Download - Mayson: Successes and Challenges
QA initiatives Lean projects Improving surgical wait list times Surgical check-list—site and procedure
specific Critical incidents analysis Dealing with the pressure demands, are
there areas we can be more efficient NSQIP—decreasing postoperative
complications
NSQIP data—Deciles (1-10)
Importance of FEEDBACK
Questions??
Reduction in Postoperative Pulmonary Complications Ventilator Acquired Pneumonia (PACU and
CSICU). Establishing best practices.Use of EVAC endotracheal tubesPatients nursed 30 degree head up Mouth care
Aug 2012 Baseline Feb 2013 Post-ICOUGH
Cardiac Surgery “Time-Out” Between anesthesia and perfusion to
enable a more patient specific approach to CPB prime and volume replacementVolulyte, albumin, or crystalloid GFR <50
Size of circuit Ultra-filtration/dialysis Blood transfusion issues Cerebral oxygenation issues including
hemodynamic/hematocrit goals
Debriefing & Anesthesia Emergence, and Handovers Appropriate Timing Standard operating procedures at
anesthesia emergence—sterile cockpit Discussion on pain management who is
responsible for orders Handover to PACU, CSICU, ICU
Speakers
Dr Mitra Maharaj—NSQIP Champion Langley, ENT
Dr Sam Bugis, St Paul’s general surgeon, BCMA representative
Dr Ron Collins, Kelowna, Anesthesiologist, ERAS lead
Dr Adrienne Melck, NSQIP Champion, St Paul’s, Endocrine surgeon