A talk by Anna Cedborg at the 2017 meeting of the Scandinavian Society of Anaestesiology and Intensive Care Medicine. All available content from SSAI2017: https://scanfoam.org/ssai2017/ Content delivered in collaboration between scanFOAM, SSAI & SFAI.

1. Perioperative Medicine
saves lives
- what are we doing to
inspire and implement change?
Anna Hårdemark Cedborg, M.D. Ph.D.
Chair of steering committee for PoMM, i.e.
Perioperative Medicine and Management
REMEO Stockholm, Medical Director
SSAI-congress, Sweden, Malmö, September 6th 2017

2. The challege of implementing
clinical guidelines,
a science of its own
2017-11-01 Anna Hårdemark Cedborg

3. Where should we focus our
efforts to implement change
the most?
2017-11-01 Anna Hårdemark Cedborg
1
24
3

4. The GAP from knowledge to implementation
2017-11-01 Anna Hårdemark Cedborg
Research
Clinical guidelines
Evidence
Local routines
Change in
clinical practiceNumber
of
people
involved
Education
Time from
new knowledge
to Implementation

5. Do we have the right tools to inspire
and effeciently implement change?
2017-11-01 Anna Hårdemark Cedborg
• Support from leaders and management
• Resitstance and sceptisism from staff
• Hesitance to invest time and money
• Shortage of resources locally
• Waning interest
• Uncertain roles etc…..
• Un-learning previous learnings
Gupta et al, Impl Sci, 2017; Pexton, 2016;

6. 2017-11-01 Anna Hårdemark Cedborg
Perioperative
Medicine and Management
PoMMPerioperative Management & Medicine
Focus on
- the medical part of management and how leading the operating room
can improve quality , productivity and cost effectiveness
- evidence based perioperative medicine and how increased knowledge
and implementation can improve patient safety and outcome through
the pre-, intra- and postoperative period.

7. Director of Perioperative
Medicine and Management
2017-11-01 Anna Hårdemark Cedborg
Responsibilities
• Evaluating relevant evidence in perioperative medicine
• Analyzing flows and processes of the perioperative period
• Leading the intraoperative team
• Managing of the perioperative process, including
implementing changes
• Measuring and evaluating quality and outcome

8. 2017-11-01 Anna Hårdemark Cedborg
Medicine and/or Management?
Management: I know how to do it but not what or why.
Medicine: I know what should be done but not how to
do it.
Combined: I know what to do and how!

9. Perioperative
Medicine and Management
trainee centered and goal directed
We dig where we stand in own workplace
5 Course weeks
in
Nordic countries
Exchange
of
experience
Auscultation
”Good
examples”Portfolio
Project of the program
A) Literature review in Perioperative Medicine
B) Patient pathway analysis
C) Implementation project

10. Educational strategies
2017-11-01 Anna Hårdemark Cedborg
Personal Mentor
Portfolio including a
Diary, reflecting on learning
Literature review
Academic supervisor
Presentations using IT-solutions
Presentations at SSAI meetings
Patient flow analysis
Project
Project supervisor
Auscultations (5 days total)
Course-weeks
Discussions, prepared pro-con debates, role-playing, games etc.
IDI
Group tasks
Homework

11. 2017-11-01 Anna Hårdemark Cedborg
Course weeks
No other mandatory time away from home clinic
Total 10 weeks off clinical work (minimum)

12. Patient flow analysis,
relations diagram
2017-11-01 Anna Hårdemark Cedborg

13. Personal commitment and
enthusiasm are required,
how else will you aspire to inspire?
• First course finished Autumn 2016, all 18 passed.
• Second course started Spring 2017, 24 participants
• Third course planned Autumn 2019, will you apply?!
2017-11-01 Anna Hårdemark Cedborg