...Response/Recommendation: Yes, autograft tissue should be soaked in an antibiotic solution prior to implantation during ACL reconstruction. Strength of Recommendation: Strong Rationale: Infection after ACL reconstruction is uncommon but can cause serious complications.1 Contributing factors that may lead to infection include diseases such as diabetes, smoking, increased time of surgery and tourniquet inflation, additional or larger incisions for arthroscopic portals and the use of a drain.2 The use of preoperative prophylactic antibiotic has been previously established to reduce infection rates in orthopedic surgery procedures.3 Traditionally, allograft anterior cruciate ligament (ACL) grafts have been associated with a higher concern...
Words: 484 - Pages: 2
...knee from picking up baskets. Per OMNI, he is diagnosed with cervical degenerative disc disease and right knee meniscus tear. He is status post right knee arthroscopic repair surgery on 04/08/13. Per Orthropedic panel QME report dated 05/13/15, it was noted that the patient started having aches and pains in both of his right shoulder and left knee on 01/01/13 a couple of weeks when he stopped working. He received a cortisone injection to the right shoulder which did not work. Since that time, his right shoulder pain worsened. He has difficulty keeping static positions with his right arm. He is unable to reach behind his back. He has left knee pain inside the kneecap. On examination of the right shoulder, there is impingement syndrome with some limitation of range of motion. Bothe knees show degenerative joint disease with crepitus and medial joint line tenderness. There is some edema in the distal lower extremities....
Words: 480 - Pages: 2
...Name: Ariagna Briceno Date: 01/23/2012 CIS110 Smartlipo Smartlipo Laser Body Sculpting is a revolutionary, minimally invasive treatment that does something, no fitness routine in the world can: permanently destroy fat cells. Since your body has only a finite amount of these cells, no new fat cells come back. You can finally have that body you have always wanted. How does Laser Body Sculpting work? This laser-assisted lipolysis procedure is performed using a one millimeter cannula (or tube) inserted into the skin. A laserfiber inside of the cannula delivers energy directly to fat cells, causing them to rupture and drain away as liquid. Simultaneously, tissue around the area coagulates, resulting in overall tighter skin tissue. What areas of the body can be treated? Laser Body Sculpting is ideal for the neck, jaw line, arms, breasts, bra fat, abdomen, inner and outer thighs and knees. Who is a good candidate? A perfect candidate is in good health and of normal body weight. How does Laser Body Sculpting compare to conventional liposuction? Convention liposuction is meant to remove greater amounts of fat. However, since this can leave behind unsightly pockets of skin. Is there a recovery period? Laser Body Sculpting is a minimally invasive procedure which usually requires only local anesthesia. Some light trauma can occur, but you will be able to return to work in a couple of days and resume exercise after 2 weeks. How...
Words: 263 - Pages: 2
...consulted with the physicians regarding the patients’ course of treatment. I began to realize what an integral role a PA can have in both a hospital and private practice setting, and the relationships that they develop with their patients. There were many times that I witnessed the PA’s spending more time and being more involved in the care and treatment of the patients than the physician for some of their regular patients. During this time, several PA’s and physicians I had worked with suggested to me that I would make an excellent physicians assistant, and that was when I first became inspired to pursue a career as a PA. I further explored the field by spending time shadowing several PA’s in various fields, including plastic surgery, vascular surgery and OB/GYN. This has inspired me to take 36 credits of prerequisite courses in one year, while still working full time. I constantly strive to excel in what I do, and I commit myself fully to any endeavor that I become passionate about. I am going back to school after almost ten years since graduating college in order to pursue my dream of becoming a PA because I believe in what I am doing, and I am passionate about my goals. I look very forward to a rewarding profession that combines my interests in clinical science and helping others while working in a team...
