The document outlines the process for managing a surgical patient, including clinical and paraclinical diagnosis, treatment selection and implementation, and follow-up. It discusses establishing rapport with the patient, performing a clinical exam to arrive at a diagnosis, determining when paraclinical exams are needed, selecting and interpreting their results to determine a pretreatment diagnosis, choosing among treatment options, preoperative preparation for surgery, the phases of surgery, postoperative care, and follow-up objectives. The overall goals are resolving the health problem safely and satisfying the patient.
Management of a Patient (All Types) - ROJosonReynaldo Joson
The document outlines the processes involved in managing a patient, whether surgical or nonsurgical. It discusses establishing rapport with the patient, performing a clinical diagnosis using pattern recognition and prevalence, determining when paraclinical diagnostic procedures are needed based on certainty of diagnosis and treatment plan, selecting and interpreting paraclinical tests, and choosing treatment modalities based on factors like effectiveness, risk and cost. For surgical patients specifically, it mentions preoperative preparation, intraoperative management phases, and postoperative care items. The overall goal is resolving the health problem while avoiding complications, disability, and legal issues.
Application of Management Principles in the Management of a Patient - ROJosonReynaldo Joson
This document outlines the application of management principles in managing a patient. It discusses establishing overall goals and strategies when a patient first consults, such as resolving their health issue without harm. It describes formulating a clinical diagnosis through interview and exam. The need for further testing is determined by diagnosis certainty and treatment plans. If needed, the most cost-effective test is selected. Finally, treatment options are considered based on benefit, risk, cost and availability to choose the most cost-effective option. The document provides examples of applying each step of the management process rationally.
ROJOSON-PEP-TALK: Pt Mgt Process – Paraclinical Diagnostic Process (Talk – Ju...Reynaldo Joson
This presentation provides an overview of the paraclinical diagnostic process as part of the patient management process. It explains that paraclinical diagnosis is done after clinical diagnosis to make the diagnosis more definite. It discusses how the physician determines if paraclinical diagnosis is needed based on certainty of clinical diagnosis and differences in treatment plans. It also covers selecting the most appropriate paraclinical procedure, interpreting the results, and advising the patient. The overall aim is to empower patients by increasing understanding of this medical process.
This PPT is mainly oriented to the Final yr MBBS students who are preparing for their Final exams. The Audit cycle has taken up from Bailey & Love - 24th edition.
This document is a checklist used to assess standards and measurable elements for inpatient care at a healthcare facility. It covers areas like scope of service, patient safety goals, assessment of patients, patient and family education, and patient and family rights. For each standard, staff are asked questions to determine if the element is met, not met, not applicable, or not tested. Remarks can also be included. The goal is to evaluate areas like patient identification, communication, safety of medications, infection control, fall risk reduction, documentation, consent processes, privacy and more.
Surgical audit is a process that systematically analyzes surgical care quality against standards to improve patient outcomes. It involves collecting data on parameters like mortality, complications and outcomes and comparing results to peers to identify areas for improvement. The goal is continuous quality improvement through a non-punitive, educational process. Surgical audit has existed for centuries but modern methods began in the early 1900s and involve retrospective review of existing data to guide practice changes.
ROJOSON-PEP-TALK: Pt Mgt Process – Clinical Diagnostic Process (Pre-session R...Reynaldo Joson
The document discusses the clinical diagnostic process that physicians use to diagnose patients. It begins with the goals of resolving health problems without death, complications, or disability while satisfying patients. Physicians establish rapport, diagnose using pattern recognition and prevalence, treat, and provide advice. Diagnoses are made by identifying the involved organ and general/specific disease. The outputs are primary and secondary diagnoses with certainty levels expressed as probability percentages. Signs support more certain diagnoses than symptoms alone.
Management of a Patient (All Types) - ROJosonReynaldo Joson
The document outlines the processes involved in managing a patient, whether surgical or nonsurgical. It discusses establishing rapport with the patient, performing a clinical diagnosis using pattern recognition and prevalence, determining when paraclinical diagnostic procedures are needed based on certainty of diagnosis and treatment plan, selecting and interpreting paraclinical tests, and choosing treatment modalities based on factors like effectiveness, risk and cost. For surgical patients specifically, it mentions preoperative preparation, intraoperative management phases, and postoperative care items. The overall goal is resolving the health problem while avoiding complications, disability, and legal issues.
Application of Management Principles in the Management of a Patient - ROJosonReynaldo Joson
This document outlines the application of management principles in managing a patient. It discusses establishing overall goals and strategies when a patient first consults, such as resolving their health issue without harm. It describes formulating a clinical diagnosis through interview and exam. The need for further testing is determined by diagnosis certainty and treatment plans. If needed, the most cost-effective test is selected. Finally, treatment options are considered based on benefit, risk, cost and availability to choose the most cost-effective option. The document provides examples of applying each step of the management process rationally.
ROJOSON-PEP-TALK: Pt Mgt Process – Paraclinical Diagnostic Process (Talk – Ju...Reynaldo Joson
This presentation provides an overview of the paraclinical diagnostic process as part of the patient management process. It explains that paraclinical diagnosis is done after clinical diagnosis to make the diagnosis more definite. It discusses how the physician determines if paraclinical diagnosis is needed based on certainty of clinical diagnosis and differences in treatment plans. It also covers selecting the most appropriate paraclinical procedure, interpreting the results, and advising the patient. The overall aim is to empower patients by increasing understanding of this medical process.
This PPT is mainly oriented to the Final yr MBBS students who are preparing for their Final exams. The Audit cycle has taken up from Bailey & Love - 24th edition.
This document is a checklist used to assess standards and measurable elements for inpatient care at a healthcare facility. It covers areas like scope of service, patient safety goals, assessment of patients, patient and family education, and patient and family rights. For each standard, staff are asked questions to determine if the element is met, not met, not applicable, or not tested. Remarks can also be included. The goal is to evaluate areas like patient identification, communication, safety of medications, infection control, fall risk reduction, documentation, consent processes, privacy and more.
Surgical audit is a process that systematically analyzes surgical care quality against standards to improve patient outcomes. It involves collecting data on parameters like mortality, complications and outcomes and comparing results to peers to identify areas for improvement. The goal is continuous quality improvement through a non-punitive, educational process. Surgical audit has existed for centuries but modern methods began in the early 1900s and involve retrospective review of existing data to guide practice changes.
ROJOSON-PEP-TALK: Pt Mgt Process – Clinical Diagnostic Process (Pre-session R...Reynaldo Joson
The document discusses the clinical diagnostic process that physicians use to diagnose patients. It begins with the goals of resolving health problems without death, complications, or disability while satisfying patients. Physicians establish rapport, diagnose using pattern recognition and prevalence, treat, and provide advice. Diagnoses are made by identifying the involved organ and general/specific disease. The outputs are primary and secondary diagnoses with certainty levels expressed as probability percentages. Signs support more certain diagnoses than symptoms alone.
Clinical audit is a quality improvement process that systematically reviews patient care against criteria to improve outcomes. It involves measuring performance, comparing to standards, and evaluating results to identify areas for improvement. Clinical audit is mandatory for medical practitioners in some countries. The audit cycle includes defining a question, identifying standards, measuring performance, analyzing gaps, implementing changes, and reauditing. Audits require collecting data, conducting peer review, and determining scope, standards, and resources. Opportunities from audits include education, systemic improvements, and continuing professional development.
