Surgical Safety and Hospital Volume Across a Wide Range of Interventions

Eggli, Yves; Halfon, Patricia; Meylan, Danielle; Taffé, Patrick

doi:10.1097/mlr.0b013e3181eaf9f6

Cited by 15 publications

(9 citation statements)

References 40 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The physical and mental condition of the surgeon on a given day is also essential, and a sudden or more insidious fatigue could reduce the surgeon’s vigilance and increase the risk of complications 3738 39 The number of procedures undertaken,40 41 excessive workloads,30 42 or resident intraoperative participation43 have also been suggested to influence surgical outcome. Although technical skills are a prerequisite for successful surgery, collective factors and a surgeon’s leadership are essential for effective teamwork within the operating room 44…”

Section: Discussionmentioning

confidence: 99%

Influence of experience on performance of individual surgeons in thyroid surgery: prospective cross sectional multicentre study

Duclos

Peix

Colin

et al. 2012

BMJ

221

155

View full text Add to dashboard Cite

Objective To determine the association between surgeons’ experience and postoperative complications in thyroid surgery.Design Prospective cross sectional multicentre study.Setting High volume referral centres in five academic hospitals in France.Participants All patients who underwent a thyroidectomy undertaken by every surgeon in these hospitals from 1 April 2008 to 31 December 2009.Main outcome measures Presence of two permanent major complications (recurrent laryngeal nerve palsy or hypoparathyroidism), six months after thyroid surgery. We used mixed effects logistic regression to determine the association between length of experience and postoperative complications. Results 28 surgeons completed 3574 thyroid procedures during a one year period. Overall rates of recurrent laryngeal nerve palsy and hypoparathyroidism were 2.08% (95% confidence interval 1.53% to 2.67%) and 2.69% (2.10% to 3.31%), respectively. In a multivariate analysis, 20 years or more of practice was associated with increased probability of both recurrent laryngeal nerve palsy (odds ratio 3.06 (1.07 to 8.80), P=0.04) and hypoparathyroidism (7.56 (1.79 to 31.99), P=0.01). Surgeons’ performance had a concave association with their length of experience (P=0.036) and age (P=0.035); surgeons aged 35 to 50 years had better outcomes than their younger and older colleagues.Conclusions Optimum individual performance in thyroid surgery cannot be passively achieved or maintained by accumulating experience. Factors contributing to poor performance in very experienced surgeons should be explored further.

show abstract

Section: Discussionmentioning

confidence: 99%

Influence of experience on performance of individual surgeons in thyroid surgery: prospective cross sectional multicentre study

Duclos

Peix

Colin

et al. 2012

BMJ

221

155

View full text Add to dashboard Cite

show abstract

“…For example, it has been noted that for a subset of major operations (eg, cardiac surgery), inpatient mortality risk is lower in high-volume hospitals than in low-volume hospitals [7]. Interestingly, this positive volumeoutcomes relationship may plateau at a certain point and then diminish.…”

Section: Introductionmentioning

confidence: 95%

NSQIP Reveals Significant Incidence of Death Following Discharge

Yu¹,

Chang²,

Osen³

et al. 2011

Journal of Surgical Research

View full text Add to dashboard Cite

“…For procedures of other surgical disciplines, e. g. pancreatectomy, carotid endarterectomy and gastrointestinal cancer surgery, it has been shown that the outcome quality measured by patient reported outcome measures (PROMs) as well as morbidity and mortality rates may vary between surgeons and institutions [187][188][189]. In this context, the so-called volume-outcome-hypothesis is repeatedly discussed on the level of hospitals and single surgeons.…”

Section: Surgical Training/surgeon-specific Factorsmentioning

confidence: 99%

“…For some complex surgical interventions, in particular abdominal, heart and vascular surgery, lower morbidity and mortality rates are seen in hospitals with higher case numbers. To some extent, this observation can no longer be confirmed when differentiating between retrospective and prospective trials, after risk adjustment, and depending on the type of intervention [187,188]. The impact of specialization and the number of cases of a single surgeon on the outcome quality is also discussed.…”

