The Impact of a Medical Procedure Service on Patient Safety, Procedure Quality and Resident Training Opportunities

Tukey, Melissa H.; Wiener, Renda Soylemez

doi:10.1007/s11606-013-2709-5

Cited by 34 publications

(79 citation statements)

References 23 publications

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“…The better a facility’s service is and the greater its reputation, the more patients were willing to receive medical treatment there. Improvement of the quality of medical service remains the core part of a hospital’s development, which may be further facilitated by better medical equipment 35,36. Only through expanding a hospital’s medical treatment capabilities, can more people actually be cured and be more satisfied with their medical experience, thereby attracting more patients to visit.…”

Section: Discussionmentioning

confidence: 99%

Factors affecting patient satisfaction with ecdemic medical care: a cross-sectional study in Nanchang, China

Liu

Lu²,

Wang³

et al. 2018

PPA

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PurposeThis study aimed to determine the factors that influence patient satisfaction with ecdemic medical care.Materials and methodsEight hundred and forty-four face-to-face interviews were conducted between October and November 2017 in two high-profile hospitals in Nanchang, China. Patient satisfaction was divided into lowest and highest satisfaction groups according the 80/20 rule. Demographic factors associated with patient satisfaction were identified by logistic regression models.ResultsRespondents’ main reasons for choosing a non-local hospital were “high level of medical treatment” (581/844), “good reputation of the hospital” (533/844), and “advanced medical equipment” (417/844). The top three items that dissatisfied the ecdemic patients were “long time to wait for treatment” (553/844), “complicated formalities” (307/844), and “poor overall service attitude” (288/844). Fewer female patients (adjusted odds ratio [AOR] =1.47, 95% confidence interval [CI] =1.03–2.11), patients with a family per-capita monthly income (FPMI) between 3,001 and 5,000 CNY (AOR =1.40, 95% CI =1.01–2.17), inpatients (AOR =1.46, 95% CI =1.01–2.13), and more patients with an FPMI >7,000 CNY (AOR =0.43, 95% CI =0.20–0.92) were detected in the lowest satisfaction group. Fewer patients with an associate’s or bachelor’s degree (AOR =2.40, 95% CI =1.37–4.20) and patients with an FPMI >7,000 CNY (AOR =3.02, 95% CI =1.10–8.33) were detected in the highest satisfaction group. Moreover, more inpatients (AOR =0.70, 95% CI =0.54–0.97) and those aged 46–65 years (AOR =0.63, 95% CI =0.33–0.98) were detected in the highest satisfaction group.ConclusionFindings suggested that managers of the medical facilities should note the importance of increasing their publicity through a rapidly developing media, as well as the necessity of creating a more patient-friendly medical care experience. Hospitals should also focus on the medical care experience of patients with relatively lower and higher income levels, male ecdemic patients, and ecdemic outpatients.

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Section: Discussionmentioning

confidence: 99%

Factors affecting patient satisfaction with ecdemic medical care: a cross-sectional study in Nanchang, China

Liu

Lu²,

Wang³

et al. 2018

PPA

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“…Procedure service teams are another option that provide timely and safe access to common procedures and have been shown to be effective solutions to the presented problem. 20 Interventional radiology is an attractive solution because it centralizes procedures in well-equipped suites with a full complement of imaging technologies (such as ultrasound, CT scan, and fluoroscopy) but has the disadvantage of shifting procedures away from clinical teams. Additionally, because procedures performed by interventionalists are more costly, having them as a backup option may be unsustainable.…”

Section: Future Directionsmentioning

confidence: 99%

Procedural Competence Among Faculty in Academic Health Centers: Challenges and Future Directions

Vaisman

Cram

2017

Academic Medicine

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Increasingly, faculty are taking on more direct responsibilities in patient care due to reductions in resident work hours, increasing admissions, and an endless push for efficiency. Furthermore, the rise of different career tracks in academia (i.e., patient care, research, education, or administration) and a drive for efficiency and subspecialization have placed additional strains on academic health centers. Combined, these factors have led to faculty increasingly being placed in the position of supervising bedside procedures that they may have not performed in years or with tools they have never trained with at all. Despite these challenges, procedural retraining for faculty remains non-standardized across most academic health centers. The resulting lack of procedural competence among faculty creates a number of challenges for the different parties involved. In this Perspective, the authors discuss the nature of the current problem of faculty procedural competence and the challenges it poses for faculty and academic health centers, medicolegal ramifications, and the challenges it poses to the faculty-trainee relationship. The authors then suggest several strategies to delineate and resolve this problem. To delineate the problem, they suggest single-center surveys to address the current paucity of data. To resolve the problem, they suggest the consideration of some modest, low-cost interventions such as having backup systems in place for procedure supervision (e.g., procedural service teams or interventional radiologists) and providing faculty with opportunities to retrain.

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“…Using the proper technique for the procedure, a portion of these complications can be avoided. 1,5,6 Infectious complications (especially catheter-relat-ed bloodstream infection), however, besides being potentially serious, are classically associated with high morbidity and mortality and high hospital costs. 7 The puncture site is one of the determinants of complications, so that pneumothorax is more common in subclavian approaches, whereas arterial puncture is more common for the femoral and jugular veins.…”

Section: Introductionmentioning

confidence: 99%

Complications of central venous catheter insertion in a teaching hospital

Comerlato

Rebelatto

Almeida

et al. 2017

Rev. Assoc. Med. Bras.

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Introduction: Central venous catheters are fundamental to daily clinical practice. This procedure is mainly performed by residents, often without supervision or structured training. Objective: To describe the characteristics of central venous catheterization and the complication rate related to it. Method: Retrospective cohort study. Adult patients undergoing central venous catheter insertion out of the intensive care unit (ICU) of a teaching hospital were selected from March 2014 to February 2015. Data were collected from medical charts using an electronic form. Clinical and laboratory characteristics from patients, procedure characteristics, and mechanical and infectious complications rates were assessed. Patients with and without complications were compared. Results: Three hundred and eleven (311) central venous catheterizations were evaluated. The main reasons to perform the procedure were lack of peripheral access, chemotherapy and sepsis. There were 20 mechanical complications (6% of procedures). Arterial puncture was the most common. Procedures performed in the second semester were associated with lower risk of complications (odds ratio 0.35 [95CI 0.12-0.98; p=0.037]). Thirty-five (35) catheter-related infection cases (11.1%) were reported. They were related to younger patients and procedures performed by residents with more than one year of training. Procedures performed after the first trimester had a lower chance of infection. Conclusion: These results show that the rate of mechanical complications of central venous puncture in our hospital is similar to the literature, but more attention should be given to infection prevention measures.

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The Impact of a Medical Procedure Service on Patient Safety, Procedure Quality and Resident Training Opportunities

Cited by 34 publications

References 23 publications

Factors affecting patient satisfaction with ecdemic medical care: a cross-sectional study in Nanchang, China

Factors affecting patient satisfaction with ecdemic medical care: a cross-sectional study in Nanchang, China

Procedural Competence Among Faculty in Academic Health Centers: Challenges and Future Directions

Complications of central venous catheter insertion in a teaching hospital

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