ROJOSON-PEP-TALK: Pt Mgt Process – Clinical Diagnostic Process (Talk July 17,...Reynaldo Joson
The document discusses the goals and clinical diagnostic process aspects of patient management. The goals of physicians in managing patients are resolution of health problems without death, complications or disability, in a way that satisfies patients. Physicians use four tasks - rapport, diagnosis/advice, treatment/advice, and advice. Diagnosis involves collecting symptom and sign data from the patient history and exam. Physicians use pattern recognition and prevalence processes to analyze this data and make a clinical diagnosis. Pattern recognition matches the patient's presentation to a known disease pattern, while prevalence considers the most common local diagnoses.
MEDICAL AUDIT
Evaluation of data, documents, and resources to check performance of systems meets specified standards
PRESCRIPTION MONITORING, ADR, DRUG RELATED PROBLEMS, staff safety, data,defining standards,
collecting data,
identifying areas for improvement,
making necessary changes
back round to defining new standards.
This document discusses medical audits, including definitions, components, stages, and types of audits. It provides information on the audit cycle and the roles and functions of an audit committee. Some key points include:
- Medical audits systematically analyze quality of care, procedures, resource use, and patient outcomes and quality of life.
- Audits can help provide reassurance that best quality services are being provided given available resources.
- The audit cycle involves setting standards, comparing practice to standards, implementing changes if needed, and closing the audit loop.
- An audit committee coordinates audits, ensures changes are made, and maintains confidentiality.
This document provides information on surgical audit and clinical research. It defines clinical audit as a quality improvement process that systematically reviews care against criteria to implement change and improve outcomes. Surgical audit similarly analyzes surgical quality and care against standards to improve practice. Audits identify if standards are met and research is used in practice, help reduce risk, and improve patient care. They follow the clinical audit cycle of choosing topics, collecting data, analyzing results against criteria, improving care, and re-auditing. Research aims to generate new knowledge by testing treatments or regimens with study design and analysis. It asks different questions than audits and requires identifying topics, designing projects, analyzing data, and publishing findings.
The document discusses performance evaluation of hospitals, which is essential to ensure health services are effective and efficiently using limited resources. It describes evaluating hospitals based on the amount and quality of work, costs, and patient satisfaction. Performance is evaluated through indicators to identify areas for improvement. Methods include indirect analysis of factors influencing care quality and direct analysis of medical records. Clinical audits also evaluate patterns of care quality and resources usage by analyzing topics like diagnostic tests, medical records, and patient satisfaction. The goal is continuously improving patient care and outcomes.
Javed Iqbal draws a comparison between cricket and surgery, noting that both are missing an important element of record keeping. For cricket, it is keeping score, while for surgery it is conducting audits. Without audits, surgical practice would be like playing cricket without keeping score. Audits are a systematic, critical review of clinical care that can help highlight opportunities for improvement. The main goals of audits are to evaluate current practices, identify areas for improvement, and implement changes to promote better patient outcomes and evidence-based healthcare.
This document provides an overview of medical audit, including:
- Definitions of medical audit and clinical audit
- The history and evolution of audit from the 1850s to modern clinical audit practices
- The need for and benefits of medical audit
- The six stages of the audit process: preparing, selecting criteria, measuring performance, making improvements, sustaining improvements, and re-audit
- Types of clinical audits such as statistical, disease-specific, death, and infection control audits
- Key aspects of implementing a successful audit such as identifying criteria and standards, collecting and analyzing data, and identifying and addressing barriers to change.
Medical audit helps determine the quality of care provided to patients. It involves systematically reviewing clinical records and hospital services against standards to identify areas for improvement. The summary analyzes key aspects of conducting a medical audit, including defining standards and criteria, collecting data, measuring performance, identifying changes, and sustaining improvements over time through re-auditing. Medical audits aim to enhance patient care and outcomes.
Measuring Quality of Care in Tanzania- Peter Binyarukaresyst
This document discusses measuring the quality of care in Tanzania. It outlines Donabedian's framework for quality of care, which includes three domains: structure, process, and outcomes. The document then examines structural factors considered in Tanzania's pay-for-performance program, such as availability of drugs, vaccines, supplies, and equipment. It describes how a structural quality index was generated and presents results showing the program improved drug availability and reduced stockouts. However, the program did not significantly impact staffing levels, equipment functioning, or availability of antiretroviral drugs. The document concludes that structural measures are an important but incomplete way to assess quality and that a multidimensional approach is needed.
This document discusses quality improvement and patient safety in anesthesia. It defines key terms like quality improvement, continuous quality improvement and differentiates it from traditional quality assurance. It outlines frameworks for improvement like the Model for Improvement and discusses tools used for quality improvement like Lean methodology, Six Sigma and PDSA cycles. It discusses important measures for quality improvement like process, outcome and balancing measures. Methods for analyzing and displaying quality improvement data like control charts and dashboards are described. Sources of quality improvement information and the importance of incident reporting are also summarized.
This document discusses clinical audits in anaesthesia. It defines clinical audits as quality improvement processes that systematically review care against criteria to improve outcomes. The document outlines the history of audits dating back to Florence Nightingale. It describes different types of audits including clinical, critical event, outcome, training, and survey audits. The audit cycle is also explained as preparing criteria, measuring performance, implementing improvements, and sustaining changes. Barriers to audits are a lack of resources, expertise, and leadership. Audits aim to improve standards but challenges include support, time constraints, and obtaining consent.
This document discusses quality improvement in health services. It defines quality as the set of attributes and characteristics of services that satisfy needs. Quality improvement frameworks are presented, including the Donabedian model of structure, process, and outcomes. Key factors for quality reproductive health programs are identified as health workers, supply of drugs/contraceptives, training, supervision, method mix, and accessibility. The document outlines various quality assurance and improvement processes like identifying problem areas, data collection, intervention planning, and customer-focused improvement approaches.
The document discusses randomization and blinding in clinical trials. It defines randomization as a process that assigns participants to experimental and control groups randomly to reduce bias. Randomization ensures groups are similar and comparable. Blinding refers to keeping participants and investigators unaware of group assignments to prevent bias in assessing outcomes. The document outlines various randomization techniques like simple randomization and stratification. It also discusses types of sampling and limitations of non-randomized trials in comparing interventions. In summary, the key points are that randomization and blinding are important design elements in clinical trials to reduce bias and ensure validity of results.
This document discusses medical audits and provides information on various types of audits including internal and external audits, managerial/organizational audits, medical/clinical audits, and financial audits. It explains the need for audits to maintain safety, quality, reputation and funding. The document outlines the six stages of clinical audits including preparing, selecting criteria, measuring performance, making improvements, sustaining improvements, and re-auditing. Methods used in audits like direct observation, checklists, documentation reviews, questionnaires and interviews are also mentioned.
