Analysis of endotracheal intubation-related judicial precedents in South Korea

Cho, Hye Yeon; Shin, Seung Young; Lee, Sang-Jin; Yoon, Seo-Yeon; Lee, Ho-Jin

doi:10.4097/kja.21020

Cited by 7 publications

(14 citation statements)

References 31 publications

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“…Additionally, a closed claim analysis in Korea showed that 58.7% of cases of airway-related malpractice lawsuits were from nonperioperative areas and that 81% of cases resulted in payments for the claims. 13 Anesthesiologists and anesthesia groups take on a significant liability risk by responding to airway pages and in serving as the immediately available, on-location hospital airway experts.…”

Section: Discussionmentioning

confidence: 99%

Understanding the Economic Impact of an Essential Service: Applying Time-Driven Activity-Based Costing to the Hospital Airway Response Team

Stone

Dasani

Grant

et al. 2022

Anesthesia &Amp; Analgesia

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BACKGROUND: As the United States moves toward value-based care metrics, it will become essential for anesthesia groups nationwide to understand the costs of their services. Time-driven activity-based costing (TDABC) estimates the amount of time it takes to perform a clinical activity by dividing complex tasks into process steps and mapping each step and has historically been used to estimate the costs of various health care services. TDABC is a tool that can be adapted for variable staffing models and the volume of service provided. Anesthesia departments often provide staffing for airway response teams (ART). The economic implications of staffing ART have not been well described. We present a TDABC model for ART activation in a tertiary-care center to estimate the cost incurred by an anesthesiology department to staff an ART. METHODS: Pages received by the Brigham and Women’s Hospital ART over a 24-month time period (January 2019 to December 2020) were analyzed and categorized. The local administrative database was queried for the Current Procedural Terminology (CPT) code used to bill for emergency airway placements. Sessions were held by multiple members of the ART to create process maps for the different types of ART activations. We estimated the staffing costs using the estimated time it took for each type of ART activation as well as the data collected for local ART activations. RESULTS: From the paging records, we analyzed 3368 activations of the ART. During the study period, 1044 airways were billed for with emergency airway CPT code. The average revenue collected per airway was $198.45 (95% CI, $190–$207). For STAT/Emergency airway team activations, process maps and non-STAT airway team activations were created, and third subprocess map was created for performing endotracheal intubation. Using the TDABC, the total staffing costs are estimated to be $218,601 for the 2-year study period. The ART generated $207,181 in revenue during the study period. CONCLUSIONS: Our analysis of ART-activation pages suggests that while the revenue generated may cover the cost of staffing the team during ART activations, it does not cover consumable equipment costs. Additionally, the current fee-for-service model relies on the team being able to perform other clinical duties in addition to covering the airway pager and would be impossible to capture using traditional top-down costing methods. By using TDABC, anesthesia groups can demonstrate how certain services, such as ART, are not fully covered by current reimbursement models and how to negotiate for subsidy agreements. As the transition from traditional fee-for-service payments to value-based care models continues in the United States, improving the understanding and communication of medical care costs will be essential. In the United States, it is common for anesthesia groups to receive direct revenue from hospitals to preserve financial viability, and therefore, knowledge of true cost is essential regardless of payer model.1 With traditional payment models, what ...

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Section: Discussionmentioning

confidence: 99%

Understanding the Economic Impact of an Essential Service: Applying Time-Driven Activity-Based Costing to the Hospital Airway Response Team

Stone

Dasani

Grant

et al. 2022

Anesthesia &Amp; Analgesia

View full text Add to dashboard Cite

show abstract

“…This study updated the data regarding critical incidents associated with pediatric anesthesia at a single tertiary teaching children's hospital in 2014-2019, and compared it 12) Pharmacological (n = 1) Medication error 0 (0) 1 (4) 1 (4) Cardiogenic shock (1) Total cardiac arrest (n = 25) 7 (28) 18 (72) 25 (100) Values are presented as number (%). PALS: pediatric advanced life support.…”

Section: Discussionmentioning

confidence: 99%

“…Second, education program should be further strengthened, especially at the beginning of each training year. Bringing attention to frequently occurring accidents as well as recognizing of complications will reduce the chances of the same events occurring again [ 18 ]. Third, it is also important to maintain constant resources and interest in what is well maintained in terms of quality management.…”

Section: Discussionmentioning

confidence: 99%

Critical incidents associated with pediatric anesthesia: changes over 6 years at a tertiary children’s hospital

