0
We're unable to sign you in at this time. Please try again in a few minutes.
Retry
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
Retry
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Invited Critique |

Surgical Care Is a Team Sport :  Comment on “Association Between Implementation of a Medical Team Training Program and Surgical Morbidity”

Gerald M. Fried, MD
Arch Surg. 2011;146(12):1374. doi:10.1001/archsurg.2011.961.
Text Size: A A A
Published online

Extract

Quality improvement is the Holy Grail for those administering surgical programs. It benefits patients by reducing complications and enhancing recovery and saves resources for the health care system. Holte and Kehlet1 have used the term fast track surgery to describe an approach whereby clinical pathways are defined for specific surgical procedures by creating high-level evidence to support each step in the process of surgical care. In this concept, surgeons work collaboratively with anesthesiologists, nurses, nutritionists, and physical therapists to develop and manage the perioperative care. Each step in the care map is based on evidence and evaluated prospectively. As a result, surgical dogma is being replaced by evidence-based surgical practice. This has led to more effective, more efficient, and less morbid surgical care. A recent meta-analysis2 reviewed the evidence in support of such a plan for colorectal operations. The investigators evaluated measures such as early ambulation, early feeding, use of regional anesthesia, avoiding hypothermia, and avoiding overhydration to identify the impact of each of these maneuvers on surgical morbidity and recovery. The ERAS (Enhanced Recovery After Surgery) collaboration has documented a similar benefit after colorectal surgery.3 They have confirmed improvement in recovery, morbidity, and postoperative symptoms in large prospective trials when clinical pathways are developed on the basis of high-level evidence and applied to specific surgical procedures. Other publications47 have shown similar benefits for a variety of surgical procedures.

Sign in

Create a free personal account to sign up for alerts, share articles, and more.

Purchase Options

• Buy this article
• Subscribe to the journal

First Page Preview

View Large
First page PDF preview

Figures

Tables

References

Correspondence

CME
Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
Submit a Comment

Multimedia

* * SCHEDULED MAINTENANCE * *

Our websites may be periodically unavailable between midnight and 04:00 ET Thursday, July 10th, for regularly scheduled maintenance.

Some tools below are only available to our subscribers or users with an online account.

Sign in

Create a free personal account to sign up for alerts, share articles, and more.

Purchase Options

• Buy this article
• Subscribe to the journal

Related Content

Customize your page view by dragging & repositioning the boxes below.

See Also...
Articles Related By Topic
Related Collections
PubMed Articles
Jobs
brightcove.createExperiences();