...that all procedures and protocols were outlined prior to the surgery having begun, and the RN, MSN Darla was well prepared to give us an overview of the entire aortic valve replacement process. One of the most important safety measures I observed at Inova was the role each physician, nurse, and other staff member played in the surgery. Each individual knew what was expected of him or her and was held accountable for one task or another. Within the pre-op room, the age, sex, race and other important information were listed on the patient chart along with the details of where each individual would stand or sit throughout the procedure. A short but concise rundown of the steps to follow during the procedure was written out on the whiteboard along with abbreviations for special equipment to be used. During the procedure, Darla explained each person’s duty and highlighted the role of the nurse who was in charge of making sure all medical supplies were accounted for at the end of the surgery. This included a magnetic board that held all the needles used during the procedure, all the gauze used during the procedure, tubes, tissues, etc. Next, she discussed the role of the nurse anesthetist who would keep monitoring the patient’s alertness levels to decide whether the patient needed another dose of anesthesia. In addition, Darla explained how the RN-First Hand nurses were able to physically help the surgeon perform the surgery because they had received special training that allowed them...
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...Heart Valve Surgery Once a valve problem has been diagnosed and surgery scheduled, you’ll have some things to do. Some preparations will help make your surgery go smoothly. Some will help you get set up for your return home from the hospital. And others will help you feel more at ease. Your doctor will talk with you about the risks. Write down all your questions in advance so you don’t forget to ask them. The Week Before Surgery Steps you take before your surgery can help make both the surgery and recovery go smoothly. Follow your doctor’s instructions. • Ask your doctor about scheduling any dental work you might need. Dental work could let bacteria into your bloodstream, which can cause infection on a new valve. • Give your doctor a list of every medication you take, including supplements and over-the-counter products. Your doctor may have you stop taking some of them or start taking others before surgery. • If you smoke, quit right away. You will do better during and after surgery. • Arrange for an adult family member or friend to drive you home from the hospital. Have a helper available for your first week or two at home. • Prepare and freeze food or arrange to have food brought in while you recover. • Make adjustments around your home to simplify movements, such as reducing the need to climb stairs. The Day Before Surgery • You may be asked to wash with special soap the night before surgery. The morning of surgery, don’t use deodorant, lotion, or perfume. • Don’t...
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...25 July 2013 Research Essay/Historical Evaluation The First Heart Operation. 1. What doctors, in 1800’s were able to perform and achieve in the operating rooms? 2. How was the first heart operation performed in 1893? 3. How did Dr. Daniel Hale Williams career change after his first heart operation? July of 1893: As a new century loomed, was this certainly particular year of great progress into new medical innovations. In that year, the first heart operation was performed and another man’s life was saved. This big achievement helped set the new stage for modern surgery. Medical professionals at that time said that: “operating on human heart was too dangerous, and there were no procedure for opening the chest.” (The first heart operation-chicagotribune.com) In 1800’s, being a doctor wasn’t easy as we may think. How was the first heart operation performed at that time and very important aspect of that, how did Dr. Williams career and life changed after his first heart operation? ...
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...Open Heart Surgery at Cabarrus Memorial Hospital Strategic Management for Healthcare Organizations EXECUTIVE SUMMARY This analysis serves as an evaluation of the current strategic plan being developed by Cabarrus Memorial Hospital. It will highlight the recommended strategies in three different categories that will aid a guide in effort to successfully implement the strategies to bring the organization to the forefront of its market. Outlined throughout the analysis is the organization’s history, the suggested Directional Strategies, the Expansion of Scope strategies, and the Implementation strategies along with other key elements that are necessary for the plan to be a success. It will provide an inside look at why new alternatives are not needed and the why the focus should be placed on the products and services already offered and the introduction of the new cardiac care unit to maintain its position in the healthcare market. The purpose is to initiate a strategic plan which makes recommendations to leadership based on the results of the study and to maintain an overall setting of patient and family satification. Key Issues The lack of open heart surgery program at Cabarrus Medical Center results in requiring patients who require open heart surgery or coronary angioplasty services to transfer to another hospital, delaying necessary treatment and causing anxiety and hassle to the patient and their family. Should the current mix of cardiac services be...
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...Running head: THE CASE FOR OPEN HEART SURGERY AT CABARRUS The Case for Open Heart Surgery at Cabarrus Memorial Hospital Terry Brown Strayer University Health Services Administration HSA 599 Dr. Donna Leveque November 17, 2012 Abstract This report will discuss the ways an open heart surgical program does or does not comply with Cabarrus Memorial Hospital’s (CMH) mission. It will analyze whether or not CMH has the infrastructure and financial resources/leverage to add this program. This report will describe the competitive situation among other hospitals that will impact the hospital’s decision. This report will further describe the changes necessary in the service area to accommodate the cardiovascular surgery service. Key Words: cardiovascular services/competition, mission, decision factors, financial considerations, changes The Case for Open Heart Surgery at Cabarrus Memorial Hospital Cabarrus Memorial Hospital (CMH) was dedicated to education. They were affiliated with Duke University Medical Center. This affiliation allowed for many specialists to practice at CMH. The goal at CMH was for everyone to have the best healthcare services. The issues now facing CMH were to address the opening of a new cardiovascular service program, in order to continue to provide this excellence in care. Cardiovascular services/competition The decision was in front of...
