TopMedTalk

Adverse outcomes, we all know they happen but how do we handle them, record them and avoid them in the first place? The discussion then moves to (Patient Recorded Outcome Measures) PROMS.

Patient optimisation is then discussed. Exercise, could it be so effective because it works as an anti inflammatory? A deep dive into the research on that is contained in this conversation.

The RELIEF trial is discussed as the team get into a discussion about what a patient sees as a good outcome. How do we communicate the risks, possible benefits and limitations, of surgery to patients?

Also in this piece, find out about a fascinating community-based multimodal prehabilitation service.

Desiree Chappell and Joff Lacey are presenting with their guests Dr Mark Edwards, Consultant in Anaesthesia and Perioperative Medicine at The University Hospital Southampton NHS Foundation Truth and Professor Gerard Danjoux, Consultant in Anaesthesia and Sleep Medicine at South Tees Hospitals NHS Foundation Trust.

Join in the debate: [email protected]

How has the Royal College of Anaethestists (RCoA) evolved over the years and why is perioperative medicine so crucial to its agenda? How has this leadership in perioperative medicine become a force for change and improvement worldwide and what are the common themes that emerge as we take a global perspective on the discipline?

The RCoA's global partnership programme is explained, how can perioperative medicine be part of helping less developed healthcare systems? The considerations are different but the principles remain the same.

The birth of the NHS gave parity of esteem to anaesthetists, the benefits of this are felt by us all in the Western world, could it be argued that this visionary decision might actually help other healthcare systems to evolve more rapidly?

Finally - where is the discipline these days? Leadership and the ability to see the bigger picture are part of it, as is communicating to that wider world with various innovations including this podcast which you, as a listener, are a part of.

Presented by Desiree Chappell and Monty Mythen with their guests Dr Liam Brennan, President of The Royal College of Anaesthetists (RCoA) and Professor Paul Myles, Director, Department of Anaesthesia and Perioperative Medicine, Alfred Hospital and Monash University, Melbourne, Australia.

Join the debate: [email protected]

What motivates an institution to adopt a value based care programme? How do readmission rates react to optimisation? How do you work care coordination into a successful practice?

This piece was originally part of our coverage of 'The American College of perioperative medicine interdisciplinary conference on value based care for orthopedics'.

Desiree Chappell speaks with Allan Beck Chief Executive Officer of the Baylor Orthopedic and Spine Hospital at Arlington.

This is taken from a longer conversation which you can find here: http://www.topmedtalk.com/barriers-and-successes-in-value-based-care/

What motivates an institution to adopt a value based care programme? How do readmission rates react to optimisation? How do you work care coordination into a successful practice?

This piece was originally part of our coverage of 'The American College of perioperative medicine interdisciplinary conference on value based care for orthopedics'.

Desiree Chappell speaks with Allan Beck Chief Executive Officer of the Baylor Orthopedic and Spine Hospital at Arlington.

This is taken from a longer conversation which you can find  here: http://www.topmedtalk.com/barriers-and-successes-in-value-based-care/

 

This piece explains the 2nd Sprint National Anaesthesia Project: Epidemiology of Critical Care provision after Surgery (SNAP-2: EpiCCS) SNAP-2: EpiCCS aims to describe the epidemiology of perioperative risk, outcome, critical care referral and admission after inpatient surgery in the UK. It will also examine whether planned postoperative critical care admission is effective as an intervention to reduce postoperative morbidity. http://www.niaa-hsrc.org.uk/SNAP-2-EpiCCS Presented by Monty Mythen with his guest Dr Ramani Moonesinghe, Director of the UK National Institute of Academic Anaesthesia Health Services Research Centre. This taken from a longer conversation here: http://www.topmedtalk.com/aser-ebpom-2017-recap-pod-three-live-from-london/ Join in the discussion: [email protected]

This piece explains the 2nd Sprint National Anaesthesia Project: Epidemiology of Critical Care provision after Surgery (SNAP-2: EpiCCS)   SNAP-2: EpiCCS aims to describe the epidemiology of perioperative risk, outcome, critical care referral and admission after inpatient surgery in the UK. It will also examine whether planned postoperative critical care admission is effective as an intervention to reduce postoperative morbidity.   http://www.niaa-hsrc.org.uk/SNAP-2-EpiCCS   Presented by Monty Mythen with his guest Dr Ramani Moonesinghe, Director of the UK National Institute of Academic Anaesthesia Health Services Research Centre.   This taken from a longer conversation here: http://www.topmedtalk.com/aser-ebpom-2017-recap-pod-three-live-from-london/   Join in the discussion: [email protected]

Goal directed fluid therapy and enhanced surgical recovery, are there still some battles not yet won? How do you get anaesthetists to curb their fluid? How do you cure the random element of fluid therapy? Dr Joff Lacey interviews his guest Dr Randall Dull, University of Illinois, live from the ASA 2017. This piece taken from a longer conversation, "Physiological Principles of Goal Directed Fluid Therapy": http://www.topmedtalk.com/live-from-boston-asa-2017-physiological-principles-of-goal-directed-fluid-therapy-fluid-responsiveness-the-stressed-system-and-the-glycocalyx/ Join in the debate: [email protected]

Goal directed fluid therapy and enhanced surgical recovery, are there still some battles not yet won? How do you get anaesthetists to curb their fluid? How do you cure the random element of fluid therapy?   Dr Joff Lacey interviews his guest Dr Randall Dull, University of Illinois, live from the ASA 2017.   This piece taken from a longer conversation, "Physiological Principles of Goal Directed Fluid Therapy": http://www.topmedtalk.com/live-from-boston-asa-2017-physiological-principles-of-goal-directed-fluid-therapy-fluid-responsiveness-the-stressed-system-and-the-glycocalyx/   Join in the debate: [email protected]

Association between intraoperative opioid administration and 30-day readmission: a pre-specified analysis of registry data from a healthcare network in New England

High intraoperative opioid dose is a modifiable anaesthetic factor that varies in the practice of individual anaesthetists and affects postoperative outcomes. Conservative standards for intraoperative opioid dosing may reduce the risk of postoperative readmission, particularly in ambulatory surgery.

https://doi.org/10.1016/j.bja.2017.12.044

Association between intraoperative opioid administration and 30-day readmission: a pre-specified analysis of registry data from a healthcare network in New England

High intraoperative opioid dose is a modifiable anaesthetic factor that varies in the practice of individual anaesthetists and affects postoperative outcomes. Conservative standards for intraoperative opioid dosing may reduce the risk of postoperative readmission, particularly in ambulatory surgery.

https://doi.org/10.1016/j.bja.2017.12.044