This document discusses measurement for quality improvement in healthcare. It defines measurement as the systematic collection of quantifiable data about processes and outcomes over time or at a single point in time. The purpose of measurement is to identify ways to improve, track performance improvements, and focus efforts on the right areas. Measurement should involve employees and measure effectiveness, efficiency, and support for strategic initiatives. Examples of potential measures for male and female wards are provided, including outcomes, processes, balancing measures. Cause and effect diagrams and building a cascading system of measures from the hospital board level down to individual caregivers and patients is also discussed.
The document summarizes key points from a presentation given by Dr. Bhaswat S. Chakraborty at the National Conference on Innovation in Pharmaceutical Industry on clinical development of new drugs. It discusses various endpoints that can be considered in cancer clinical trials, including overall survival, progression-free survival, tumor response rates, quality of life measures, biomarkers, and symptom-based endpoints. It notes the merits and limitations of different endpoints and trial designs.
Clinical trials are conducted to test new drugs, treatments or medical devices in humans to assess their safety and efficacy. There are four main phases of clinical trials:
Phase I trials involve small groups of people to determine basic safety and dosing requirements. Phase II trials expand the testing to more people to determine efficacy and further evaluate safety. Phase III trials involve large groups of people to confirm effectiveness, monitor side effects, compare to commonly used treatments and collect information to allow safe use of the intervention. Phase IV trials occur after the intervention has been marketed to gather information on effects in various populations and any long-term side effects.
Physician age and outcomes in elderly patients in hospial in the US: observat...Akshay Mehta
- This study examined the relationship between physician age and patient outcomes among elderly Medicare beneficiaries admitted to hospitals in the US from 2011-2014.
- The study found that patients treated by older hospitalists had higher 30-day mortality rates compared to patients treated by younger hospitalists, except for those treated by hospitalists with high patient volumes.
- Readmission rates did not meaningfully vary with physician age, while costs of care were slightly higher among older physicians. The results suggest that differences in practice patterns or quality measures between physicians of varying experience levels could influence patient outcomes.
This document discusses multicentric clinical trials. It begins by defining clinical trials and introducing that a multicenter trial is conducted across multiple medical centers. Key points are that multicenter trials require standardization of procedures, uniformity, high data quality, and collaboration across sites. The document distinguishes between multi-site and multicentric studies, noting that in multicentric studies investigators at sites are co-investigators in planning and responsible for results, while in multi-site studies sites merely carry out tasks. Coordination in multicenter studies involves centralized activities like protocol development and data management to standardize procedures. Advantages include larger sample sizes and evaluating efficacy across populations. The document concludes by summarizing a phase II multicenter trial of sunit
ROJOSON-PEP-TALK: Patient Management Process – An Overview (Pre-session Recor...Reynaldo Joson
The document discusses a patient empowerment program that aims to educate laypeople about the patient management process. This involves understanding how patients are diagnosed and treated for health issues. It introduces a 6-part framework for the patient management process, covering clinical diagnosis, testing, treatment selection, advice to patients, and limitations of medical practice. The goal is to empower patients to make informed decisions about their healthcare by understanding how physicians assess and manage health concerns through established processes rather than isolated questions and answers.
The document discusses the importance of preoperative assessment and preparation of patients prior to surgery. Key aspects of assessment include taking a thorough medical history, conducting a physical examination, evaluating nutritional status, ordering relevant investigations, and determining surgical risk. Important elements of preparation are obtaining informed consent, preventing cardiovascular and respiratory complications, reducing risk of aspiration, preparing the bowels if needed, and ensuring adequate sleep, skin preparation, catheterization and pre-medication when applicable. The goals are to identify risk factors, optimize the patient's health status, and reduce postoperative complications.
Clinical audit is a quality improvement process that systematically reviews patient care against criteria to improve outcomes. It involves measuring performance, comparing to standards, and evaluating results to identify areas for improvement. Clinical audit is mandatory for medical practitioners in some countries. The audit cycle includes defining a question, identifying standards, measuring performance, analyzing gaps, implementing changes, and reauditing. Audits require collecting data, conducting peer review, and determining scope, standards, and resources. Opportunities from audits include education, systemic improvements, and continuing professional development.
ROJOSON-PEP-TALK: Pt Mgt Process – Clinical Diagnostic Process (Talk July 17,...Reynaldo Joson
The document discusses the goals and clinical diagnostic process aspects of patient management. The goals of physicians in managing patients are resolution of health problems without death, complications or disability, in a way that satisfies patients. Physicians use four tasks - rapport, diagnosis/advice, treatment/advice, and advice. Diagnosis involves collecting symptom and sign data from the patient history and exam. Physicians use pattern recognition and prevalence processes to analyze this data and make a clinical diagnosis. Pattern recognition matches the patient's presentation to a known disease pattern, while prevalence considers the most common local diagnoses.
MEDICAL AUDIT
Evaluation of data, documents, and resources to check performance of systems meets specified standards
PRESCRIPTION MONITORING, ADR, DRUG RELATED PROBLEMS, staff safety, data,defining standards,
collecting data,
identifying areas for improvement,
making necessary changes
back round to defining new standards.
This document discusses medical audits, including definitions, components, stages, and types of audits. It provides information on the audit cycle and the roles and functions of an audit committee. Some key points include:
- Medical audits systematically analyze quality of care, procedures, resource use, and patient outcomes and quality of life.
- Audits can help provide reassurance that best quality services are being provided given available resources.
- The audit cycle involves setting standards, comparing practice to standards, implementing changes if needed, and closing the audit loop.
- An audit committee coordinates audits, ensures changes are made, and maintains confidentiality.
This document provides information on surgical audit and clinical research. It defines clinical audit as a quality improvement process that systematically reviews care against criteria to implement change and improve outcomes. Surgical audit similarly analyzes surgical quality and care against standards to improve practice. Audits identify if standards are met and research is used in practice, help reduce risk, and improve patient care. They follow the clinical audit cycle of choosing topics, collecting data, analyzing results against criteria, improving care, and re-auditing. Research aims to generate new knowledge by testing treatments or regimens with study design and analysis. It asks different questions than audits and requires identifying topics, designing projects, analyzing data, and publishing findings.
The document discusses performance evaluation of hospitals, which is essential to ensure health services are effective and efficiently using limited resources. It describes evaluating hospitals based on the amount and quality of work, costs, and patient satisfaction. Performance is evaluated through indicators to identify areas for improvement. Methods include indirect analysis of factors influencing care quality and direct analysis of medical records. Clinical audits also evaluate patterns of care quality and resources usage by analyzing topics like diagnostic tests, medical records, and patient satisfaction. The goal is continuously improving patient care and outcomes.
Javed Iqbal draws a comparison between cricket and surgery, noting that both are missing an important element of record keeping. For cricket, it is keeping score, while for surgery it is conducting audits. Without audits, surgical practice would be like playing cricket without keeping score. Audits are a systematic, critical review of clinical care that can help highlight opportunities for improvement. The main goals of audits are to evaluate current practices, identify areas for improvement, and implement changes to promote better patient outcomes and evidence-based healthcare.
This document provides an overview of medical audit, including:
- Definitions of medical audit and clinical audit
- The history and evolution of audit from the 1850s to modern clinical audit practices
- The need for and benefits of medical audit
- The six stages of the audit process: preparing, selecting criteria, measuring performance, making improvements, sustaining improvements, and re-audit
- Types of clinical audits such as statistical, disease-specific, death, and infection control audits
- Key aspects of implementing a successful audit such as identifying criteria and standards, collecting and analyzing data, and identifying and addressing barriers to change.
