It\u27s Midnight. Do you know how your patient is doing?

Transitions of care are vulnerable points in patient care. With the volume of information transferred, quality of care and patient safety are at risk. Numerous attempts at standardization of transitions of care have been utilized; however no consensus regarding the optimal method has been reached. We developed a “watcher” model in addition to standard end of shift sign out. Patients at risk were identified by the day team and seen overnight by a senior and junior surgery resident, along with a nursing representative: either a bedside RN or nursing supervisor. We hypothesized that these midnight rounds could proactively identify patient care issues and intervention would be implemented sooner in a patient’s hospital coursehttps://jdc.jefferson.edu/patientsafetyposters/1036/thumbnail.jp

Limited post-operative narcotic use in elective laparoscopic cholecystectomy

Purpose: To limit narcotics use Cochrane review: multiple studies have shown postoperative pain can be managed with non-narcotic meds with good outcome Less medication related side effects:N/V, constipation, disorientation Prevents substance addiction/abusehttps://jdc.jefferson.edu/patientsafetyposters/1069/thumbnail.jp

Standardized Consent Forms for Surgical Procedures: An Intervention to Improve the Resident-led Informed Consent Process

Objectives and Goals: To provide high quality, consistent consent forms for common surgical procedures and improve resident workflow by creating and implementing standardized printed consents for common surgical procedures. These consents will be used by residents consenting patients in the ED or inpatient setting. Consents shall include standardized procedure descriptions, risks and benefits of the procedure, and alternative treatment option descriptions, risks and benefitshttps://jdc.jefferson.edu/patientsafetyposters/1057/thumbnail.jp

Comprehensive Review of Cardiovascular Disease Risk in Nonalcoholic Fatty Liver Disease

Nonalcoholic Fatty Liver Disease (NAFLD) is a growing global phenomenon, and its damaging effects in terms of cardiovascular disease (CVD) risk are becoming more apparent. NAFLD is estimated to affect around one quarter of the world population and is often comorbid with other metabolic disorders including diabetes mellitus, hypertension, coronary artery disease, and metabolic syndrome. In this review, we examine the current evidence describing the many ways that NAFLD itself increases CVD risk. We also discuss the emerging and complex biochemical relationship between NAFLD and its common comorbid conditions, and how they coalesce to increase CVD risk. With NAFLD\u27s rising prevalence and deleterious effects on the cardiovascular system, a complete understanding of the disease must be undertaken, as well as effective strategies to prevent and treat its common comorbid conditions

Persistent left superior vena cava: Review of the literature, clinical implications, and relevance of alterations in thoracic central venous anatomy as pertaining to the general principles of central venous access device placement and venography in cancer patients

Persistent left superior vena cava (PLSVC) represents the most common congenital venous anomaly of the thoracic systemic venous return, occurring in 0.3% to 0.5% of individuals in the general population, and in up to 12% of individuals with other documented congential heart abnormalities. In this regard, there is very little in the literature that specifically addresses the potential importance of the incidental finding of PLSVC to surgeons, interventional radiologists, and other physicians actively involved in central venous access device placement in cancer patients. In the current review, we have attempted to comprehensively evaluate the available literature regarding PLSVC. Additionally, we have discussed the clinical implications and relevance of such congenital aberrancies, as well as of treatment-induced or disease-induced alterations in the anatomy of the thoracic central venous system, as they pertain to the general principles of successful placement of central venous access devices in cancer patients. Specifically regarding PLSVC, it is critical to recognize its presence during attempted central venous access device placement and to fully characterize the pattern of cardiac venous return (i.e., to the right atrium or to the left atrium) in any patient suspected of PLSVC prior to initiation of use of their central venous access device

Implementation of Standardized Discharge Instructions

Introduction Previously, same-day surgical discharge instructions were handwritten by residents on generic fill-in-the-blank forms leading to inconsistent discharge instructions. Residents started an initiative to create these standardized discharge instructions. These instructions were designed to improve documentation for post-operative instructions as well as enhance overall patient safety in an attempt to eliminate miscommunications with patients.https://jdc.jefferson.edu/patientsafetyposters/1140/thumbnail.jp