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Length of stay after Major Surgery | Perioperative Coach Feb 04, 2019

Show notes

In short; Post-Op recovery in less than 3 days with over 90% mobilised on day 1.

This in depth discussion relates to the consensus paper from the Perioperative Quality Initiative, see link below. It focuses on: outcomes, length of stay and DREAMS (Drinking, Eating and Mobilising) within hours after major surgery- all key measures of compliance and success in an Enhanced Recovery Program.

Monty Mythen and Joff Lacey with Mike Grocott presenting with contributions from Dr Julie Thacker, Colorectal Surgeon from Duke University and President of the American Society of Enhanced Recovery and Dr Tim Miller, Anesthesiologist from Duke University.

POQI website is here: http://www.poqi.org

For further CME read the paper in Perioperative Medicine:

https://perioperativemedicinejournal.biomedcentral.com/articles/10.1186/s13741-017-0062-7

Attend our next meeting: http://www.ebpom.org/EBPOM-USA

This piece is taken from a longer discussion here: http://www.topmedtalk.com/aser-ebpom-2017-pod-two-live-from-washington-dc/

Greater National Advocates | Sunday Special Feb 03, 2019

Show notes

Please do all you can to help share this a hugely important piece, both for practitioners and patients. Adverse outcomes can be avoided, stories like the one on this podcast are fuel in the engine of those who advocate true perioperative care. If you want to help go to the Greater National Advocates website here: https://www.gnanow.org/ The Patient Safety Movement is here: https://patientsafetymovement.org/

Presented by Desiree Chappell and Monty Mythen with their guests L. Bradley Schwartz, president of Founder and President of Greater National Advocates he has served on the Board of Directors of both the National Association of Healthcare Advocacy Consultants (NAHAC) and the Patient Advocate Certification Board (PACB). Also in the conversation is Joseph Frankel, President, Frankel Design, Inc. - The Art of Brand Development & Promotional Marketing.

Dan Martin, OBE | TopMedTalks to... Feb 02, 2019

Show notes

Desiree and Monty catch up with Dan Martin, OBE, and speak with him about treating infectious diseases and in particular patients with ebola. Presented by Desiree Chappell and Monty Mythen with their guest Dan Martin, OBE anaesthetist and intensivist at the Royal Free Hospital and Reader at University College London (UCL).

POET 1.09 | How to drive perioperative care. Feb 01, 2019

Show notes

This piece discusses how the contributors are driving better perioperative care in their clinics; the importance of getting patient records in advance; ERAS for obstetrics; challenging opioid use with the multimodal pain management; shared decision making in pain management; the importance of clear communication pathways and patient literacy.

This podcast features Desiree Chappell interviewing; Dr Ellen Flanagan, anaesthesiologist and medical director at the Duke preoperative assessment testing clinic, Dr Attila Kett, anaesthesiologist and Chairman at St Peter's University Hospital at New Jersey and Lynn Reede, CRNA and chief clinical officer at the (AANA) American Association of Nurse Anaesthetists.

Anesthesiology, New England Journal of Medicine: Triple low alerts | Journal Club Jan 31, 2019

Show notes

Triple-low Alerts Do Not Reduce Mortality: A Real-time Randomized Trial.

Sessler DI, Turan A, Stapelfeldt WH, Mascha EJ, Yang D, Farag E, Cywinski J, Vlah C, Kopyeva T, Keebler AL, Perilla M, Ramachandran M, Drahuschak S, Kaple K, Kurz A. Anesthesiology. 2019 Jan;130(1):72-82. doi: 10.1097/ALN.0000000000002480.

https://www.ncbi.nlm.nih.gov/pubmed/30312182

Why Money Alone Can't (Always) "Nudge" Physicians: The Role of Behavioral Economics in the Design of Physician Incentives.

Lubarsky DA, French MT, Gitlow HS, Rosen LF, Ullmann SG. Anesthesiology. 2019 Jan;130(1):154-170. doi: 10.1097/ALN.0000000000002373. https://www.ncbi.nlm.nih.gov/pubmed/30074931

Beyond Nudges - When Improving Health Calls for Greater Assertiveness.

Ubel PA, Rosenthal MB. N Engl J Med. 2019 Jan 24;380(4):309-311. doi: 10.1056/NEJMp1806371.

https://www.ncbi.nlm.nih.gov/pubmed/30673544

EBPOM Highlight 1.08 | Post-operative critical care: what should we do? Jan 30, 2019

Show notes

"Post-operative critical care: what should we do?" - originally streamed live from The Institute of Engineering and Technology (IET) in London during EBPOM 2018 on www.topmedtalk.com

Hear this excellent talk, for free, on this podcast.

If you'd like to attend an event like this ensure your next click is here: www.ebpom.org/meetings

If you have any comments or questions you'd like to send to the team email: contact@topmedtalk.com

Presented by Denny Levett, Professor in Perioperative Medicine and Critical Care at Southampton University Hospital NHS Foundation trust and Honorary Associate Professor at the University of Southampton.

Urine output | Perioperative Coach Jan 28, 2019

Show notes

Should we still measure urine output? How useful is permissive oliguria?

Presented by Professor Monty Mythen and Dr Joff Lacey featuring guests Dr Tim Miller from Duke University Medical Centre and John A. Kellum, Tenured Professor, Critical Care Medicine from The University of Pittsburgh.

Medical Linguistic Anthropology and Patient Autonomy | Sunday Special Jan 27, 2019

Show notes

How do the insights of a 'medical linguistic anthropologist' impact upon our understanding of 'shared decision making'? How do patients make decisions about surgery? When, in the perioperative process, do they decide what is best for them?

Does patient autonomy actually even exist?

A bubble bursting conversation with a frequent favourite on TopMedTalk, this podcast is bound to get you thinking!

Presented by Desiree Chappell and Monty Mythen with their guest Dr Lee Fleisher Professor and Chair of Anesthesiology and Critical Care, University of Pennsylvania.

Joe Kiani | TopMedTalks to... Jan 26, 2019

Show notes

The concern for patient safety naturally flows throughout the healthcare continuum. In our discussion with Masimo Founder, Joe Kiani, we discuss the 'planning for zero' initiative and how we can realistically reach perfection in this area. The Patient Safety Movement Foundation is an organization dedicated to a goal of ZERO in-hospital preventable deaths by 2020. They request that you and your organization get involved and commit to this goal. Find out more at www.patientsafetymovement.org Presented by Desiree Chappell and Monty Mythen with their guest Joe Kiani, Founder, Chairman & CEO of Masimo, Cercacor & Patient Safety Movement Foundation.

POET 1.08 | If patients come to us anaemic - they just do worse Jan 25, 2019

Show notes

How important is it to screen patients for anaemia before surgery? Has anaemia fallen off the health care agenda? We begin with a conversation about patients who are anaemic and then turn to why this is sometimes not checked enough. Monty Mythen mentions UK University students appear to suffer from the condition more these days and Lori Heller points out that treating the condition, as part of patient optimisation, is something of a revelation for some, even occasionally removing the need for surgery altogether. Discussion continues regarding haemoglobin levels and the differentiation between men and women. The importance of discovering the condition early on in the pre-habilitation process is also emphasised. Towards the end of the piece Monty makes some time to speak about the "Iron Woman - Iron Therapy for Female athletes" study instigated by Professor Toby Richards. This piece features Professors Monty Mythen and Mike Grocott with guests Lori Heller, Cardiac Anaestheisologist from US Anaesthesia Partners at the Swedish Medical Center in Seattle, and Mike Scott, Professor in the department of Anesthesiology Virginia Commonwealth University Health System in Richmond USA.

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