Medical audit helps determine the quality of care provided to patients. It involves systematically reviewing clinical records and hospital services against standards to identify areas for improvement. The summary analyzes key aspects of conducting a medical audit, including defining standards and criteria, collecting data, measuring performance, identifying changes, and sustaining improvements over time through re-auditing. Medical audits aim to enhance patient care and outcomes.
Measuring Quality of Care in Tanzania- Peter Binyarukaresyst
This document discusses measuring the quality of care in Tanzania. It outlines Donabedian's framework for quality of care, which includes three domains: structure, process, and outcomes. The document then examines structural factors considered in Tanzania's pay-for-performance program, such as availability of drugs, vaccines, supplies, and equipment. It describes how a structural quality index was generated and presents results showing the program improved drug availability and reduced stockouts. However, the program did not significantly impact staffing levels, equipment functioning, or availability of antiretroviral drugs. The document concludes that structural measures are an important but incomplete way to assess quality and that a multidimensional approach is needed.
This document discusses quality improvement and patient safety in anesthesia. It defines key terms like quality improvement, continuous quality improvement and differentiates it from traditional quality assurance. It outlines frameworks for improvement like the Model for Improvement and discusses tools used for quality improvement like Lean methodology, Six Sigma and PDSA cycles. It discusses important measures for quality improvement like process, outcome and balancing measures. Methods for analyzing and displaying quality improvement data like control charts and dashboards are described. Sources of quality improvement information and the importance of incident reporting are also summarized.
This document discusses clinical audits in anaesthesia. It defines clinical audits as quality improvement processes that systematically review care against criteria to improve outcomes. The document outlines the history of audits dating back to Florence Nightingale. It describes different types of audits including clinical, critical event, outcome, training, and survey audits. The audit cycle is also explained as preparing criteria, measuring performance, implementing improvements, and sustaining changes. Barriers to audits are a lack of resources, expertise, and leadership. Audits aim to improve standards but challenges include support, time constraints, and obtaining consent.
This document discusses quality improvement in health services. It defines quality as the set of attributes and characteristics of services that satisfy needs. Quality improvement frameworks are presented, including the Donabedian model of structure, process, and outcomes. Key factors for quality reproductive health programs are identified as health workers, supply of drugs/contraceptives, training, supervision, method mix, and accessibility. The document outlines various quality assurance and improvement processes like identifying problem areas, data collection, intervention planning, and customer-focused improvement approaches.
The document discusses randomization and blinding in clinical trials. It defines randomization as a process that assigns participants to experimental and control groups randomly to reduce bias. Randomization ensures groups are similar and comparable. Blinding refers to keeping participants and investigators unaware of group assignments to prevent bias in assessing outcomes. The document outlines various randomization techniques like simple randomization and stratification. It also discusses types of sampling and limitations of non-randomized trials in comparing interventions. In summary, the key points are that randomization and blinding are important design elements in clinical trials to reduce bias and ensure validity of results.
This document discusses medical audits and provides information on various types of audits including internal and external audits, managerial/organizational audits, medical/clinical audits, and financial audits. It explains the need for audits to maintain safety, quality, reputation and funding. The document outlines the six stages of clinical audits including preparing, selecting criteria, measuring performance, making improvements, sustaining improvements, and re-auditing. Methods used in audits like direct observation, checklists, documentation reviews, questionnaires and interviews are also mentioned.
This document discusses measurement for quality improvement in healthcare. It defines measurement as the systematic collection of quantifiable data about processes and outcomes over time or at a single point in time. The purpose of measurement is to identify ways to improve, track performance improvements, and focus efforts on the right areas. Measurement should involve employees and measure effectiveness, efficiency, and support for strategic initiatives. Examples of potential measures for male and female wards are provided, including outcomes, processes, balancing measures. Cause and effect diagrams and building a cascading system of measures from the hospital board level down to individual caregivers and patients is also discussed.
The document summarizes key points from a presentation given by Dr. Bhaswat S. Chakraborty at the National Conference on Innovation in Pharmaceutical Industry on clinical development of new drugs. It discusses various endpoints that can be considered in cancer clinical trials, including overall survival, progression-free survival, tumor response rates, quality of life measures, biomarkers, and symptom-based endpoints. It notes the merits and limitations of different endpoints and trial designs.
Clinical trials are conducted to test new drugs, treatments or medical devices in humans to assess their safety and efficacy. There are four main phases of clinical trials:
Phase I trials involve small groups of people to determine basic safety and dosing requirements. Phase II trials expand the testing to more people to determine efficacy and further evaluate safety. Phase III trials involve large groups of people to confirm effectiveness, monitor side effects, compare to commonly used treatments and collect information to allow safe use of the intervention. Phase IV trials occur after the intervention has been marketed to gather information on effects in various populations and any long-term side effects.
Physician age and outcomes in elderly patients in hospial in the US: observat...Akshay Mehta
- This study examined the relationship between physician age and patient outcomes among elderly Medicare beneficiaries admitted to hospitals in the US from 2011-2014.
- The study found that patients treated by older hospitalists had higher 30-day mortality rates compared to patients treated by younger hospitalists, except for those treated by hospitalists with high patient volumes.
- Readmission rates did not meaningfully vary with physician age, while costs of care were slightly higher among older physicians. The results suggest that differences in practice patterns or quality measures between physicians of varying experience levels could influence patient outcomes.
This document discusses multicentric clinical trials. It begins by defining clinical trials and introducing that a multicenter trial is conducted across multiple medical centers. Key points are that multicenter trials require standardization of procedures, uniformity, high data quality, and collaboration across sites. The document distinguishes between multi-site and multicentric studies, noting that in multicentric studies investigators at sites are co-investigators in planning and responsible for results, while in multi-site studies sites merely carry out tasks. Coordination in multicenter studies involves centralized activities like protocol development and data management to standardize procedures. Advantages include larger sample sizes and evaluating efficacy across populations. The document concludes by summarizing a phase II multicenter trial of sunit
ROJOSON-PEP-TALK: Patient Management Process – An Overview (Pre-session Recor...Reynaldo Joson
The document discusses a patient empowerment program that aims to educate laypeople about the patient management process. This involves understanding how patients are diagnosed and treated for health issues. It introduces a 6-part framework for the patient management process, covering clinical diagnosis, testing, treatment selection, advice to patients, and limitations of medical practice. The goal is to empower patients to make informed decisions about their healthcare by understanding how physicians assess and manage health concerns through established processes rather than isolated questions and answers.
The document discusses the importance of preoperative assessment and preparation of patients prior to surgery. Key aspects of assessment include taking a thorough medical history, conducting a physical examination, evaluating nutritional status, ordering relevant investigations, and determining surgical risk. Important elements of preparation are obtaining informed consent, preventing cardiovascular and respiratory complications, reducing risk of aspiration, preparing the bowels if needed, and ensuring adequate sleep, skin preparation, catheterization and pre-medication when applicable. The goals are to identify risk factors, optimize the patient's health status, and reduce postoperative complications.