Words: 269 - Pages: 2
...Case Study 2: Shouldice Hospital Kenneth Snell, David Drummond 1. How successful is the Shouldice Hospital? a. Perform a comparison of the cost to patients at Shouldice vs other Hospitals The cost to a patient at Shouldice is based on an average 3.5 day stay: ($320.00/day x 3.5 days) = $1120.00 $650.00 surgical fee $300 anesthesia fee (20% of the patients) = 300 x .2 = $60.00 Average cost to patient is $1120.00 + $650.00 + $60.00 = $1830.00 Average charge for operations performed at other facilities: $5,240.00 b. Perform an analysis of the profitability of the operation at Shouldice. Include Return on Investment (7,600 patients/year) x $1120.00/patient = $13,908.00 annually Operating budget for the clinic: $3.5M Operating budget for the hospital: $8.5M Estimated annual net income: $13.9M - $12M = $1.908M *Net income is the numerator for any return calculation, and typically shareholder’s equity and total assets would be in the denominator. Since insufficient data was given to estimate total INVESTED CAPITAL in this business, ROI cannot be effectively calculated. c. How is all this achieved? How do you account for this performance? The keys to financial success for the hospital is that Shouldice manages its expenses to reduce overhead costs through allowing patients to be active participants in the service delivery process, reducing...
Words: 2308 - Pages: 10
...Memorandum To: Hospital Staff, Peer Review Committee, Hospital Trustees From: -Lead Surgeon Date: January 20, 2013 Subject: Heart Transplant Candidate The purpose of this memorandum is to come to a conclusion about which individual should receive the heart transplant taking into account ethics. There are three people who are in need of the organ transplant; Jerry, Lisa, and Ozzy. In order to make an informed decision it is important to look at all three cases. Candidate #1- Jerry is a 55 year old male with three children. In his early 20’s Jerry used steroids which in turn damaged his heart. His life expectancy would increase by about 10-15 years with this transplant. Candidate #2- Lisa is a 12 year old female. Her heart was damaged when she contracted pneumonia a year ago. Lisa has had health problems all her life due to a lupus-like immune deficiency. Even with the transplant, it is unlikely that Lisa will live through her 20’s. Candidate #3- Ozzy is a 38 year old male who has a history of drug abuse. As a result of Ozzy’s drug use, he will not be able to live past the month. With the transplant Ozzy has the life expectancy of 10+ years. The Rights Theory The Rights Theory state that an action is ethical is it respects the rights that all individuals have. Taking this theory into account, I do not think it is ethical to accept the 2 million dollars which are being offered to the hospital in exchange for Lisa to receive the transplant. All three of the candidates...
Words: 487 - Pages: 2
...in each man. Roman Catholic accounts report the 3rd-century saints Damian and Cosmas as replacing the gangrenous leg of the Roman deacon Justinian with the leg of a recently deceased Ethiopian. The first successful corneal allograft transplant was performed in 1837 in a gazelle model; the first successful human corneal transplant, a keratoplastic operation, was performed by Eduard Zirm at Olomouc Eye Clinic, now Czech Republic, in 1905. Pioneering work in the surgical technique of transplantation was made in the early 1900s by the French surgeon Alexis Carrel, with Charles Guthrie, with the transplantation of arteries or veins. Their skilful anastomosis operations, the new suturing techniques, laid the groundwork for later transplant surgery and won Carrel the 1912 Nobel Prize in Physiology or Medicine. From 1902 Carrel performed transplant experiments on dogs. Surgically successful in moving kidneys,...
Words: 377 - Pages: 2
...The job description listed is the rewritten version based on the tasks that the writer accomplishes daily. The original job description follows the updated version for comparison. There were changes primarily because the original document did not discuss all of the required daily tasks the employee completes. The areas in red are the changes and additions to the original job description. Opening Date: August 31, 2011 Closing Date: September 09, 2011 Position: Lead Medical Supply Technician, GS-0622-06 Salary: $34,907 - $45,376 Annual Place of Work: BAMC, Department of Anesthesia & Operative Services, Fort Sam Houston, Texas Position Status: This is a Permanent position. -- Full Time Number of Vacancy: 01 Duties: Leads 2-3 civilian personnel in accomplishing the work of the unit. The primary responsibility is to oversee personnel workload and section work processes that promotes efficiency and compliance. Responsibilities include but are not limited to: • Must maintain, order, receive, and verify quantity, quality, and storage of the supplies for the Operating Room, Central Materiel Section, Post-Anesthesia Care Unit, and Anesthesia Service in the Department of Anesthesia and Operative Services. • Monitors price changes and conducts inventories within PYXIS and the Vascular Room. Establishes, revises, and cancels stock levels on items based on demand. • Projects reorder requirements based on demand supported stock levels, expiration dates, and thorough...