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...19 CASE The Case for Open Heart Surgery at Cabarrus Memorial Hospital Situation It was a clear, crisp October morning in Concord, North Carolina. The board of trustees of Cabarrus Memorial Hospital gathered in the windowless, walnut paneled boardroom for its monthly meet- ing (see Exhibit 19/1 for board members). Board chairman George Batte opened the meeting saying, “Because we do not have an open heart surgery program, patients needing open heart surgery or coronary angioplasty have to be transferred to another hospi- tal, causing inconvenience to the patient’s families and risks from delayed treatment. There are several questions we have to answer in addressing this issue. Should we add open heart surgery to the mix of cardiac services we offer? Does the hospital’s existing service area provide adequate patient volumes to support the program? What This case was written by Fred H. Campbell, The University of North Carolina at Charlotte, and Darise D. Caldwell, Executive Vice President and Chief Operating Officer, Northeast Medical Center. It is intended as a basis for classroom discussion rather than to illustrate either effective or ineffective handling of an administrative situation. Used with permission from Fred Campbell. 804 Exhibit 19/1: CMH Board of Trustees Mr. George A. Batte, Jr., Chairman (Retired Manufacturing Executive) Mr. L. D. Coltrane, III, Vice Chairman (Telephone Company President) Mr. Robert L. Wall (President, Cabarrus...
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...That is exactly what Jillian Benfield did. A new mother who learned that her nine-month-old son needed open-heart surgery, she wrote a thank-you letter to the heart surgeon who did the operation. Her son, Anderson, was born with Down syndrome and a heart defect. Dr. John Nigro, a pediatric cardiac surgeon at Phoenix Children's Hospital, was to do the operation and walked Benfield and her husband through it. But even with a doctor explaining the process to you, heart surgery is heart surgery: a scary prospect. “I can't think of something more terrifying than a doctor cutting open your child's heart, but thankfully everything went well and Dr. Nigro made us feel calm and at ease,” Benfield...
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...STRATEGIC MANAGEMENT What is strategic management? Strategic management can be used to determine mission, vision, values, goals, objectives, roles and responsibilities, timelines, etc. Top of Category What is strategic planning? Strategic planning is a management tool, period. As with any management tool, it is used for one purpose only: to help an organization do a better job - to focus its energy, to ensure that members of the organization are working toward the same goals, to assess and adjust the organization's direction in response to a changing environment. In short, strategic planning is a disciplined effort to produce fundamental decisions and actions that shape and guide what an organization is, what it does, and why it does it, with a focus on the future. (Adapted from Bryson's Strategic Planning in Public and Nonprofit Organizations). A word by word dissection of this definition provides the key elements that underlie the meaning and success of a strategic planning process: The process is strategic because it involves preparing the best way to respond to the circumstances of the organization's environment, whether or not its circumstances are known in advance; nonprofits often must respond to dynamic and even hostile environments. Being strategic, then, means being clearr bout the organization's objectives, being aware of the organization's resources, and incorporating both into being consciously responsive to a dynamic environment. The process is about planning...
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...Read Activity 5.1: CON for Open Heart Surgery beginning on page 87 of the Harris text. Assuming that Jackson County Hospital decided to appeal the state's initial decision on the CON application, what arguments should the Hospital make as part of its appeal to get the initial determination reversed? A certificate of need (CON), is a legal document required for proposed acquisitions, expansions, or creations of facilities are allowed. CONs are issued by a regulatory agency. The concept was developed in the 1970’s with concept of reducing healthcare costs and prevent unneeded cost due competition that may create inflated prices in the marketplace. The original CON concept was embraced by many states due to increased funding by the federal government. Over the years with increasing criticism many states have repelled CON laws. Criticisms of the CON process have been that it eliminates competition and may favor larger institutions and contribute to monopolization of the healthcare services in a particular community. The rejection of the Jackson County Hospital request for the CON for the open heart...
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...innovations in medicine today is fetal surgery. Fetal surgery is an exciting, accurate, and sharp new technology and in particular the surgery they use to help myelomeningocele. It is more advanced than other surgeries and takes more time. It also uses an extensive amount of doctors. Fetal surgery for myelomeningocele (MMC) needs more specialists and surgeons in the OR compared to other surgeries. Spina Bifida Spina bifida is the most common neural tube defect (NTD) today. According to the March of Dimes, “About 1,500 to 2,000 babies are born with spina bifida each year in the United States.” (What is SB, 5). A defect forms in the spine before birth and causes a hole to be left open in the spine. Spina bifida is broken...