1.8 APPROACHES TO MANAGEMENT OF STIs.pptxJohnmvula3
The document discusses different approaches to managing sexually transmitted infections (STIs). It describes the objectives of STI case management and two main approaches: the classical method which identifies the causative agent through clinical or laboratory diagnosis and the syndromic method which diagnoses and treats based on clinical symptoms. The syndromic approach is recommended where laboratory facilities are limited. It has advantages like wider treatment access but can result in overtreatment. Syndromic management involves using flowcharts to diagnose syndromes and provide standardized treatment and education.
Principles of preoperative and operative surgeryMEEQAT HOSPITAL
This document discusses principles of preoperative and operative surgery. It covers four main principles: preoperative preparation of the patient, a systems approach to preoperative evaluation, additional preoperative considerations, and a preoperative checklist. For preoperative evaluation and preparation, the document emphasizes assessing patient risk factors, especially cardiovascular risk, and optimizing high-risk patients prior to surgery through testing, medication, and consultation with specialists. The goal is to identify any medical issues that could impact the surgical outcome and take steps to improve the patient's status and reduce perioperative risk.
Application of the Management Process in Thyroid NodulesReynaldo Joson
16th Chancellor Alfredo T. Ramirez Memorial Lecture
Application of the Management Process in Thyroid Nodules: Thirty Years of Experience.
Reynaldo O. Joson
September 7, 2016
Diamond Hotel, Manila
https://rojosonmedicalclinic.wordpress.com/2016/09/07/application-of-the-management-process-in-thyroid-nodules-thirty-years-of-experience/
Patient safety assistantship Professor Vinod PatelVinod0901
This document provides an overview of a lecture on promoting patient safety in the NHS after the Berwick Report. It discusses the four ethical principles of autonomy, beneficence, non-maleficence and justice. It then describes elements of a professional skills suite including reducing inequalities, health promotion, patient safety, consent and more. Key models for understanding medical errors like the Swiss cheese model and human factors are presented. The document summarizes the Berwick Report which examined failings in care and made recommendations to improve patient safety, including being more open, transparent and prioritizing patient needs. It also discusses tools like the surgical safety checklist and their impact in reducing complications and deaths.
The nursing process is a framework for providing patient-centered care that involves 5 steps: assessment, diagnosis, planning, implementation, and evaluation (ADPIE). It is a cyclic and ongoing process used to address any health issues identified for the patient. The steps include comprehensively assessing the patient's health status and needs, diagnosing any issues needing attention, planning care in collaboration with the patient, implementing the planned care, and evaluating outcomes to determine if goals were met or if revisions are needed.
This document discusses key performance indicators (KPIs) and metrics for measuring healthcare operations management. It begins by outlining the objectives and levels of study for the module. It then defines process and outcomes measures that can be used. The document distinguishes between KPIs and the underlying metrics. It provides examples of common clinical and non-clinical metrics in healthcare like average length of stay, patient satisfaction, and operating margin. It also discusses quality metrics used by CMS and principles for effective KPI selection. Overall, the document provides an overview of how performance in healthcare can be measured using metrics and KPIs to enhance organizational performance.
Clinical indicators are measures that assess healthcare processes and outcomes. They are needed to identify areas for improvement like preventable medical errors. Some key points about clinical indicators include that they can measure structure, process, outcomes, and be rate-based or sentinel. Examples provided include surgical site infection rates and unplanned returns to the operating room. Departments like nursing, surgery, emergency departments, and more have specific clinical indicators tailored to assess quality in their areas.
The document discusses international patient safety goals in hospital settings. It outlines 6 main goals: [1] Identify patients correctly; [2] Improve communication among caregivers; [3] Improve safety of high-alert medications; [4] Ensure correct procedures and patients; [5] Reduce health care-associated infections; [6] Reduce risk of falls. The goals aim to prevent medical errors and harm to patients by establishing safety protocols for identification, communication, medication use, surgery, infection control, and fall prevention.
The document discusses the nursing process, which is a systematic method for planning and providing nursing care. It outlines the key steps as assessment, diagnosis, planning, implementation, and evaluation. Assessment involves collecting both subjective and objective data from various sources like the client, family, and medical records. This data is then organized, interpreted, and documented. The nursing diagnosis phase further analyzes the collected data to identify any actual or potential health problems nurses can address. The overall nursing process provides structure to nursing care and allows for continuity and quality of care.
SHARE Webinar: Why Should I Join a Clinical Trial with Dr. Hershmanbkling
Dr. Dawn L. Hershman of the Herbert Irving Comprehensive Cancer Center at Columbia University presented the basics of clinical trials and emphasized how important it is for more patients to participate in them. She also discussed trials currently available for early stage and metastatic breast cancers. The webinar was presented on June 25, 2014. To hear the webinar, visit www.sharecancersupport.org/hershman
This document discusses fundamentals of quality in healthcare. It defines key terms like quality assurance, quality of care, and factors driving attention to quality like limited resources and patient demands. It describes Donabedian's framework for assessing quality, which looks at structure, process and outcomes. Achieving quality requires accessible, efficient and acceptable services. Ensuring quality involves continuous quality improvement approaches like plan-do-check-act cycles and evidence-based medicine. The goal is to provide high quality care through ongoing evaluation and improvement.
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The document outlines the proper approach and process for treating a surgical patient, which includes: taking a thorough history and conducting a physical exam, developing differential diagnoses, ordering appropriate investigations, determining the best treatment plan, performing surgery if needed, providing postoperative care and monitoring the patient's recovery, and documenting each step of the process in the patient's notes. It emphasizes the importance of considering all factors before making decisions regarding a patient's diagnosis and treatment.
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3. Management of a Surgical Patient [Process]
Introduction
Practice of medicine - essentially management of a patient,
a person with a health problem
Surgical patient - person with a surgical disorder
Surgical disorder - health problem or condition that
is treated by surgery or an operation
Nonsurgical patient - one with a nonsurgical
disorder
4. Management of a Surgical Patient [Process]
Introduction
Regardless of type of patient or disorder, whether surgical
or nonsurgical,
basic processes in the management are essentially
similar
Only difference lies in the specific treatment
modality and procedure employed,
whether surgical or nonsurgical means
5. Management of a Surgical Patient [Process]
Introduction
All primary health care physicians are expected at least to
know the basic processes in the management of a
surgical patient.
This learning session gives an overview of the processes
involved in the management of a surgical patient.
6. Management of a Surgical Patient [Process]
Learning Objectives
7. Management of a Surgical Patient [Process]
Learning Objectives
1. State the overall goals in the management of a patient
(whether surgical or not).
2. Enumerate the four functions of a physician in the
management of a patient (whether surgical or not).
3. Describe the clinical diagnostic process.
4. Describe how to determine the indication for a
paraclinical diagnostic procedure.
5. Describe how a paraclinical diagnostic procedure should
be selected among several options.
8. Management of a Surgical Patient [Process]
Learning Objectives
6. Describe how to interpret results of a paraclinical
diagnostic procedure to come out with a
pretreatment diagnosis.
7. Describe how a treatment modality should be selected
among several options.