Words: 1302 - Pages: 6
...scope of influence overseas. Hospitals are now sending surgeons overseas to perform surgical procedures with real time information being delivered back and forth electronically between physical locations. This allows major hospitals here at home to now compete internationally and push back against the increasing popular phenomenon known as medical tourism, the practice of seeking low-cost healthcare in foreign countries. The Cleveland Clinic not only engages in this practice but is now actively expanding and building hospitals overseas. Electronic medical records and medical robotics have allowed the Cleveland Clinic health system here in Ohio to monitor all procedures being done overseas and even allows surgeons here in the US to perform surgery on international patients from right here at home. The advancement of surgical robotics and information communication technologies have allowed surgeons to transcend traditionally human limitations. These new technologies allow major hospitals like the Cleveland Clinic to increase their capacity for competition in foreign countries. Having said that, the flattening of the industry also increases competition from foreign countries against major hospitals here at home. The flattening of the healthcare industry due to technological advancements hospitals here in the US will begin facing an increased amount of competition as other countries around the world invest more resources into becoming...
Words: 421 - Pages: 2
...Jenny Ramos HCA 240 1/16/2013 Tirizia York Explanation of the Monthly Budget A variance report is a report where it demonstrates and compares the cost for our hospital. This reports shows what the budget was estimated for, the actual amount spent, and the variance. The variance means what we profited in or lost. I work in one the few bigger hospitals as a finance manager. There was recently a tornado that killed eight people, destroyed over a couple dozen homes, and injured about hundred people. Obviously, this was an unexpected event that had impacted my budget. Many of these patients did not have medical insurance, therefore, we were not receiving as much profit as we were losing. Even though my Vice President was aware of the tornado he asked me to explain and write out a variance report on why we went over our allowed budget. I wrote a letter of explanation for our Vice President which gives details on why did not meet our budget. This is a letter intended to explain why our monthly budget results were not as planned. For this month, we exceeded our monthly budget. This month our salary cost was higher than what was budgeted. Our budget count estimated for salary for our employees was 200,000 dollars. This budget was supposed to cover the salary for the whole hospital. The actual amount calculated was 240,000. The variance for this was 40,000 dollars. This means that our budget was exceeded by twenty percent. As you already know there was a tornado in our city...
Words: 710 - Pages: 3
...Shouldice system has led to great competitive positioning, the hospital is falling victim to its own success. Demand for Shouldice services is so much higher than its current capacity of 89 beds that it is in a constant state of operations backlog, which grows by 100 patients every 6 months. Thus, Shouldice needs to find a solution to its single most critical question – how to expand the hospital’s capacity while simultaneously maintaining quality control of service delivery. The analysis below is designed to assess the current operations at the hospital, in addition to explaining our recommendation that Shouldice should invest $4MM in a new unit, which will increase bed capacity by 50% and require its surgeons to perform Saturday surgeries. As the financial analysis shows, this change will allow Shouldice to capture unmet demand without compromising its unique system of patient and employee care. Lastly, our recommendation will be also juxtaposed to other options we evaluated as potential solutions, but that neither make financial sense nor solve the current dilemma for the hospital. Hospital Overview Shouldice Hospital is a “focused factory:” a hospital with a specific area of expertise that gives it competitive strength resulting in lower cost, higher quality service for its patients, and better pay for and loyalty from its employees. Specializing in external abdominal hernias, Shouldice doctors execute the “Shouldice Technique” developed by founder Dr. Edward...
Words: 2357 - Pages: 10
...Performance Pay for Massachusetts General Orthopaedic Association Spring 2014 Christopher J. Tukiendorf March 17, 2014 Performance Pay for MGOA Physicians Key Problems Faced by MGOA I believe that there are three key problems that the Massachusetts General Orthopaedic Associated (MGOA) faced when Dr. Harry Rubash and Dr. James Herndon arrived to help remedy the association’s financial situation. The first of the three issues was the financial problem that MGOA was faced with. Over time MGOA had not addressed the issues of receiving fewer monies from private and governmental insurers and that amount had now grown to a staggering $1 million dollars that the orthopaedic association had borrowed from the hospital. The second issue was the number of practicing physician’s that bought in less revenue than the expenses that they accrued by using the hospital’s facilities. The third and final issue was the apparent lack of administrative organization and communication. The lack of leadership really gave way to the financial issues and poor performing physicians that now plagued MGOA. The Massachusetts General Hospital realized these three issues were becoming major problems and decided to bring Rubash and Herndon on board to help turn the association around. The Solution and Roll Out Rubash and Herndon realized they needed to act fast and the first order of business was to communicate the problems to the staff. Rubash held meetings that allowed the staff to express their...
