Comparison of Clinical and Economic Outcomes of an Optimized Lean Versus a Standard Transcatheter Aortic Valve Implantation Program (from SOLAR [Safe Outcomes Lean And Resourceful] Study).

The increasing prevalence of aortic stenosis (AS) and the increasing number of patients indicated for transcatheter aortic valve implantation (TAVI) can lead to increased hospital constraints. This study aimed to compare, from the hospital perspective, the costs, resource use, and 30-day clinical outcomes of patients who underwent TAVI under an optimized or standard clinical pathway. A single-center, retrospective study was conducted among patients with native AS who underwent TAVI between January 2018 and March 2021.

On-the-Job Safety During Enlarging an Intensive Care Unit for the COVID-19 Pandemic: Team-Based Approach with Low Infection Rate of the Staff.

Objective: Healthcare workers had a 7.4-fold risk of severe coronavirus disease-19 than non-essential employees in the United Kingdom during the first phase of the pandemic. In this study, we describe interdisciplinary measures for increasing on-the-job safety used during the first phase of the pandemic in an Italian hospital.

Long-Term Outcomes After Implantation of Magnesium-Based Bioresorbable Scaffolds-Insights From an All-Comer Registry.

Background: The magnesium-based sirolimus-eluting bioresorbable scaffold (Mg-BRS) Magmaris™ showed promising clinical outcomes, including low rates of both the target lesion failure (TLF) and scaffold thrombosis (ScT), in selected study patients. However, insights regarding long-term outcomes (>2 years) in all-comer populations remain scarce.

Methods: We analyzed data from a single-center registry, including patients with acute coronary syndrome (ACS) and chronic coronary syndrome (CCS), who had undergone percutaneous coronary intervention (PCI) using the Mg-BRS.

Development of a value-based healthcare delivery model for sarcoma patients.

The urgent need to restructure healthcare delivery to address rising costs has been recognised. Value-based health care aims to deliver high and rising value for the patient by addressing unmet needs and controlling costs. Sarcoma is a rare disease and its care is therefore usually not organised as an institutional discipline.

Impact of Adrenal Function on Hemostasis/Endothelial Function in Patients Undergoing Surgery.

Context: Glucocorticoids regulate hemostatic and endothelial function, and they are critical for adaptive functions during surgery. No data regarding the impact of adrenal function on hemostasis and endothelial function in the perioperative setting are available.

Objective: We assessed the association of adrenal response to adrenocorticotropic hormone (ACTH) and markers of endothelial/hemostatic function in surgical patients.

Improved Procedural Efficiency of Atrial Fibrillation Ablation Using a Dedicated Ablation Protocol and Lean Management.

Objectives: In this study the authors hypothesized that "Lean management" within a dedicated ablation protocol could standardize the pulmonary vein isolation (PVI) procedure and improve quality.

Background: There is a large variability in safety, effectiveness, and efficiency of PVI.

Methods: This was a single-center prospective study with inclusion of all consecutive PVI procedures from 2017 to 2019.

[Increasing Complexity in Performance Delivery - Management Approach for Tertiary Care Centers].

Increasing Complexity in Performance Delivery - Management Approach for Tertiary Care Centers Abstract. General social trends such as individualization and female shift increase the complexity for management in both technical and system management in addition to the inherent development in the hospital industry such as subspecialization, ageing societies and multimorbidity. Reduction of complexity is therefore absolutely necessary in order to be able to manage in a patient-friendly way as a maximum care provider.

[Accidental central venous administation of 0.1 % chlorhexidine mouthwash].

Medication errors are frequent and a serious safety concern. Chlorhexidine (CHX) is used daily in healthcare as a disinfectant. Its accidental intravascular injection is scarcely described.

Application of Benford's law: a valuable tool for detecting scientific papers with fabricated data? : A case study using proven falsified articles against a comparison group.

Background: In naturally occurring numbers the frequencies of digits 1-9 in the leading position are counterintuitively distributed because the frequencies of occurrence are unequal. Benford-Newcomb's law describes the expected distribution of these frequencies. It was previously shown that known fraudulent articles consistently violated this law.

Separate Medication Preparation Rooms Reduce Interruptions and Medication Errors in the Hospital Setting: A Prospective Observational Study.

Background: Interruptions and errors during the medication process are common, but published literature shows no evidence supporting whether separate medication rooms are an effective single intervention in reducing interruptions and errors during medication preparation in hospitals. We tested the hypothesis that the rate of interruptions and reported medication errors would decrease as a result of the introduction of separate medication rooms.