8. Enumerate at least 4 essential items in the preoperative
preparation of a surgical patient.
9. Enumerate in correct chronological order 7 phases in
the intraoperative management starting from the
incision to wound closure.
9. Management of a Surgical Patient [Process]
Learning Objectives
10. Enumerate at least 4 items in the immediate
postoperative care of a surgical patient.
11. Enumerate the two objectives of a follow-up plan after
treatment of a patient (whether surgical or not).
12. Describe how to advice patients on clinical diagnosis,
paraclinical diagnostic procedures, treatment,
follow-up, and health promotion and maintenance.
13. Describe when and to whom to refer.
10. Management of a Surgical Patient
[Process]
Reynaldo O. Joson, MD, MS Surg
Self-Instructional Program
https://sites.google.com/site/patientmanagement process
http://edhedephi.tripod.com RJoson’s Writings
12. Management of a Surgical Patient [Process]
• I have decided to approach the topic by first presenting
the steps in the management of a surgical patient in
outline form.
Facilitator’s Approach to Learning Session
• Then, I will present some simulated patients or exercises
to expound on the process.
15. MANAGEMENT OF A PATIENT
PROBLEM-SOLVING AND DECISION-MAKING
GOALS
RESOLUTION OF HEALTH PROBLEM
LIVE PATIENT
NO COMPLICATION
NO DISABILITY
SATISFIED PATIENT
NO MEDICOLEGAL SUIT
17. MANAGEMENT OF A PATIENT
PROBLEM-SOLVING AND DECISION-MAKING
TASKS
RAPPORT
DIAGNOSIS
ADVICE
TREATMENT
ADVICE
Quality Standards:
Rational, effective, efficient, humane
G
O
A
L
S
19. Management of a Surgical Patient [Process]
Rapport
Establishing rapport with the patient and his/her relatives
- best strategy for obtaining satisfaction from
patient and his/her relative
- strongest strategy in the prevention of
medicolegal suit in case of errors of
commission and omission
20. Management of a Surgical Patient [Process]
Rapport
Some ways of establishing rapport with patient and his/her
relatives:
1. Being courteous
2. Showing respect to person and beliefs
3. Giving honest and clear advice on diagnosis,
paraclinical diagnostic procedures,
and treatment
4. Demonstrating humaneness and compassion
21. Management of a Surgical Patient [Process]
Rapport
Some ways of establishing rapport with patient and his/her
relatives:
5. Being gentle in words and deeds (physical
examination, procedure)
6. Showing the patient and relatives that you are
trying your very best
7. Being helpful when it comes to medical expenses
8. Making the patient and relatives feel that you are
approachable and easy to talk to
22. Management of a Surgical Patient [Process]
Learning Objectives
1. State the overall goals in the management of a patient
(whether surgical or not).
2. Enumerate the four functions of a physician in the
management of a patient (whether surgical or not).
23. Management of a Surgical Patient [Process]
Clinical Diagnostic
Process
24. Management of a Surgical Patient [Process]
Clinical Diagnostic Process
Diagnosis - label or nature of the health problem
Clinical Diagnosis - diagnosis derived from interview
(history) and physical examination
Clinical Diagnostic Process - processing of data from
interview and physical examination to arrive to a
diagnosis
25. CLINICAL DIAGNOSTIC PROCESS
DATA NEEDED
SYMPTOMS (from interview or history)
SIGNS (from physical examination)
PERSONAL DATA OF PATIENT
26. CLINICAL DIAGNOSTIC PROCESS
PROCESSING OF DATA
PATTERN RECOGNITION
-realization that the patient’s presentation
conforms to a previously learned picture or
pattern of disease
PREVALENCE
- choice of a diagnosis is based on the frequency
of occurrence of the disease in a certain locality,
in a certain age and sex group, and in the
affected organ and system
28. CLINICAL DIAGNOSTIC PROCESS
PROCESSING OF DATA
PATTERN RECOGNITION
-realization that the patient’s presentation
conforms to a previously learned picture or
pattern of disease
PREVALENCE
- choice of a diagnosis is based on the frequency
of occurrence of the disease in a certain locality,
in a certain age and sex group, and in the
affected organ and system
29. CLINICAL DIAGNOSTIC PROCESS
PROCESSING OF DATA
Knowing the common manifestations of 5 different diseases as
follows:
Disease A - abcd (manifestations)
Disease B - fghi
Disease C - klmn
Disease D - pqrs
Disease E - uvwx
Given a patient manifesting with pqrs, your diagnosis is Disease D.
What is the process used?
Pattern Recognition
30. CLINICAL DIAGNOSTIC PROCESS
PROCESSING OF DATA
Knowing the common manifestations of 3 different diseases and
relative frequency of each as follows:
Disease A - abcd (manifestations) Least common
Disease B - abcd
Disease C - abcd Most common
Given a patient manifesting with abcd, your diagnosis is Disease C.
What is/are processes used?
Pattern Recognition but mainly Prevalence
31. CLINICAL DIAGNOSTIC PROCESS
PROCESSING OF DATA
Knowing the most common diagnosis of a thyroid nodule is a benign
colloid adenomatous goiter, given a patient with a thyroid
nodule, you gave the abovementioned diagnosis.
What is/are processes used?
Prevalence
32. CLINICAL DIAGNOSTIC PROCESS
PROCESSING OF DATA
PATTERN RECOGNITION
-realization that the patient’s presentation
conforms to a previously learned picture or
pattern of disease
PREVALENCE
- choice of a diagnosis is based on the frequency
of occurrence of the disease in a certain locality,
in a certain age and sex group, and in the
affected organ and system
33. Management of a Surgical Patient [Process]
Paraclinical
Diagnostic Process
34. Management of a Surgical Patient [Process]
Paraclinical Diagnostic Process
Indication - to be more definite on the clinical diagnosis
Selection
Interpretation
35. Management of a Surgical Patient [Process]
Paraclinical Diagnostic Process - Indication
DATA NEEDED
PRIMARY CLINICAL DIAGNOSIS
SECONDARY CLINICAL DIAGNOSIS
36. Management of a Surgical Patient [Process]
Paraclinical Diagnostic Process - Indication
PROCESSING OF DATA
CERTAINTY OF CLINICAL Dx
1O Dx 60% 99%
needed not needed
TREATMENT PLAN FOR 1O & 2O Dx
Different Same
needed not needed
37. Management of a Surgical Patient [Process]
Paraclinical Diagnostic Process - Indication
OUTPUT EXPECTED
DIAGNOSTIC PROCEDURE
NEEDED or
NOT NEEDED
38. Management of a Surgical Patient [Process]
Paraclinical Diagnostic Process - Indication
Certainty Plan of Treatment
Primary clinical diagnosis 98% Surgical
Secondary clinical diagnosis 1-2% Nonsurgical
Is a paraclinical diagnostic procedure needed?
NO unless there is a strong reason to do so (exception to
the rule)
39. Management of a Surgical Patient [Process]
Paraclinical Diagnostic Process - Indication
Certainty Plan of Treatment
Primary clinical diagnosis 60% Surgical
Secondary clinical diagnosis 40% Nonsurgical
Is a paraclinical diagnostic procedure needed?
