TopMedTalk

This piece is the second part of a conversation about leadership in medicine, during times of change. It follows on from the first part where our speaker outlines his thoughts in a short talk. Now questions from the audience are considered and the conversation develops. What have we learned after the recent huge changes we've seen in our profession?

Presented by Desiree Chappell and Monty Mythen with Jeff Vender, Emeritus, Harris Family Foundation Chairman of the Department of Anesthesiology at NorthShore University Health System, Evanston, Illinois and Clinical Professor at the University Of Chicago Pritzker School Of Medicine in Chicago, Illinois.

"I believe most people can be leaders or better leaders. You can create or participate in change and a better future. You can make a difference in your own lives, the lives of others and the life of your organization. If you believe you can."

This piece contains a powerful, inspirational and prescient talk about leadership. Part 1 contains some conversation and the talk, to be followed by questions from the audience in Part 2. Where do leaders come from, what makes them stand out and how do they learn the skills necessary to take what they do to the next level?

Presented by Desiree Chappell and Monty Mythen with Jeff Vender, Emeritus, Harris Family Foundation Chairman of the Department of Anesthesiology at NorthShore University Health System, Evanston, Illinois and Clinical Professor at the University Of Chicago Pritzker School Of Medicine in Chicago, Illinois.

This question and answer session was a highlight of EBPOM London 2020, it works as a standalone piece or as a companion piece to this talk here: https://topmedtalk.libsyn.com/ebpom-2020-london-am-i-safe

The discussion follows themes outlined in the presentation as our online audience asked a series of questions.

Some of the questions included in the discussion are "How should leaders deal with anxiety both in themselves and their team? What is the evidence on perceived command gradient in residents and the fear of looking inadequate in front of peers and superiors? Bad for patients, versus bad for me? The people at the top end, the older people within an organization, are often the most resistant to culture change, yet they have the most influence over culture, any advice? What defines the people who are ready for change?"

Conversational in tone this piece was first heard on the "TopMedTalk stage" at Evidence Based Perioperative Medicine (EBPOM) for more details go now to www.ebpom.org

Presented by Monty Mythen and Desiree Chappell with Lee Fleisher, Emeritus Professor of Anesthesiology and Critical Care, University of Pennsylvania.

This piece focuses on iDelirium; The International Federation of Delirium Societies on world delirium day. As well as considering this difficult condition the conversation asks what the latest research shows us and how things could improve both for patients and practitioners. For more detail check out their website here: http://www.idelirium.org/

Presented by Desiree Chappell and Monty Mythen with their guests Heidi L. Lindroth, Senior Associate Consultant Nurse Scientist, Nursing Research Division Critical Care Nurse, Gideon Caplan, Director, Geriatric Medicine, Prince of Wales Hospital, Alasdair Macclullich, Professor of Geriatric Medicine, Honorary Consultant in Geriatric Medicine, Edinburgh, Delirium Research Group, Rakesh C. Arora, Co-Founder of IDelirium, Professor and Head of Cardiac Surgery and Cardiac Critical Care at Max Rady College of Medicine - University of Manitoba, Canada.

"The goal of ERAS® Cardiac is when you leave one of our meetings, you're going to be chock full of tips and tricks that you can take back and implement, if not the next day, then in the next week or next month."

TopMedTalk's coverage of The Society for Enhanced Recovery After Cardiac Surgery (ERAS® Cardiac) conference continues with a conversation that covers the nuggets and insights that a conference such as this delivers. This exclusive chat is only possible thanks to the support of the society who's excellent website is here: https://erasvirtual2021.com/

"I think that also your [TopMedTalk] platform is going to be key. We need to have more of these podcasts. We need short little vignettes, eight to 15 minutes that people can listen to in the car on the way home where they learn and thought leaders having interactive discussions and get ideas. And that's the future really of education"

Presented by Desiree Chappell with her guests, Seenu Reddy, Cardiothoracic Surgeon at HCA's TriStar Cardiovascular Surgery in Nashville, National Physician Director for HCA Healthcare's CV Service line and Daniel Engelman, Cardiac Surgeon, Medical Director of the Heart, Vascular and Critical Care Units at Baystate Medical Center, Associate Professor of Surgery at The University of Massachusetts - Baystate, Associate Professor-Adjunct at Tufts University School of Medicine and President of the ERAS Cardiac international Society.

"You didn't have to think about it, the compliance continued, because it was so standardized. We had a well oiled machine that just kept on working through COVID".

The Society for Enhanced Recovery After Cardiac Surgery (ERAS® Cardiac)'s conference has gotten off to a great start; this exclusive chat gets into some of the stand out moments so far; nutrition, data collection, the essentials of ERAS and the importance of standardization.

For more information on the conference check out https://www.erascardiac.org/

We mention Dan Engelman in this piece, he features in this popular conversation from the TopMedTalk archives here: https://www.topmedtalk.com/sunday-special-preoperative-optimization-framing-up-the-value-proposition/

Paul Wischmeyer gets mentioned on this piece as a "fan favourite", he features frequently. If you've not yet heard him start with this podcast - one of our most popular so far - here: https://www.topmedtalk.com/topmedtalks-to-dr-paul-wischmeyer/

Presented by Desiree Chappell with her guests Gina McConnell, ERAS Coordinator for all WakeMed health systems and Cheryl Crisafi, Cardiac Surgery Care Coordinator Nurse at Baystate Medical Center in Springfield, MA.

"You have to take the viewpoint that if the Nurses and the Physical Therapists and the Pharmacists are resisting the idea that you're putting forward, then there's probably something wrong with it, it doesn't work for them, for some reason, and you got to find out what that is..."

