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Attending surgeon burnout and satisfaction with the establishment of a regional acute care surgical service.

https://arctichealth.org/en/permalink/ahliterature122040
Source
Can J Surg. 2012 Oct;55(5):312-6
Publication Type
Article
Date
Oct-2012
Author
Ramzi M Helewa
Ramin Kholdebarin
David J Hochman
Author Affiliation
The Department of Surgery, University of Manitoba, Winnipeg, Manitoba, Canada.
Source
Can J Surg. 2012 Oct;55(5):312-6
Date
Oct-2012
Language
English
Publication Type
Article
Keywords
Adult
Burnout, Professional - epidemiology
Cross-Sectional Studies
Female
General Surgery - organization & administration
Humans
Job Satisfaction
Male
Manitoba - epidemiology
Medical Staff, Hospital - psychology - statistics & numerical data
Middle Aged
Questionnaires
Surgery Department, Hospital - organization & administration
Workload
Abstract
Establishment of the Acute Care Surgical Service (ACSS) has dramatically changed the management of acute, nontrauma surgical patients in Winnipeg, Manitoba. Its formation was partially driven by increasing strain on surgeons and surgical services. We sought to determine surgeon level of burnout and satisfaction with the ACSS.
All Winnipeg ACSS surgeons were mailed surveys. Burnout was established using the Maslach Burnout Inventory Human Services Survey. Satisfaction was ascertained with a series of questions.
We attained a response rate of 76%. Most surgeons were married men with children. A burnout level of 61% was determined. Although most surgeons felt the ACSS was a positive change in their careers, they felt that operating room accessibility and teaching opportunities were lacking.
Although a high level of burnout exists among ACSS surgeons, most are satisfied with its establishment. Factors such as operating room accessibility and teaching opportunities must be addressed.
Notes
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PubMed ID
22854111 View in PubMed
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Canadian Pediatric Surgical Network: a population-based pediatric surgery network and database for analyzing surgical birth defects. The first 100 cases of gastroschisis.

https://arctichealth.org/en/permalink/ahliterature159279
Source
J Pediatr Surg. 2008 Jan;43(1):30-4; discussion 34
Publication Type
Article
Date
Jan-2008
Author
Erik D Skarsgard
Jennifer Claydon
Sarah Bouchard
Peter C W Kim
Shoo K Lee
Jean-Martin Laberge
Douglas McMillan
Peter von Dadelszen
Natalie Yanchar
Author Affiliation
Department of Surgery, British Columbia Children's Hospital, University of British Columbia, Vancouver, BC, Canada. eskarsgard@cw.bc.ca
Source
J Pediatr Surg. 2008 Jan;43(1):30-4; discussion 34
Date
Jan-2008
Language
English
Publication Type
Article
Keywords
Abdominal Wall - surgery
Canada - epidemiology
Confidentiality
Congenital Abnormalities - epidemiology - surgery
Database Management Systems
Female
Gastroschisis - epidemiology - surgery
General Surgery - organization & administration
Humans
Incidence
Infant, Newborn
Information Services
Male
Pediatrics - organization & administration
Pregnancy
Prenatal Diagnosis
Risk assessment
Sex Distribution
Survival Rate
Treatment Outcome
Abstract
Outcomes studies for gastroschisis are constrained by small numbers, prolonged accrual, and nonstandardized data collection. The aim of this study is to create a national pediatric surgical network and database for gastroschisis (GS) that tracks cases from diagnosis to hospital discharge.
The 16-center network serves a population of 32 million. Gastroschisis cases are ascertained at prenatal diagnosis. Perinatal data include maternal risk and fetal ultrasound variables, delivery plan and outcome, a postnatal bowel injury score, intended and actual surgical treatment, and neonatal outcomes. Institutional review board-approved data collection conforms to regional privacy legislation. Deidentified data are centralized and accessible for research through the network steering committee.
To date, 114 cases of pre- and/or postnatal gastroschisis have been uploaded. Of 106 live-born infants (40 [38%] by cesarean delivery), 100 had complete records, and overall survival to discharge was 96%, with a mean survivor length of stay (LOS) of 46 days. Infants treated with attempted urgent closure (61%) had significantly shorter LOS (42 vs 57 days; P = .048) but comparable LOS compared with those treated with silos and delayed closure. Fetal bowel dilation 18 mm or greater did not predict a difference in outcome.
Population-based databases allow rapid case accrual and enable studies that should aid in the identification of optimal perinatal treatment.
PubMed ID
18206451 View in PubMed
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[Consequences for nephrology following reorganization of surgery].

https://arctichealth.org/en/permalink/ahliterature176652
Source
Tidsskr Nor Laegeforen. 2005 Jan 6;125(1):52-3
Publication Type
Article
Date
Jan-6-2005

Delivery models of rural surgical services in British Columbia (1996-2005): are general practitioner-surgeons still part of the picture?