YES
40. Management of a Surgical Patient [Process]
Paraclinical Diagnostic Process - Indication
Certainty Plan of Treatment
Primary clinical diagnosis 60% Surgical Excision
Secondary clinical diagnosis 40% Surgical Excision
Is a paraclinical diagnostic procedure needed?
NO unless there is a strong reason to do so (exception to
the rule)
41. Management of a Surgical Patient [Process]
Paraclinical Diagnostic Process - Indication
Certainty Plan of Treatment
Primary clinical diagnosis 90% Mutilating Op
Secondary clinical diagnosis 10% Nonmutilating Op
Is a paraclinical diagnostic procedure needed?
YES unless there is a strong reason NOTto do so
(exception to the rule)
42. Management of a Surgical Patient [Process]
Paraclinical Diagnostic Process - Indication
Certainty Plan of Treatment
Primary clinical diagnosis 70% Chemotherapy
Secondary clinical diagnosis 30% Radiotherapy
Is a paraclinical diagnostic procedure needed?
YES unless there is a strong reason NOTto do so
(exception to the rule)
43. Management of a Surgical Patient [Process]
Paraclinical Diagnostic Process - Indication
Tickler -
Which of the following statements is the strongest indication for a
paraclinical diagnostic procedure?
A. You can never be absolutely certain of your clinical diagnosis
B. You want to confirm a clinical diagnosis which are certain of
C. You want to document a clinical diagnosis which you are certain
of
D. When you are not certain of your clinical diagnosis
Best Answer is D
44. Management of a Surgical Patient [Process]
Paraclinical Diagnostic Process - Selection
DATA NEEDED
OPTIONS OF
DIAGNOSTIC PROCEDURES
45. Management of a Surgical Patient [Process]
Paraclinical Diagnostic Process - Selection
SELECTION PROCESS
Options Benefit Risk Cost Availability
1
2
3
46. Management of a Surgical Patient [Process]
Paraclinical Diagnostic Process - Selection
OUTPUT EXPECTED
MOST COST-EFFECTIVE
DIAGNOSTIC PROCEDURE
47. Management of a Surgical Patient [Process]
Paraclinical Diagnostic Process - Selection
SELECTION PROCESS
Procedure Benefit Risk Cost (PhP) Availability
Options
1 most direct acceptable 1000 available
2 indirect acceptable 1500 available
3 indirect acceptable 1000 available
Which is the most cost-effective procedure?
Option 1
48. Management of a Surgical Patient [Process]
Paraclinical Diagnostic Process - Selection
SELECTION PROCESS
Procedure Benefit Risk Cost (PhP) Availability
Options
1 accuracy 99% acceptable 5000 available
2 accuracy 90% acceptable 3000 available
3 accuracy 50% acceptable 1000 available
Which is the most cost-effective procedure?
Option 2 or Option 1?
49. Management of a Surgical Patient [Process]
Paraclinical Diagnostic Process - Selection
SELECTION PROCESS
Procedure Benefit Risk Cost (PhP) Availability
Options
1 accuracy 95% acceptable 5000 available
2 accuracy 90% acceptable 3000 available
3 accuracy 50% acceptable 1000 available
Which is the most cost-effective procedure?
Option 2 or Option 1?
50. Management of a Surgical Patient [Process]
Paraclinical Diagnostic Process - Selection
SELECTION PROCESS
Procedure Benefit Risk Cost (PhP) Availability
Options
1 yield greatest acceptable 4000 available
2 yield 90% acceptable 4000 available
3 yield 80% acceptable 3000 available
Which is the most cost-effective procedure?
Option 1
51. Management of a Surgical Patient [Process]
Paraclinical Diagnostic Process - Interpretation
DATA NEEDED
PRIMARY CLINICAL DIAGNOSIS
SECONDARY CLINICAL DIAGNOSIS
RESULT OF PARACLINICAL
DIAGNOSTIC PROCEDURE
52. Management of a Surgical Patient [Process]
Paraclinical Diagnostic Process - Interpretation
INTERPRETATION PROCESS
CORRELATE
RESULT OF PARACLINICAL DIAGNOSTIC PROCEDURE
WITH
PRIMARY AND SECONDARY CLINICAL DIAGNOSIS
CONGRUENT - ACCEPT
INCONGRUENT - MAKE A DECISION!
(Accept or Hold!)
53. Management of a Surgical Patient [Process]
Paraclinical Diagnostic Process - Interpretation
Tickler -
Determine which paraclinical diagnosis should be accepted as the
pretreatment diagnosis and which one should be put on hold for further
decision-making. Write (A) for accept and (H) for hold.
7.1 Paraclinical diagnosis is the same as the primary clinical
diagnosis.
7.2 Paraclinical diagnosis is the same as the secondary clinical
diagnosis
7.3 Paraclinical diagnosis is a clinical diagnosis least considered.
7.4 Paraclinical diagnosis does not jibe with the clinical picture or
diagnosis.
7.1 A 7.2 A 7.3 H 7.4 H
54. Management of a Surgical Patient [Process]
Learning Objectives
3. Describe the clinical diagnostic process.
4. Describe how to determine the indication for a
paraclinical diagnostic procedure.
5. Describe how a paraclinical diagnostic procedure should
be selected among several options.
6. Describe how to interpret results of a paraclinical
diagnostic procedure to come out with a
pretreatment diagnosis.
55. Management of a Surgical Patient [Process]
Learning Objectives
7. Describe how a treatment modality should be selected
among several options.
8. Enumerate at least 4 essential items in the preoperative
preparation of a surgical patient.
9. Enumerate in correct chronological order 7 phases in
the intraoperative management starting from the
incision to wound closure.
56. Management of a Surgical Patient [Process]
Learning Objectives
10. Enumerate at least 4 items in the immediate
postoperative care of a surgical patient.
11. Enumerate the two objectives of a follow-up plan after
treatment of a patient (whether surgical or not).
57. Management of a Surgical Patient [Process]
Treatment Process
58. Management of a Surgical Patient [Process]
Treatment Process - Selection
DATA NEEDED
PRETREATMENT DIAGNOSIS
SEVERITY OR STAGE
GOALS AND OBJECTIVES
TREATMENT OPTIONS
59. Management of a Surgical Patient [Process]
Treatment Process - Selection
SELECTION PROCESS
Options Benefit Risk Cost Availability
1
2
3
60. Management of a Surgical Patient [Process]
Treatment Process - Selection
OUTPUT EXPECTED
MOST COST-EFFECTIVE
TREATMENT PROCEDURE
ACHIEVEMENT OF GOALS OF
PATIENT MANAGEMENT!
61. Management of a Surgical Patient [Process]
Treatment Process - Selection
SELECTION PROCESS
Treatment Benefit Risk Cost (PhP) Availability
Options
1 greatest surv rate acceptable 5000 available
2 rate < 1 > 3 acceptable 4000 available
3 least surv rate acceptable 3000 available
Which is the most cost-effective treatment option?
Option 1
62. Management of a Surgical Patient [Process]
Treatment Process - Selection
SELECTION PROCESS
Treatment Benefit Risk Cost (PhP) Availability
Options
1 SR1 = SR2 lesser 5000 available
2 SR2= SR1 more 5000 available
Which is the more cost-effective treatment option?
