Within the naval medical center construct, the disparate disciplines encompassed within ancillary services lend themselves to formal quality analysis and process improvement. This analysis uses the Six Sigma approach. Error rates were investigated and calculated for various processes within ancillary services at Naval Medical Center, San Diego. These were translated into the common metric of defects per million opportunities (DPMO). DPMO rates vary between 21.5 and 420,000. These correspond to Sigma values from 1.7 to approaching 6. Rates vary with biological complexity of the system and the degree of automation available. Some ancillary services translate well into a Six Sigma schema. Systems with high potential patient risk if performed poorly and those amenable to second checking and computer oversight may be candidates for such optimization. This should be undertaken in a local environment conducive to individual error reporting, and in a corporate environment with the will and funding to support the transition.
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http://dx.doi.org/10.1097/00019514-200301000-00009 | DOI Listing |
Stroke
January 2025
Anesthésie et Neuro-Réanimation chirurgicale Babinski, Département d'Anesthésie-Réanimation, Assistance Publique Hôpitaux de Paris (AP-HP), Groupe Hospitalier Pitié-Salpêtrière, Sorbonne Université, France (C.T., R.B., A.J., V.D.).
Background: Mechanical thrombectomy is the treatment of choice for ischemic strokes of the anterior circulation with proximal occlusion. Mechanical thrombectomy can be performed under sedation, which can lead to episodes of periprocedural agitation. The aim of this study is to describe the prevalence of agitation and determine the consequences during and after mechanical thrombectomy.
View Article and Find Full Text PDFEnviron Res
December 2024
Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois Chicago, USA.
Background: Previous studies have demonstrated associations of persistent organic pollutants (POPs) with sex-related hormones; however, findings were inconsistent. Sex-specific impacts and pathways through which adiposity influences associations are not completely understood. We sought to evaluate sex-specific associations of POPs serum concentration with sex-related hormones and to explore pathways through which adiposity may modify associations.
View Article and Find Full Text PDFCardiovasc Drugs Ther
December 2024
AP-HP, Hôpitaux Universitaires Henri-Mondor, Service de Médecine Intensive Réanimation, 94010, Créteil, France.
Purpose: Hypoxemia is a risk factor for mortality and long-term neuropsychological impairment during severe acute respiratory distress syndrome (ARDS). Veno-venous extracorporeal membrane oxygenation (VV-ECMO) is a potential treatment for such cases but may not suffice. We aimed to evaluate the effects of pharmacological interventions for cardiac output (CO) control using ivabradine or beta-blockers for refractory hypoxemia during VV-ECMO.
View Article and Find Full Text PDFKidney Med
January 2025
Division of Rheumatology, Department of Medicine, University of California San Francisco, San Francisco, CA.
Rationale & Objective: Dialysis patient care technicians (PCTs) provide essential, frontline care for patients receiving in-center hemodialysis. We qualitatively explored perceptions of the PCT job role, responsibilities, and training among current PCTs, non-PCT dialysis staff, and patients receiving hemodialysis.
Study Design: Focus group study.
JB JS Open Access
December 2024
Department of Orthopedic Surgery and Sports Medicine, University of Florida, Gainesville, Florida.
Introduction: Private equity (PE) investment in health care has increased more than 250% between 2010 and 2020. This is mirrored by an increasing number of published materials in medical journals. The objective of our study was to identify and characterize trends and key themes seen within publications discussing the topic of PE investment into orthopaedic surgery practices and bias within those publications.
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