Laboratory Management

Cibas, Edmund S.

doi:10.1016/b978-1-4557-4462-6.00018-0

Cited by 4 publications

(1 citation statement)

References 42 publications

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“…Those who underwent autologous breast reconstruction with an abdominally based flap and intraoperative TAP block were identified using common procedural terminology (CPT) and Healthcare Common Procedure Coding System (HCPCS) codes (Appendix Table 5). The utilization of both of the CPT and HCPCS coding systems, managed by the American Medical Association (AMA) and the Centers for Medicare and Medicaid Services (CMS), respectively, ensured maximal inclusion of the desired patient population [18]. Morphine milligram equivalents (MME) were calculated for perioperative prescriptions which were filled between 30 days prior to and 30 days after surgery.…”

Section: Data Source and Study Cohortmentioning

confidence: 99%

Transversus abdominus plane blocks do not reduce rates of postoperative prolonged opioid use following abdominally based autologous breast reconstruction: a nationwide longitudinal analysis

et al. 2022

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Background The transversus abdominus plane (TAP) block reduces postoperative donor site pain in patients undergoing autologous breast reconstruction with an abdominally based flap. This study aimed to determine the effect of TAP blocks on rates of conversion to chronic opioid use. Methods The Clinformatics Data Mart was queried from 2003 to 2019, extracting adult encounters for abdominally based free and pedicled flaps based on common procedural terminology (CPT) codes. Patients were excluded if they had filled a narcotic prescription 1 year to 30 days prior to surgery. The exposure variable—TAP block—was identified by CPT codes. Outcomes were evaluated using morphine milligram equivalents (MME) from prescriptions filled between 30 days prior to and 30 days after surgery. Chronic opioid use (COU) was defined as receiving 4 unique prescriptions or a 60-day supply between 30 and 180 days after surgery. Results Of the 4091 patients, (mean age 51.2 ± 9.0 years), 181 (4.4%) had a TAP block placed. Perioperative MMEs/day, postoperative COU, and length of stay did not differ in patients who received a TAP block (p = 0.142; p = 0.271). Significant predictors of risk of conversion to COU included younger age, pedicled abdominal flap, Elixhauser comorbidity index score > 3, filling a psychiatric medication prescription, and filling a benzodiazepine prescription. Conclusions In patients undergoing autologous breast reconstruction with abdominally based flap reconstruction, TAP blocks do not decrease perioperative MME/day, conversion to chronic opioid use, or length of stay. These data suggest that intraoperative TAP block placement may be a low-yield opioid-reduction strategy. Level of evidence: Level III, risk/prognostic study

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Section: Data Source and Study Cohortmentioning

confidence: 99%

Transversus abdominus plane blocks do not reduce rates of postoperative prolonged opioid use following abdominally based autologous breast reconstruction: a nationwide longitudinal analysis

et al. 2022

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Quality Assurance in Cytology

Pantanowitz¹

2020

Veterinary Cytology

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Teaching laboratory management and quality assurance/quality improvement skills in a cytopathology fellowship program

Fan

2017

Cancer Cytopathology

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and serves as the Barbara F. Atkinson, MD Endowed Professor of Pathology. Her book Cytopathology Review, which she co-wrote with Ivan Damjanov, is in its second edition and contains a chapter regarding questions on the management of cytopathology laboratories. Dr. Fan also is a coauthor of a chapter in the newly published book Quality Management in Anatomic Pathology, published by College of American Pathologists Press. Dr. Fan currently serves on the Cytopathology Committee of the College of American Pathologists.Teaching Laboratory Management and Quality Assurance/Quality Improvement Skills in a Cytopathology Fellowship Program Cytopathology laboratories are highly regulated, with many policies, procedures, and quality monitors. One important aspect of cytopathology fellowship training is training in laboratory management and quality assurance/quality improvement (QA/QI) skills. Laboratory management is one of the competencies listed in the cytopathology milestones developed by the Accreditation Council for Graduate Medical Education (ACGME) under Systems-Based Practice (SBP) in the evaluation of cytopathology fellows. 1 Following the descriptors and targets under SBP items 1 through 5 in the milestones, we have developed and implemented the following teaching and evaluation methods for cytopathology fellows.

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Laboratory Management

Cited by 4 publications

References 42 publications

Transversus abdominus plane blocks do not reduce rates of postoperative prolonged opioid use following abdominally based autologous breast reconstruction: a nationwide longitudinal analysis

Transversus abdominus plane blocks do not reduce rates of postoperative prolonged opioid use following abdominally based autologous breast reconstruction: a nationwide longitudinal analysis

Quality Assurance in Cytology

Teaching laboratory management and quality assurance/quality improvement skills in a cytopathology fellowship program

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