Reimagining the self at late-career transitions: how identity threat influences academic physicians' retirement considerations.

Purpose: There is scant empirical work exploring academic physicians' psychosocial adjustment during late-career transitions or on the factors that influence their retirement decisions. The authors examine these issues through the lens of sociopsychological identity theory, specifically examining how identity threat influences academic physicians' decisions about retirement.

Method: Participants were academic physicians at a Canadian medical school and were recruited via e-mail requests for clinical faculty interested in discussing late-career and retirement planning issues.

Evaluation of a preoperative team briefing: a new communication routine results in improved clinical practice.

BACKGROUND Suboptimal communication within healthcare teams can lead to adverse patient outcomes. Team briefings were previously associated with improved communication patterns, and we assessed the impact of briefings on clinical practice. To quantify the impact of the preoperative team briefing on direct patient care, we studied the timing of preoperative antibiotic administration as compared to accepted treatment guidelines.

Canadian Association of University Surgeons' Annual Symposium: W(h)ither generalism(?).

This 2008 Symposium of the Canadian Association of University Surgeons (CAUS) brought together surgeons from a number of jurisdictions to discuss generalism in general surgery and its future. Dr. John Birkmeyer, the 2008 Charles Tator lecturer, started the symposium by framing the problem: the need to improve surgical outcomes, selective referral, centres of excellence, process compliance and performance feedback.

Timing of surgical antibiotic prophylaxis administration: complexities of analysis.

Background: The timing of prophylactic antibiotic administration is a patient safety outcome that is recurrently tracked and reported. The interpretation of these data has important implications for patient safety practices. However, diverse data collection methods and approaches to analysis impede knowledge building in this field.

Evaluation of a preoperative checklist and team briefing among surgeons, nurses, and anesthesiologists to reduce failures in communication.

Objective: To assess whether structured team briefings improve operating room communication.

Design, Setting, And Participants: This 13-month prospective study used a preintervention/postintervention design. All staff and trainees in the division of general surgery at a Canadian academic tertiary care hospital were invited to participate.

Empiric antimicrobial therapy in critical illness: results of a surgical infection society survey.

Background: Antibiotics are prescribed commonly in the intensive care unit (ICU). Often, therapy is initiated empirically; practice patterns are not well characterized. We documented approaches to empiric antibiotic therapy among members of the Surgical Infection Society (SIS).

Successful management of severe group A streptococcal soft tissue infections using an aggressive medical regimen including intravenous polyspecific immunoglobulin together with a conservative surgical approach.

Intravenous polyspecific immunoglobulin G (IVIG) has been reported to be efficacious as adjunctive therapy in patients with toxic shock syndrome caused by a group A streptococci (GAS). GAS is also an important cause of necrotizing fasciitis, for which an early and extensive surgical intervention is currently advocated. Here we report on the use of an aggressive medical regimen including high-dose IVIG together with a conservative surgical approach in severe GAS soft tissue infection.

Defining medical error.

Medical errors represent a serious public health problem and pose a threat to patient safety. As health care institutions establish "error" as a clinical and research priority, the answer to perhaps the most fundamental question remains elusive: What is a medical error? To reduce medical error, accurate measurements of its incidence, based on clear and consistent definitions, are essential prerequisites for effective action. Despite a growing body of literature and research on error in medicine, few studies have defined or measured "medical error" directly.

Achieving clinical improvement: an interdisciplinary intervention.

This study evaluates whether training health care teams in continuous quality improvement methods results in improvements in the care of and outcomes for patients. Nine of the 25 teams who participated in the study were successful in improving the care/outcomes for patients. Successful teams were more effective at problem solving, engaged in more functional group interactions, and were more likely to have physician participation.