https://arctichealth.org/en/permalink/ahliterature155820
Source
Can J Surg. 2008 Jun;51(3):173-8
Publication Type
Article
Date
Jun-2008
Author
Nancy Humber
Temma Frecker
Author Affiliation
Department of Family Practice (Research Division), University of British Columbia, Vancouver, BC. Saffron2@telus.net
Source
Can J Surg. 2008 Jun;51(3):173-8
Date
Jun-2008
Language
English
Publication Type
Article
Keywords
Appendectomy - statistics & numerical data
British Columbia
Delivery of Health Care - manpower - organization & administration
Emergency Medical Services - statistics & numerical data
Family Practice - organization & administration
Foreign Medical Graduates
General Surgery - organization & administration
Humans
Maternal Health Services - statistics & numerical data
Outcome Assessment (Health Care)
Physician's Practice Patterns - statistics & numerical data
Physician's Role
Referral and Consultation - statistics & numerical data
Retrospective Studies
Rural Health Services - manpower - organization & administration
Surgical Procedures, Operative - statistics & numerical data
Abstract
To define the models of surgical service delivery in rural communities that rely solely on general practitioner (GP)-surgeons for emergency care, to examine how they have changed over the past decade and to identify some effects on communities that have lost their local surgical program.
We undertook a retrospective study using the Population Utilization Rates and Referrals For Easy Comparative Tables database (versions 6.0 and 9.0) and telephone interviews to hospitals that we identified. We included all hospitals in rural British Columbia with surgical programs that had no resident specialist surgeon and that relied on general practitioner-surgeons (GP-surgeons) for emergency surgical care. We examined surgical program characteristics, community size, distance from referral centre, role of itinerant surgery, where GPs were trained, their age and years of experience and referral rates for appendectomies and obstetrics.
Changes over the past decade include a decrease in the total number of GP-surgeons operating in these communities, more itinerant surgery and the loss of 3 of 12 programs. GP-surgeons are older, are usually foreign-trained and have more than 5 years of experience. Communities with no local program or that rely on solo practitioners refer more emergencies out of the community and do less maternity care than those with more than a single GP-surgeon.
GP-surgeons still play an integral role in the provision of emergency and elective surgical services in rural communities without the population base to sustain resident specialist surgeons. As GP-surgeons retire and surgical programs close, there is no accredited training program to replace them. More outcome comparisons between procedures performed by GP-surgeons and general surgeons are needed, as is the creation of a nationally accredited training program to replace these practitioners as they retire.
Notes
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PubMed ID
18682795 View in PubMed
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[Development of pediatric surgery in Leningrad-Saint Petersburg].

https://arctichealth.org/en/permalink/ahliterature205349
Source
Vestn Ross Akad Med Nauk. 1998;(4):47-50
Publication Type
Article
Date
1998

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

https://arctichealth.org/en/permalink/ahliterature159245
Source
Arch Surg. 2008 Jan;143(1):12-7; discussion 18
Publication Type
Article
Date
Jan-2008
Author
Lorelei Lingard
Glenn Regehr
Beverley Orser
Richard Reznick
G Ross Baker
Diane Doran
Sherry Espin
John Bohnen
Sarah Whyte
Author Affiliation
University of Toronto, 200 Elizabeth St, Eaton South 1-565, Toronto ON M5G 2C4, Canada. lorelei.lingard@utoronto.ca
Source
Arch Surg. 2008 Jan;143(1):12-7; discussion 18
Date
Jan-2008
Language
English
Publication Type
Article
Keywords
Adult
Anesthesiology - organization & administration
Communication
Evaluation Studies as Topic
Female
General Surgery - organization & administration
Health Services Research
Hospitals, Teaching
Humans
Interprofessional Relations
Male
Middle Aged
Nursing, Team - organization & administration
Odds Ratio
Ontario
Operating Rooms
Patient Care Team - organization & administration
Probability
Prospective Studies
Safety Management - organization & administration
Total Quality Management
Abstract
To assess whether structured team briefings improve operating room communication.
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. Participants included 11 general surgeons, 24 surgical trainees, 41 operating room nurses, 28 anesthesiologists, and 24 anesthesia trainees.
Surgeons, nurses, and anesthesiologists gathered before 302 patient procedures for a short team briefing structured by a checklist. Main Outcome Measure The primary outcome measure was the number of communication failures (late, inaccurate, unresolved, or exclusive communication) per procedure. Communication failures and their consequences were documented by 1 of 4 trained observers using a validated observational scale. Secondary outcomes were the number of checklist briefings that demonstrated "utility" (an effect on the knowledge or actions of the team) and participants' perceptions of the briefing experience.
One hundred seventy-two procedures were observed (86 preintervention, 86 postintervention). The mean (SD) number of communication failures per procedure declined from 3.95 (3.20) before the intervention to 1.31 (1.53) after the intervention (P
Notes
Comment In: Arch Surg. 2008 Oct;143(10):1023-4; author reply 102418936388
PubMed ID
18209148 View in PubMed
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[Experience in organizing surgical care during the combat operations in the Chechen Republic].

https://arctichealth.org/en/permalink/ahliterature208242
Source
Voen Med Zh. 1997 Jun;318(6):4-12, 80
Publication Type
Article
Date
Jun-1997
Author
P G Briusov
V I Khrupkin
Source
Voen Med Zh. 1997 Jun;318(6):4-12, 80
Date
Jun-1997
Language
Russian
Publication Type
Article
Keywords
General Surgery - organization & administration
Humans
Military Medicine - organization & administration
Military Personnel
Multiple Trauma - surgery
Russia
Transportation of Patients - organization & administration
Triage - organization & administration
War
Wounds, Gunshot - surgery
Abstract
In the article the final analysis of organization of surgical care during the local military conflict in northern Caucasus was presented. The real possibilities of different medical units such as single medical company and medical squadron of special assignment was described. Also concrete contents of emergency specialized surgical care and its role in improvement of outcomes in patients with combined combat injuries was reflected. Mortality in this patients was decreased from 25.2 to 12.8%. The defects of surgical care were analyzed and the main ways of improvement of surgical care in local military conflict were presented. In the result of using the principle of moving the medical care closer to the wounded in the whole system of consecutive care the mortality was decreased up to 1.3%.
PubMed ID
9412060 View in PubMed
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36 records – page 1 of 4.