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...trauma center that has 852 beds in all, to accommodate the patients that need our services. Being a level one trauma center we receive all of the more extensive cases and life threatening illnesses that our fellow hospitals can not accommodate. We have 6 beds set up in the emergency room to be able to perform emergency surgery at the bedside. This helps us give the patient who may not have the time to be prepped for surgery get the care they need immediately. In order to be considered a level one trauma center, we have to have 24-hour in-house coverage by general surgeons, and prompt availability of care in specialties such as orthopedic surgery, neurosurgery, anesthesiology, emergency medicine, radiology, internal medicine, plastic surgery, oral and maxillofacial, pediatric and critical care. At the medical center, we have also incorporated a comprehensive quality assessment program in order evaluate and improve patient care and wait times when they arrive at the emergency room. (http://www.amtrauma.org/?page=TraumaLevels) Twin oaks offers a full range of diagnostic, medical and surgical specialties in areas such as emergency medicine and trauma, heart and vascular, oncology, orthopedics, neurology, and women’s and children’s services. We are committed to providing the highest overall quality of care and treatment, to have the highest outcomes and performance of our fellow hospitals. We have a committed team of doctors and nurses who are experts in their field. We...
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...Memorandum To: File Reviewer From: Angela Warren Date: 11/8/13 Re: Heart Transplant As the surgeon for this case I received a call today telling me that a heart has become available for one of three patients that are in need of a transplant. I must make a quick choice in which patient will receive the heart and then schedule him/her surgery for today. I must set up anesthesia, surgery room and have all the required personnel to help with the preparation for the transplant. According to J. S. Mill, if I use the utilitarian logic for each patient that is in need of the heart transplant. Each of the three patients is a tremendously important, with many loved ones whose death would bring a great deal of grief and actual physical discomfort of their family members passing. As the acting surgeon for the patient I must decide on who gets the heart transplant and quickly. As an act of utilitarian, in this situation the question would be complicated on deciding which patient gets the donated heart transplant? I say this because Dr. Jonathan Doe has offered the hospital $2 Million Dollars in exchange so that his daughter would be able to get the heart transplant. According to Lisa’s chart, she has a history of suffering health issues all her life due to various viral infections and a lupus-like immune deficiency. Her heart has been damaged due to pneumonia that she had last year and in which her heart had actually stopped. Who is to say that she will even survive the transplant...
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...Derbyshire et al (2)found that one minute after laryngoscopy and tracheal intubation,mean arterial pressure increase by about 35% and heart rate by 18% over the control levels.These cardiovascular changes are accompanied by elevations in plasma catecholamines: adrenaline increases by 40% and nor-adrenaline by 45%.Sribman et al(27) has divided the pressor response into two...
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...one trauma center that has 852 beds in all, to accommodate the patients that need our services. Being a level one trauma center we receive all of the most extensive cases and life threatening illnesses that our fellow hospitals can not accommodate. We have six beds set up in the emergency room to be able to perform emergency surgery at the bedside. This helps us give the patient who may not have the time to be prepped for surgery get the care they need immediately. In order to be considered a level one trauma center, we have to have 24-hour in-house coverage by general surgeons, and prompt availability of care in specialties such as orthopedic surgery, neurosurgery, anesthesiology, emergency medicine, radiology, internal medicine, plastic surgery, oral and maxillofacial, pediatric and critical care. At the medical center, we have also incorporated a comprehensive quality assessment program in order evaluate and improve patient care and wait times when they arrive at the emergency room. (Trauma Center Levels Explained, n.d.) Twin Oaks offers a full range of diagnostic, medical and surgical specialties in areas such as emergency medicine and trauma, heart and vascular, oncology, orthopedics, neurology, and women’s and children’s services. We are committed to providing the highest overall quality of care and treatment, to have the highest outcomes and performance of our fellow hospitals. We have a committed team of doctors and nurses who are experts in their field. We also have...
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...By Jonas Wilson, Ing. Med. Vascular Surgery The surgical branch dealing with disorders of the circulatory system, which includes arteries, veins and lymphatic vessels, is called vascular surgery. These specialists treat varying conditions, such as aneurysms and atherosclerosis. These are abnormal dilations in vessel walls and narrowing/ hardening of the arteries, respectively. Vascular surgeons are focused on fixing vessels in nearly all parts of the body with the exception of the brain and heart. They also deal with peripheral vascular disorders like ulcers on the lower extremities and poor circulation. Surgical approaches to vascular repair may be endovascular (i.e. closed) or open surgery. Endovascular surgery Procedures that fall...
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