Becker's Clinical Quality & Infection Control

64 QUALITY IMPROVEMENT & MEASUREMENT Stanford Medicine opens VR anatomy lab to aid surgery planning, resident training: 5 notes By Jessica Kim Cohen T he neurosurgery department at Stanford (Calif.) Medicine opened an anatomy lab to complement its existing virtual reality center, the university announced March 8. Here are five notes on the neuroanatomy lab. 1. Stanford Medicine opened its neurosurgical simulation and virtual reality center in 2016 to allow neurosurgery residents and surgeons to explore digital 3-D renditions of brain structures. e center uses simulation soware to transform 2-D patient datasets, such as MRIs and CT scans, to create 3-D images. Residents use the soware to practice their skills, while surgeons use it to plan operations. 2. To transition VR into hands-on training, the de- partment opted to launch the anatomy lab. In the lab, residents are able to project 3-D models onto cadavers and practice surgical procedures. In a March 8 statement, Anand Veeravagu, MD, an assistant professor of neuro- surgery and orthopedic surgery at Stanford Medicine, said the lab helps residents "build confidence and training in what they're doing." 3. Stanford Medicine procured the lab's equipment, worth more than $1.5 million and donated by various organiza- tions, during the course of about 18 months. Medtronic, Stryker, Haag-Streit USA and Mizuho donated equipment to the lab. 4. Neurosurgery leaders at Stanford Medicine hope the anatomy lab will act as a "bridge" between the simulation center and the operating room for residents looking to hone their skills. "In the simulation lab, the residents can put on the gog- gles, interact with the patient anatomy and learn about the case they're about to do the next day," said Harminder Singh, MD, clinical associate professor of neurosurgery at Stanford Medicine. "en in the anatomy lab, they do the dissection on real cadaver heads and practice the surgery techniques." 5. e anatomy lab is only a prototype, according to the March 8 statement, since the building it's housed in is scheduled for demolition within the next few years. Fol- lowing the demolition, the anatomy and simulation labs will be relocated to a permanent location. Neurosurgery leaders at Stanford Medicine hope the future anatomy lab will be larger, with space for three additional dissection stations. n 5 Joint Commission hospital requirements most commonly cited as 'not compliant' in 2017 By Anuja Vaidya T he Joint Commission identified the requirements most commonly cited as "not compliant" during surveys for various types of accreditation and certification for calendar year 2017. Here are the top five requirements hospitals failed to meet during accreditation surveys. 1. The hospital provides and maintains systems for extinguishing fires — 86 percent noncompliant 2. The hospital manages risks associated with its utility systems — 73 percent 3. The hospital provides and maintains building features to pro- tect individuals from fire and smoke hazards — 72 percent 4. The hospital reduces the risk of infections associated with med- ical equipment, devices and supplies — 72 percent 5. The hospital established and maintains a safe, functional envi- ronment — 70 percent n 2 blood thinners linked to shorter hospital stays By Anuja Vaidya B lood thinners rivaroxaban and dabigatran correlated with shorter hospitalizations, according to study published in Plos One. Researchers examined a U.S.-based commercial database from Nov. 1, 2010, to March 31, 2014, and identified adults with atrial fibrillation hospitalized for bleeding after starting to take the following blood thinners: • Warfarin (2,446 users) • Dabigatran (442 users) • Rivaroxaban (256 users) The study shows warfarin users were hospitalized two days lon- ger than dabigatran users and 2.6 days longer than rivaroxaban users. Dabigatran users were hospitalized 0.6 days longer than rivaroxaban users. Researchers found no differences in the proportion of intensive care unit admissions among the three groups of users. However, among ICU admissions, warfarin users' hospitalizations were three days longer than dabigatran users and 2.4 days longer than rivaroxaban users. There was no difference in ICU stay between dabigatran and rivaroxaban users. Additionally, there were no differences in 30-and 90-day all-cause mortality among the three groups. n

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