate trainees.

Methods: The Health Professional Education in Patient Safety Survey was administered to medical students and postgraduate trainees in January 2012.

Safety Perceptions of Health Care Leaders in 2 Canadian Academic Acute Care Centers.

Objectives: An estimated 7.4% of patients admitted to acute care facilities in Canada experience injury or death due to health care mishaps, and 38% of these events are deemed preventable. Commitment of executive leaders to a culture of safety is important for the reduction of risk to Canadian patients.

Brief review: Adoption of electronic medical records to enhance acute pain management.

Purpose: The purpose of this paper is to examine physician barriers to adopting electronic medical records (EMRs) as well as anesthesiologists' experiences with the EMRs used by the acute pain management service at two tertiary care centres in Canada.

Source: We first review the recent literature to determine if physician barriers to adoption are changing given the exponential growth of information technology and the evolving healthcare environment. We next report on institutional experience from two academic health sciences centres regarding the challenges they encountered over the past ten years in developing and implementing an electronic medical record system for acute pain management.

Chronic pain, healthcare utilization, and quality of life following gastrointestinal surgery.

Objectives: Our aim in this pilot study was to identify potential predictors of chronic post-surgical pain (CPSP) and other outcomes to consider for inclusion in future prospective studies of CPSP following abdominal gastrointestinal surgery.

Methods: We followed 76 surgical patients during this prospective single-centre cohort study. Pain characteristics, health-related quality of life (HRQOL), and healthcare utilization were assessed preoperatively, at six weeks postoperatively, and at six months postoperatively.

Impact of perioperative pain intensity, pain qualities, and opioid use on chronic pain after surgery: a prospective cohort study.

Background And Objectives: A better understanding of the pathogenesis of chronic postsurgical pain is needed in order to develop effective prevention and treatment interventions. The objective of this study was to evaluate the incidence and risk factors for chronic postsurgical pain in women undergoing gynecologic surgery.

Methods: Pain characteristics, opioid consumption, and psychologic factors were captured before and 6 months after surgery.

How do patients perceive electronic documentation at the bedside?

Electronic patient records provide an opportunity for real-time access to patient information at the bedside, which has the potential to improve healthcare quality because it would increase efficiency and facilitate best practice. Patients in this study reported that portable computers used at the bedside did not affect the clinician-patient relationship. Many patients thought that the technology was a valuable tool and that it could foster an efficient hospital atmosphere and promote reliable and accurate medical documentation.

Pain, health-related quality of life and health care utilization after inpatient surgery: a pilot study.

Background: Little is known about pain-related outcomes in surgical inpatients after discharge from the hospital. An ongoing risk and outcomes monitoring system would provide valuable feedback to improve the quality of patient care.

Objectives: The purpose of the present pilot study was to describe postoperative pain, medication use, health care utilization and health-related quality of life (HRQOL) immediately and four weeks after surgery; merge clinically captured data with Web-based follow-up data; and examine patients' willingness to complete Web-based health questionnaires.

A comparison of paper with electronic patient-completed questionnaires in a preoperative clinic.

Unlabelled: In this unblinded randomized control trial we compared electronic self-administered Pre-Admission Adult Anesthetic Questionnaires (PAAQ) using touchscreen technology with pen and paper. Patients were recruited in the Pre-assessment Clinic if they had completed a PAAQ in the surgeon's office. Patients were randomized to study PAAQ using paper, hand-held computer (PDA), touchscreen desktop computer (kiosk), or tablet.

Recommendations for improved acute pain services: Canadian collaborative acute pain initiative.

The Canadian Collaborative Acute Pain Initiative, established in 2002, is a voluntary, multidisciplinary consortium of acute pain health professionals from across Canada whose goal is to improve acute pain management through discussion and consensus. The group met in January 2002 to define strategic areas related to the treatment of acute pain. The areas identified were: the definition of pain; the epidemiology of pain; the concept of an 'ideal' acute pain management service; education; therapeutic options; symptom management; and research and safety.

In Canada, anesthesiologists are less likely to respond to an electronic, compared to a paper questionnaire.

Purpose: A randomized unblinded controlled trial was used to assess the utility of electronic questionnaires in a survey of Canadian anesthesiologists.

Methods: Postal or electronic questionnaires were sent between November 2001 and March 2002 to 1,333 anesthesiologists registered with the Canadian Anesthesiologists' Society. The primary outcome measure was the difference in response rates between electronic and postal questionnaires.

Acute pain management services have progressed, albeit insufficiently in Canadian academic hospitals.

Purpose: Acute pain management services (APMS) evolved in response to the desire for improved management of postoperative pain. The management of postoperative pain received formal support from international organizations over the past decade and by 1993 half of the Canadian university-affiliated teaching hospitals had implemented an APMS. The purpose of this survey was to describe APMSs in Canadian academic institutions, with specific emphasis on postoperative analgesics, new analgesic methods, training and research.

The impact of sampling and measurement on the prevalence of self-reported pain in Canada.

Background: Pain is an important public health problem in Canada. International estimates of general population pain prevalence range from 2% to 46%.

Objectives: The purpose of this paper is to critically examine the potentially misleading use of overall prevalence estimates in the pain literature and to use two Canadian population-based surveys to assess the impact of sampling and measurement on prevalence.

Definitions of "respiratory depression" with intrathecal morphine postoperative analgesia: a review of the literature.

Purpose: To review the postoperative intrathecal morphine (ITM) analgesia literature for their definitions of "respiratory depression" (RD).

Source: Medline (1966 - June Week 5 2001) and reference lists were searched for original studies involving bolus-dose ITM for postoperative analgesia, which used "respiratory depression" or similar terms.

Principle Findings: The search identified 209 studies.

Using a personal digital assistant enhances gathering of patient data on an acute pain management service: a pilot study.

Purpose: Handheld computer technology provides a unique opportunity for health care professionals to access real time or near real time patient information and evidence-based resources at the point-of-care. The purpose of this study was to assess one physician's experience using acute pain assessment software on a personal digital assistant (PDA) to assess patients on an acute pain management service (APMS).

Methods: Using a historical control and a "time and motion" study design, comparisons were made on acute pain assessment time and comprehensiveness when patient assessments are documented on a PDA vs the current paper-based method.

The relationship between movement-evoked versus spontaneous pain and peak expiratory flow after abdominal hysterectomy.

Unlabelled: The pathogenesis of postoperative lung dysfunction implies a role for movement-evoked pain (e.g., splinting/hypoventilation because of pain avoidance).

A survey of directors of Canadian academic acute pain management services: the nursing team members role--a brief report.

Purpose: The purpose of this study was to identify Canadian academic centres with Acute Pain Management Service (APMS), and to describe the nature of nursing involvement on the APMS.

Methods: Departments of Anesthesiology in the 16 Canadian medical schools were contacted to obtain a list of affiliated hospitals and the person most responsible for acute pain. A questionnaire designed to gain insight into nursing involvement on APMS was sent out to the 62 hospitals between June 2000 and January 2001.