This long form conversation is a highlight for TopMedTalk's coverage of The Society for Enhanced Recovery After Cardiac Surgery (ERAS® Cardiac) conference. The conversation covers a wide range of interesting areas, including; the nature of leadership in medicine, the global nature of many of the questions we face, how the internet is changing what we do, what the phrase "better never stops" means, how to take and use feedback and why the patient has to be at the heart of what we do, the importance of "the growth mindset".

Also, discover how one of our guests has learned from his experience becoming a Lieutenant Colonel, US Army Reserves; what can a military mindset tell us about the task we face as advocates of perioperative medicine?

We wrap with a conversation about blood transfusion reduction.

This exclusive chat is only possible thanks to the support of the society, their excellent website is here: https://erasvirtual2021.com/

Presented by Desiree Chappell with her guests Kevin Lobdell, Professor and the Director of Regional Cardiovascular and Thoracic Quality, Education, and Research for Carolinas HealthCare System, Charlotte, NC, USA, as well as the Clinical Professor at the University of North Carolina-Chapel Hill, Chapel Hill, NC, USA and Rawn Salenger, Chief of Cardiac Surgery at University of Maryland St. Joseph Medical Center, Assistant Professor of Surgery at the University of Maryland School of Medicine.

"Our real 'next barrier' in the continuum of care is, it's okay to have pain, right? It's expected to have pain. [...] but it is better for you recovery wise, complication wise; to be able to get up, move around, know what's going on, not be confused, right? A little bit of that education goes a really long way."

The opioid crisis, spine surgery, working as a team, pioneering efforts being done at the world leading Norton Leatherman Spine Center, enhanced recovery after surgery (ERAS) and some of the fascinating research our guest is conducting; all this and more as our "TopMedTalks to..." series makes a welcome return.

Presented by Desiree Chappell with Jeffrey Gum, Assistant Clinical Professor (Gratis), Department of Orthopaedic Surgery, University of Louisville, Pediatric and Adult spine surgeon at the Leatherman Spine Center in Louisville, KY.

This piece is a continued deep dive into the subject, of 'fitness, function, or frailty' and, perhaps, "fixing". It's essential listening for anyone interested in the latest thinking on this crucial topic and was a highlight of the London conference.

How can we integrate frailty and cognitive scores in risk assessment tools to facilitate inclusion in shared decision making? How can we improve a surgical colleague's ability to identify frailty? Most patients will have an operation sometime in their life; should surgical school be renamed and moved to being a "well being" clinic and offered to all patients? What screening tools would you recommend if only minimal time or money is available? Is pre-op screening actually 'public health' and should it really be being done for everyone? What are the differences and where is the overlap between fitness functional capacity, frailty, and sarcopenia? In mild cognitive impairment, should we tell patient that it will work and postop and not be expected to fully recover? What strategies have you found most helpful in engaging surgeons with identifying their frail patients? How are we tackling the workforce shortage among geriatricians? What has your experience been in advising achieving physical fitness in patients who present to surgery with persistent pain which is a limitation?

This is part two of a two part piece. Each of the contributors comments upon talks which they gave at EBPOM 2020, all of which are now available as part of the TopMedTalk podcast. To ensure you are among the first to hear information of this kind please investigate www.ebpom.org for more details about how you can attend our online conferences.

--

Presented by Scarlett McNally, Deputy Director of The Centre for Perioperative Care (CPOC) consultant Orthopaedic Surgeon, Eastbourne DGH, UK and Monty Mythen, Smiths Medical Professor of Anaesthesia and Critical Care at University College London with questions from the online audience for their guests; Denny Levett, Professor in Perioperative Medicine and Critical Care at Southampton University Hospital NHS Foundation trust and Honorary Associate Professor at the University of Southampton, Daniel Conway, Consultant in Anaesthesia and Critical Care, Group Lead for Perioperative Medicine, Manchester Royal Infirmary, UK and Chair of the Manchester Perioperative Medicine Society, Jude Partridge, consultant geriatrician POPS, honorary senior lecturer, King's College London, Chairs the British Geriatrics Society POPS SIG, Vicki Morton, Director of Clinical and Quality Outcomes at Providence Anesthesiology Associates, P.A.

Fitness, function and, or, frailty are important determinants of the quality of the life that we live. In the context of major surgery it's very important we recognize and work with individual patients improving and optimizing them and their ability to handle an operation. This piece is an essential deep dive into the subject, essential listening for anyone interested in the latest thinking on this crucial topic.

What are the limitations on your resources when considering a plan of preoperative evaluation?

This is part one of a two part piece. Each of the contributors comments upon talks which they gave at EBPOM 2020, all of which are now available as part of the TopMedTalk podcast. To ensure you are among the first to hear information of this kind please investigate www.ebpom.org for more details about how you can attend our online conferences.

--

Presented by Scarlett McNally, Deputy Director of The Centre for Perioperative Care (CPOC) consultant Orthopaedic Surgeon, Eastbourne DGH, UK and Monty Mythen, Smiths Medical Professor of Anaesthesia and Critical Care at University College London with questions from the online audience for their guests; Denny Levett, Professor in Perioperative Medicine and Critical Care at Southampton University Hospital NHS Foundation trust and Honorary Associate Professor at the University of Southampton, Daniel Conway, Consultant in Anaesthesia and Critical Care, Group Lead for Perioperative Medicine, Manchester Royal Infirmary, UK and Chair of the Manchester Perioperative Medicine Society, Jude Partridge, consultant geriatrician POPS, honorary senior lecturer, King's College London, Chairs the British Geriatrics Society POPS SIG, Vicki Morton, Director of Clinical and Quality Outcomes at Providence Anesthesiology Associates, P.A.