Cho

Lee

et al. 2022

Anesth Pain Med

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Background: Sustained interest is needed in the characteristics of critical incidents in pediatric anesthesia and related changes, for determining the causes and degree of potential harm; this will also improve the quality of medical care. This study aimed to analyze the incidence of critical incidents recorded in 2014–2019, and to compare them with those in 2008–2013.Methods: Critical incidents associated with pediatric anesthesia, including cardiac arrest, recorded in a voluntary departmental reporting system between January 2014 and December 2019 were compared with those reported between January 2008 and August 2013 using chi-square test. Results: We identified 295 (0.55%) critical incidents from 53,541 cases of pediatric anesthesia (3,471 cardiothoracic surgeries); this is consistent with the previously reported incidence of 0.46%. Among the critical incidents, the incidences of adverse events, sentinel event, near miss case and no-harm events were 93.9%, 1.7%, 0%, and 6.1% in 2014–2019, whereas those were 98.3%, 2.6%, 1.7%, and 0% in 2008–2013 (P = 0.023, 0.686, 0.08, and < 0.001, respectively). Cardiac arrest accounted for 25 (8.5%) cases of the 295 critical events, which significantly lower than that previously reported (18.3%; P = 0.02). Human factor-related events accounted for 61.0% of all critical incidences; this was similar to the previous data (58.5%). Conclusions: Over six years, there has been no significant difference in the total incidence of critical events. Despite the decrease in the incidence of serious critical events, perioperative care in pediatric anesthesia can be further improved.

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“…Because this study was performed to analyze HICS effectiveness via actual measurements, it focused on an area in which HICS had been applied. The study area was located in Jangyu Mugye-dong, Gimhae-si, Gyeongsangnam-do, where the Ministry of Environment of the Republic of Korea has implemented a project to prevent heatwaves as a climate change adaptation measure [37]. Trees and vegetation, green roofs, cool pavements, and cool roofs have been established in the region as HICS.…”

Section: Study Area and Analysis Targetsmentioning

confidence: 99%

Comparative Analysis of Urban Heat Island Cooling Strategies According to Spatial and Temporal Conditions Using Unmanned Aerial Vehicles(UAV) Observation

Cho,

Yoon,

Lee

2023

Applied Sciences

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Heat island cooling strategies (HICSs) are used to mitigate urban heat island phenomena and adapt to climate change as proposed by the U.S. Environmental Protection Agency (EPA), the Intergovernmental Panel on Climate Change (IPCC), and the World Health Organization (WHO). This study investigated urban heat island reduction and assessed the cooling effect of HICSs under various temporal and spatial conditions in urban areas. The study area was the Mugye-dong urban area in South Korea. To identify the effectiveness of heat island cooling strategies (HICSs), unmanned aerial vehicle (UAV)-based remote sensing and microclimate sensors were used to generate land cover, sky view factor (SVF) distribution, and land surface temperature (LST) maps of the study area. Differences in cooling effect according to spatial density (SD) were identified by dividing the SVF into five intervals of 0.2. Temporal changes were investigated throughout the day and under cloudiness-based meteorological conditions affected by solar radiation or less affected by solar radiation. Lower SD was associated with a greater cooling effect; meteorological conditions affected by solar radiation had a stronger cooling effect. The variation of the daytime cooling effect increased with decreasing SD. The difference in cooling effect between morning and afternoon was <1 °C under conditions less affected by solar radiation. Under conditions affected by solar radiation, the maximum temperatures were −6.716 °C in urban green spaces and −4.292 °C in shadow zones, whereas the maximum temperature was −6.814 °C in ground-based albedo modification zones; thus, differences were greater under conditions affected by solar radiation than under conditions less affected by solar radiation. As a result, it was found that HICS show a high cooling effect, high diurnal variation, and high morning-afternoon deviation under weather conditions with low SD and under conditions affected by solar radiation. This study quantitatively calculated the cooling effect of HICSs applied in urban areas under various spatiotemporal conditions and compared differences by technology. Accordingly, it is believed that it will serve as a basis for supporting the practical effects of the concepts presented by international organizations for climate change adaptation.

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Analysis of endotracheal intubation-related judicial precedents in South Korea

Abstract: This article has been accepted for publication and has undergone full peer review but has notbeen through the copyediting, typesetting, pagination, and proofreading processes, which may lead to differences between this version and the version of record.

Cited by 7 publications

References 31 publications

Understanding the Economic Impact of an Essential Service: Applying Time-Driven Activity-Based Costing to the Hospital Airway Response Team

Understanding the Economic Impact of an Essential Service: Applying Time-Driven Activity-Based Costing to the Hospital Airway Response Team

Critical incidents associated with pediatric anesthesia: changes over 6 years at a tertiary children’s hospital

Comparative Analysis of Urban Heat Island Cooling Strategies According to Spatial and Temporal Conditions Using Unmanned Aerial Vehicles(UAV) Observation

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