Words: 918 - Pages: 4
...What is the role of the anaesthetist? Anaesthetists play a very important role in surgery. In addition to the administration and monitoring of anaesthetics and sedation, they have a responsibility to keep the patient comfortable and in a stable condition. The anaesthetist has a role in the pre, peri and postoperative stages. Including: Preoperative- Gaining consent from the patient and choosing the most suitable anaesthetic/s Perioperative- Monitoring the patient (most important, the patient’s airway) Postoperative- Continue monitoring the patient, documentation of anaesthetics given and the patient’s state throughout the pre, peri and postoperative stages. (State Government of Victoria, 2011) Outside of theatre, anaesthetists can assist with pain relief and management in a wide variety of areas. State Government of Victoria (2011, February 12). Anaethetist. Pick Vic! Retrieved March 6, 2014, http://pickvic.ssa.vic.gov.au/jobs/healthcare-medical-and-community/medical-and-nursing/anaesthetist Sterile Field A sterile field is created to provide a surgically aseptic workspace. It should be considered a restricted area. Asterile drape may be used to establish a sterile field or to extend the sterile working area. The sterile drape should be waterproof on one side, with that side placed down on the work surface. After establishing the sterile field, other sterile items needed, including solutions, are added. Sterile items and sterile gloved hands are the only...
Words: 636 - Pages: 3
...Robotic Surgery Technology, Society, and Culture HUMN432 Introduction: Robotic Surgery Robotic surgery is the latest development that uses robots and computer aided apparatus to aid in normal surgical procedures. It is a new technology and mostly used in well-developed countries. With robotic surgery a single surgeon is able not only to perform multiple surgeries but also do his/her work from any part of the world (McConnell, Schneeberger & Michler, 2003). Robotic surgery is a type of procedure that is similar to laparoscopic surgery. It also can be performed through smaller surgical cuts than traditional open surgery. There are small precise movements that are possible with this type of surgery. It gives some advantages over standard endoscopic techniques. Sometimes robotic-assisted laparoscopy can allow a surgeon to perform a less-invasive procedure that was once only possible with more invasive open surgery. Once it is placed in the abdomen, a robotic arm is easier for the surgeon to use than the instruments in endoscopic surgery. The robot reduces the surgeon’s movements. The robot assistance reduces some of the hand tremors and movements that might otherwise make the surgery less precise. Robotic instruments can access hard-to-reach areas of your body more easily through smaller incisions compared to traditional open and laparoscopic surgery. This procedure is done under general anesthesia where you are asleep and pain free. The surgeon sits at a computer...
Words: 1434 - Pages: 6
...Andrea Moore PSYC 320-001 January 19, 2012 Frank and Lillian Gilbreth Scientific Management Studies The Gilbreths studies were great contributions to not only scientific management, but to the modern world we live in today. They were innovative, and efficient in all aspects of life. Their values and ideals were influences by their unique and fulfilled lives, enriched with the responsibility of caring for twelve children. Certainly, Frank and Lillian had a lot on their hands, so they had to always find the best way to function as a very large family. Therefore, the Gilbreths instilled their main goal, to search for the one best way to organize and execute, into studies of work flows and processes. Their ultimate purpose was to insure quality work performance and satisfaction (BMJ Journals, 2009). Their great studies and creditability lead to interesting careers in consulting, and lifelong recognition of efficiency. One of the studies that I found interesting dealt with the quality and safety in healthcare. The Gilbreths used motion-picture films, to analyze job handling, in this case physician behavior in the surgical room. From the article, Frank Gilbreth and health care delivery method study driven learning, Denis R. Towill states, “Frank Gilbreth invented the micro chronometer, a large clock that could record time to 1/2,000th of a second. By placing the micro chronometer next to the worker in the film camera’s field of vision and attaching a flashing strobe light...
Words: 496 - Pages: 2