Aim: Our aim was to evaluate the effect of separate medication rooms on interruptions during medication preparation and on self-reported medication error rates.

[Ventilator-associated pneumonia (VAP) : A risk already at the time of anesthetic induction].

Background: Ventilator-associated pneumonia (VAP) is one of the most common and preventable infections in mechanically ventilated patients. It is associated with a high mortality rate. To prevent VAP, various strategies address this issue using "VAP-bundles", which are implemented in many intensive care units.

[Management for the operating room].

Business companies, which in the current times also includes hospitals, must create customer benefits and as a prerequisite for this must sustainably generate profits. Management in the world of business means the formation and directing of a company or parts of a company on a permanent basis, whereby management in this context is not exercising power but function. This concept of management is exemplary developed in this article for the important services sector of the operating room (OR) and individual functions, such as resource control, capacity planning and materials administration are presented in detail.

Effect of intraoperative infiltration with local anesthesia on the development of chronic pain after inguinal hernia repair: a randomized, triple-blinded, placebo-controlled trial.

Background: Chronic pain is a common complication after inguinal hernia repair. The objective of this randomized trial was to assess the effect of intraoperative infiltration with local anesthetic versus placebo on the development of chronic pain after inguinal hernia repair.

Methods: Patients with single- or double-sided inguinal hernia were enrolled in a randomized, controlled, triple-blinded trial with a sequential adaptive design.

[OR-Management - Essentials].

Operating theaters are strongly linked to other units in a hospital such as the ICU, the wards and the emergency room for example. Good management skills are necessary to improve the productivity by 2-3 percent per year. To reach these goals resources' such as personnel, IT-systems, specific equipment and the adherence to professional standards are required.

[OR-management and self-improvement - a discrepancy?].

Today, operating room management is essential for a modern hospital. The strategic controls of this cost-intensive area and the ongoing cost pressure have necessitated management attention to this area. Economical, processual and quality data are well-known and established, although analysis of different health delivering organisations by benchmarking is still difficult.

[OR management - Checklists for OR-design for OR-managers - results of a workshop].

The construction of an operating room (OR) suite represents an important intermediate- and long term investment. The planning process starts with the quantitative estimation of the procedures to be carried out which defines the operative capacity for the life time of the facility. This permits the calculation of the number of ORs and the definition of the resources for the recovery room, the intermediate care and intensive care unit.

[From financial to scientific fraud : methods to detect discrepancies in the medical literature].

Fraud is as old as Mankind. There are an enormous number of historical documents which show the interaction between truth and untruth; therefore it is not really surprising that the prevalence of publication discrepancies is increasing. More surprising is that new cases especially in the medical field generate such a huge astonishment.

Telemedicine in the management of diving accidents: correlation of phone-assessed symptom severity with clinical findings.

Introduction: The object of this study was to evaluate to what extend the severity of decompression illness (DCI) assessed by a diving medicine specialist over the phone correlates with actual clinical findings.

Methods: The phone protocols of calls received by a diving medical hotline between January 2008 and December 2009 were analysed. Each case was followed up after completion of the treatment and categorized into one out of four severity groups according to the same standard protocol used for categorisation at the time of the initial hotline call.

Different Learning Curves for Axillary Brachial Plexus Block: Ultrasound Guidance versus Nerve Stimulation.

Little is known about the learning of the skills needed to perform ultrasound- or nerve stimulator-guided peripheral nerve blocks. The aim of this study was to compare the learning curves of residents trained in ultrasound guidance versus residents trained in nerve stimulation for axillary brachial plexus block. Ten residents with no previous experience with using ultrasound received ultrasound training and another ten residents with no previous experience with using nerve stimulation received nerve stimulation training.

[Who is suited as operation room manager? Evaluation process for hospitals and candidates].

Operation room (OR) management is not an end in itself. The challenge is more to organize the complex, inhomogeneous and interference-prone machinery of intraoperative service provision according to business objectives. Although business objectives may differ in some details the ultimate consequence is always to assure the quality of medical care along with adhering to the general economic conditions.

Tensile strength decreases and perfusion pressure of 3-holed polyamide epidural catheters increases in long-term epidural infusion.

Background And Objectives: Epidural analgesia is an established method for pain management. The failure rate is 8% to 12% due to technical difficulties (catheter dislocation and/or disconnection; partial or total catheter occlusion) and management. The mechanical properties of the catheters, like tensile strength and flow rate, may also be affected by the analgesic solution and/or the tissue environment.