Section: Surgical Training/surgeon-specific Factorsmentioning

confidence: 99%

Qualität in der chirurgischen Therapie chronisch entzündlicher Erkrankungen der Nasennebenhöhlen

Hildenbrand

Ketterer

2020

Laryngo-Rhino-Otol

View full text Add to dashboard Cite

Hildenbrand T et al. Qualität in der chirurgischen … Laryngo-Rhino-Otol 2020; 99: S5-S33 ZusaMMenfassung Die endonasale endoskopische Nasennebenhöhlenchirurgie hat sich als Standard der operativen Therapie bei chronisch entzündlichen Erkrankungen der Nasennebenhöhlen etabliert. Eine Verbesserung der subjektiven Beschwerden und objektiven Befunde konnte in zahlreichen Studien nachgewiesen werden. Aufgrund der häufig beobachteten Diskrepanz zwischen objektiven und subjektiven Ergebnissen nach Nasennebenhöhlenchirurgie kommt der Messung des sog. patient reported outcome eine zunehmende Bedeutung zu. Qualität und Effizienz in der Medizin haben in den letzten Jahren zunehmend an Bedeutung gewonnen. In vielen Ländern und auch länderübergreifend wurden bereits durch Zusammenschluss von Experten, z.T unter Federführung verschiedener Fachgesellschaften, Initiativen zur Verbesserung der Qualität in der chirurgischen Versorgung gegründet.Die vorliegende Arbeit stellt eine Übersicht qualitätsrelevanter Faktoren in der chirurgischen Therapie chronisch entzündlicher Erkrankungen der Nasennebenhöhlen anhand der vorhandenen Literatur, v.a. der Prozess-und Ergebnisqualität, dar. Ein besonderes Augenmerk liegt auf der subjektiven Bewertung der Ergebnisqualität durch den Patienten.absTraCT Endonasal endoscopic surgery of the paranasal sinuses is the gold standard in surgical treatment of chronic inflammatory diseases of the paranasal sinuses. Improvement of subjective complaints and objective findings has been confirmed in numerous studies. Due to the discrepancy between objective and subjective results after paranasal sinus surgery, the assessment of patient reported outcomes has gained importance.Quality and efficiency in medicine became increasingly important during the last years. In many countries and transnationally, the association of experts, partly coordinated by different medical societies, led to initiatives focusing on improvement of the quality of surgical care. The present article represents an overview of quality-related factors in surgical treatment of chronic inflammatory diseases of the paranasal sinuses, summarizing the existing literature and focusing particularly on process and outcomes quality. Particular attention will be paid to the outcome quality individually assessed by the patients. S5Online publiziert: 16.03.2020 Hildenbrand T et al. Qualität in der chirurgischen … Laryngo-Rhino-Otol 2020; 99: S5-S33 Referat < 200 200 -400 Anzahl der Operationen Anzahl der Kliniken in % > 400 57,6 % 38,3 % 36,4 % 12,8 % städtisch/kirchlich/privat Uniklinik Krankenhaus S7 Hildenbrand T et al. Qualität in der chirurgischen … Laryngo-Rhino-Otol 2020; 99: S5-S33 Referat ren < 20 Operationen pro Jahr durch. Zwischen 20 und 50 Operationen werden von 38,4 % der Kliniken durchgeführt und mehr als 50 Operationen geben lediglich 2 % der Kliniken an (▶abb. 2). 83,1 % aller Kliniken gaben an, an einem interdisziplinären Tumorboard teilzunehmen und 68,4 % führen interdisziplinäre Tumoroperationen bei Erkrankungen der Nasennebenhöhle...

show abstract

Surgical Safety and Hospital Volume Across a Wide Range of Interventions

Cited by 15 publications

References 40 publications

Influence of experience on performance of individual surgeons in thyroid surgery: prospective cross sectional multicentre study

Influence of experience on performance of individual surgeons in thyroid surgery: prospective cross sectional multicentre study

NSQIP Reveals Significant Incidence of Death Following Discharge

Qualität in der chirurgischen Therapie chronisch entzündlicher Erkrankungen der Nasennebenhöhlen

Contact Info

Product

Resources

About