Becker's Clinical Quality & Infection Control

51 SURGICAL SAFETY NIH Program Seeks to Reduce Health Disparities in Surgical Outcomes By Max Green T here is a disparity between surgical outcomes for minority and disadvantaged groups compared to the overall popula- tion. e National Institutes of Minority Health and Health Disparities has set out to learn more about why this happens. "Disparities in surgical care can result in poorer functional outcomes, prolonged rehabilitation, recovery and lower quality of life, particularly for disadvantaged population groups," NIMHD Director Eliseo J. Pérez-Stable, MD, said in a statement. "Racial and ethnic minority and low-income population groups are oentimes disproportionately affected by access, availability and affordability to the most advanced healthcare services." Studies have shown that patients with lower socioeconomic status experience higher surgical mortality rates regardless of access to care, race or age. Other factors, such as a higher prevalence of chronic disabling conditions and poorer quality of life, are also associated with disadvantaged populations, according to the National Institutes of Health. e new initiative is offering grant opportunities to better under- stand and address these disparities. e American College of Sur- geons has also announced five priorities for addressing surgical disparities, which dovetail with the new NIHMD project. ese five goals include: 1. Improving patient-clinician communication by helping clini- cians deliver culturally dexterous, competent care and measuring its effect on the elimination of disparities. 2. Fostering engagement and community outreach by using technol- ogy to optimize patient education, health literacy, and shared decision making in a culturally relevant way; disseminating these technologies; and evaluating their effect on reducing surgical disparities. 3. Improving care at facilities with a higher proportion of mi- nority surgical and trauma patients. is includes evaluation of regionalization of care versus strengthening of safety-net hospi- tals with the context of differential access and surgical disparities. 4. Evaluating the longer-term effect of acute interventions and rehabilitation support within the critical period of injury or illness on functional outcomes and patient-defined perceptions of quality of care. 5. Improving patient centeredness by identifying expectations for postoperative and post-injury recovery. is includes adhering to patient values regarding advanced healthcare planning and palliative care needs. e Agency for Healthcare Research and Quality is also collabo- rating on the program. n Surgery Program Directors Say Flexible Hours for Residents Improve Education, Patient Safety By Shannon Barnet M any surgery program directors agree; residency pro- grams with flexible policies for duty hour requirements are superior to standard requirements regarding resi- dent education and well-being, as well as patient care, accord- ing to a study in Journal of the American College of Surgeons. Researchers surveyed 117 surgery program directors last summer as part of their study. Here are three takeaways from the survey results. 1. Every director indicated that residents in their program utilized the flexible hours at some point or another to complete tasks they had started or to stabilize a critically ill patient. 2. Directors of programs with flexible hours observed more positive effects than directors of programs with standard policies in the safety of patient care, continuity of care and resident ability to attend educational activities. 3. Directors of both finds of programs indicated that adopting more flexible duty hours were improve continuity of care (94 percent), quality of resident education (83.8 percent), patient safety (71.8 percent) and resident wellbeing (55.6 percent). n AORN Campaign Aims to 'Clear' Hazardous Smoke From ORs By Max Green S urgical smoke, or plume, is sometimes produced in operat- ing rooms as a byproduct of medical devices. Plume is so hazardous to clinicians in ORs that researchers equate the use of an electrosurgery device that produces it on a single gram of tissue to smoking six unfiltered cigarettes in 15 minutes. Although the long-term effects of surgical smoke are still unknown, statistics show that nurses working in ORs are twice as likely to have respiratory complications as the general pop- ulation. The Association of periOperative Registered Nurses has launched a campaign aimed at mitigating the health risks that might be created by surgical smoke. "We created the Go Clear Award program to give surgical team members and administrators the tools they need to establish and maintain a safe surgical setting," Linda Groah, RN, executive di- rector and CEO of AORN, said in a statement. "At this time, there is very little awareness about smoke hazards and there is too little consistency in safe practices. We need to turn that around." The Go Clear program includes elements of testing, interpro- fessional education, compliance monitoring and gap analysis to evaluate how surgical teams can reduce and eliminate hazards related to plume. Materials for those interested in participating in the campaign will be released in August. n

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