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Transitions From Hospital to Home
Worldwide more than 200 million surgeries are performed each year; in the United States more than 50 million inpatient procedures occur annually. In 2009, the World Health Organization demonstrated that implementation of a relatively simple day-of-surgery checklist was associated with…
Delivering Value Based Care: The UK Perspective
Introduction: Rising Demand and Resource Constraint One of the few constants throughout health-care is an inexorable rise in demand. This rise has been ongoing for many years and is driven by several factors. Across the decades, as health-care has advanced,…
Improving Health-Care Quality Through Measurement
“Wherever we see systematic measurement of results in health-care–no matter what the country–we see those results improve.” Michael E. Porter, Harvard Business Review (October 2013) Extensive evidence exists demonstrating that health-care is plagued with overutilization of inappropriate services, underutilization of…
Economic Analysis of Perioperative Optimization
The goal of this chapter is to make the following points: 1. Taxpayers, employers, and employees demand that medicine deliver better value. Physicians need evidence-based medicine to establish which interventions are truly beneficial and modern management techniques to implement those…
Role of Palliative Care
Defining Palliative Care Palliative care is defined by the World Health Organization as “an approach that improves the quality of life of patients and their families facing the problem associated with life-threatening illness, through the prevention and relief of suffering…
Postoperative Cognitive Dysfunction and Delirium
Introduction Since the inception of anesthesia changed and expanded surgery, some patients have experienced changes in cognitive function postoperatively. Elderly patients are at higher risk of these changes in neurocognitive function, probably because of reduced cognitive reserve and increased cerebral…
Improving Pain and Outcomes in the Perioperative Setting
The Growth of Unidimensional Pain Assessment Tools A subjective and personal experience, pain remains difficult to quantify within the confines of empirically based medical tradition. Regardless of this challenge, however, management still necessitates accurate and timely assessment, particularly in the…
Endocrine and Electrolyte Disorders
Introduction Perioperative electrolyte and endocrine disorders are dealt with by anesthesiologists on a daily basis. With the rising incidence of diabetes and obesity and their relation to increased morbidity in the perioperative period, it is imperative that clinicians are skilled…
Acute Respiratory Failure
Definition Respiratory failure occurs when the lungs fail to oxygenate the arterial blood adequately and/or fail to prevent carbon dioxide retention. Although the definition does not contain any absolute values, an arterial O 2 of less than 60 mmHg and…