Option 1
63. Management of a Surgical Patient [Process]
Treatment Process - Selection
SELECTION PROCESS
Treatment Benefit Risk Cost (PhP) Availability
Options
1 as effective as 2 acceptable 8000 available
2 as effective as 1 acceptable 4000 available
Which is the more cost-effective treatment option?
Option 2
64. Management of a Surgical Patient [Process]
Treatment Process - Selection
SELECTION PROCESS
Treatment Benefit Risk Cost (PhP) Availability
Options
1 most effective acceptable 2000 available
2 effectivity <1 >3 acceptable 3000 available
3 least effective acceptable 4000 available
Which is the most cost-effective treatment option?
Option 1
65. Management of a Surgical Patient [Process]
Surgical Treatment Process
PREOP PREPARATION
66. Management of a Surgical Patient [Process]
Surgical Treatment Process - Preop Preparation
INFORMED CONSENT
PSYCHOSOCIAL SUPPORT
OPTIMIZATION
SCREENING
OPERATIVE MATERIALS
67. Management of a Surgical Patient [Process]
Surgical Treatment Process
INTRAOP
MANAGEMENT
68. Management of a Surgical Patient [Process]
Surgical Treatment Process - Intraop Mgt
PHASES
INCISION
EXPOSURE
INTRAOP EVALUATION
OPERATIVE PROCEDURE PROPER
HEMOSTASIS CHECK
CORRECT COUNT
WOUND CLOSURE
69. Management of a Surgical Patient [Process]
Surgical Treatment Process - Intraop Mgt
Quality Standards:
GENTLE
METICULOUS and PRECISE
NO IATROGENIC INJURIES
NO UNNECESSARY MOVES
EVERY MOVE HAS A REASON!
70. Management of a Surgical Patient [Process]
Surgical Treatment Process
POSTOP CARE
71. Management of a Surgical Patient [Process]
Surgical Treatment Process - Postop Care
•SUPPLY BASIC NEEDS OF PATIENT
COMFORT
ANALGESICS
FLUID AND ELECTROLYTES
NUTRITION
SUPPORT ORGAN FUNCTION
WOUND CARE
MONITORING FOR COMPLICATIONS
ADVICE ON
HOME CARE
FOLLOW-UP PLAN
72. Management of a Surgical Patient [Process]
Surgical Treatment Process
POSTOP FOLLOW-UP
PLAN
73. Management of a Surgical Patient [Process]
Surgical Treatment Process - Postop Follow-up
Plan
OBJECTIVES:
EVALUATE TREATMENT OUTCOME
PROVIDE PSYCHOSOCIAL SUPPORT
MONITORING GUIDELINE:
PHYSICAL EXAMINATION
SYMPTOM-DIRECTED
INVESTIGATION
74. Management of a Surgical Patient [Process]
Surgical Treatment Process - Postop Follow-up
Plan
FF-UP FREQUENCY GUIDELINES: CONSIDER
USUAL COURSE OF DISEASE
PERSONALITY OF PATIENT
PATIENT’S CONVENIENCE
75. Management of a Surgical Patient [Process]
Learning Objectives
7. Describe how a treatment modality should be selected
among several options.
8. Enumerate at least 4 essential items in the preoperative
preparation of a surgical patient.
9. Enumerate in correct chronological order 7 phases in
the intraoperative management starting from the
incision to wound closure.
76. Management of a Surgical Patient [Process]
Learning Objectives
10. Enumerate at least 4 items in the immediate
postoperative care of a surgical patient.
11. Enumerate the two objectives of a follow-up plan after
treatment of a patient (whether surgical or not).
77. Management of a Surgical Patient [Process]
Learning Objectives
12. Describe how to advice patients on clinical diagnosis,
paraclinical diagnostic procedures, treatment,
follow-up, and health promotion and maintenance.
13. Describe when and to whom to refer.
78. Management of a Surgical Patient [Process]
HOW TO GIVE
ADVICES
79. Management of a Surgical Patient [Process]
HOW TO GIVE ADVICES
1. Always include the relatives of the patient in the
advising, if they are available.
2. Assess the psychological make-up, the health beliefs, and
the level of competency of the patient and the
relatives before making any advice. Make strategies
that will promote rapport.
2.1 Be honest but not brutally frank.
Example, slowly divulge the diagnosis of an
incurable disease or a frightening disease.
2.2 Use terminologies or explanations that can be
easily understood by the patient and his
relatives.
80. Management of a Surgical Patient [Process]
HOW TO GIVE ADVICES
3. Use all kinds of strategies that will make the patient and
his relatives like you.
4. Explain to the patient and relatives the processes you
use in arriving to a diagnosis, recommendation for a
paraclinical diagnostic procedures and treatment.
81. Management of a Surgical Patient [Process]
REFERRAL
WHEN
TO WHOM
82. Management of a Surgical Patient [Process]
Referral - When to Refer?
All physicians, both certified and not yet certified, must
know their limitations.
Only they themselves can determine their own limitations.
They must realize their limitations so that they do not
cause undue harm to their patients and so that they
know when to refer to colleagues.
83. Management of a Surgical Patient [Process]
Referral - To Whom to Refer?
Referral must be made to somebody
who may or can solve the patient’s health
problem
rationally, effectively, efficiently, and
humanely, and
who has a good track record of handling
the kind of problem on hand.
84. Management of a Surgical Patient [Process]
Learning Objectives
85. Management of a Surgical Patient [Process]
Learning Objectives
1. State the overall goals in the management of a patient
(whether surgical or not).
2. Enumerate the four functions of a physician in the
management of a patient (whether surgical or not).
3. Describe the clinical diagnostic process.
4. Describe how to determine the indication for a
paraclinical diagnostic procedure.
5. Describe how a paraclinical diagnostic procedure should
be selected among several options.
86. Management of a Surgical Patient [Process]
Learning Objectives
6. Describe how to interpret results of a paraclinical
diagnostic procedure to come out with a
pretreatment diagnosis.
7. Describe how a treatment modality should be selected
among several options.
8. Enumerate at least 4 essential items in the preoperative
preparation of a surgical patient.
9. Enumerate in correct chronological order 7 phases in
the intraoperative management starting from the
incision to wound closure.
87. Management of a Surgical Patient [Process]
Learning Objectives
10. Enumerate at least 4 items in the immediate
postoperative care of a surgical patient.
11. Enumerate the two objectives of a follow-up plan after
treatment of a patient (whether surgical or not).
12. Describe how to advice patients on clinical diagnosis,
paraclinical diagnostic procedures, treatment,
follow-up, and health promotion and maintenance.
13. Describe when and to whom to refer.
88. Management of a Surgical Patient [Process]
HOPE
u have enjoyed this
learning session!
Text or email me for any feedback and questions:
0918-804-03-04
rjoson2001@yahoo.com
89. Management of a Surgical Patient [Process]
Recommended Additional Readings:
Basic Introduction to the Operation
Maxims, Rules, and Guides in the Management of a
Patient
Preoperative Evaluation (Risk Assessment and
Management)
Text or email me for any feedback and questions:
0918-804-03-04
rjoson2001@yahoo.com