Author
Abdel-Hadi S. Breizat
Bio: Abdel-Hadi S. Breizat is an academic researcher. The author has contributed to research in topics: WHO Surgical Safety Checklist & Checklist. The author has an hindex of 2, co-authored 2 publications receiving 4770 citations.
Papers
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TL;DR: Implementation of the checklist was associated with concomitant reductions in the rates of death and complications among patients at least 16 years of age who were undergoing noncardiac surgery in a diverse group of hospitals.
Abstract: The rate of death was 1.5% before the checklist was introduced and declined to 0.8% afterward (P = 0.003). Inpatient complications occurred in 11.0% of patients at baseline and in 7.0% after introduction of the checklist (P<0.001). Conclusions Implementation of the checklist was associated with concomitant reductions in the rates of death and complications among patients at least 16 years of age who were undergoing noncardiac surgery in a diverse group of hospitals.
4,764 citations
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TL;DR: In this article, the authors assess the relationship between changes in clinician attitude and changes in postoperative outcomes following a checklist-based surgical safety intervention and find that improvements in post-operative outcomes were associated with improved perception of teamwork and safety climate among respondents, suggesting that changes in these may be partially responsible for the effect of the checklist.
Abstract: Objectives To assess the relationship between changes in clinician attitude and changes in postoperative outcomes following a checklist-based surgical safety intervention.
Design Pre- and post intervention survey.
Setting Eight hospitals participating in a trial of a WHO surgical safety checklist.
Participants Clinicians actively working in the designated study operating rooms at the eight hospitals.
Survey instrument Modified operating-room version Safety Attitudes Questionnaire (SAQ).
Main outcome measures Change in mean safety attitude score and correlation between change in safety attitude score and change in postoperative outcomes, plus clinician opinion of checklist efficacy and usability.
Results Clinicians in the preintervention phase (n=281) had a mean SAQ score of 3.91 (on a scale of 1 to 5, with 5 representing better safety attitude), while the postintervention group (n=257) had a mean of 4.01 (p=0.0127). The degree of improvement in mean SAQ score at each site correlated with a reduction in postoperative complication rate (r=0.7143, p=0.0381). The checklist was considered easy to use by 80.2% of respondents, while 19.8% felt that it took a long time to complete, and 78.6% felt that the programme prevented errors. Overall, 93.4% would want the checklist used if they were undergoing operation.
Conclusions Improvements in postoperative outcomes were associated with improved perception of teamwork and safety climate among respondents, suggesting that changes in these may be partially responsible for the effect of the checklist. Clinicians held the checklist in high regard and the overwhelming majority would want it used if they were undergoing surgery themselves.
460 citations
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TL;DR: This 5-year evaluation provides strong evidence that the classification of complications is valid and applicable worldwide in many fields of surgery, and subjective, inaccurate, or confusing terms such as “minor or major” should be removed from the surgical literature.
Abstract: Background and Aims:The lack of consensus on how to define and grade adverse postoperative events has greatly hampered the evaluation of surgical procedures. A new classification of complications, initiated in 1992, was updated 5 years ago. It is based on the type of therapy needed to correct the co
7,537 citations
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Boston Children's Hospital1, Harvard University2, King's College London3, Lund University4, Massachusetts Eye and Ear Infirmary5, University of São Paulo6, University of California, San Diego7, Imperial College London8, Brigham and Women's Hospital9, Partners In Health10, Royal North Shore Hospital11, Medical College of Wisconsin12, Monash University13, Nanyang Technological University14, University of Sierra Leone15, University of Oxford16, Mongolian National University17, University of Malawi18, Flinders University19, Beth Israel Deaconess Medical Center20, Bhabha Atomic Research Centre21, Royal Australasian College of Surgeons22, Stanford University23, University of California, San Francisco24
TL;DR: The need for surgical services in low- and middleincome countries will continue to rise substantially from now until 2030, with a large projected increase in the incidence of cancer, road traffic injuries, and cardiovascular and metabolic diseases in LMICs.
2,209 citations
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TL;DR: The epidemiology of endemic health-care-associated infection in developing countries is assessed and a need to improve surveillance and infection-control practices is indicated.
1,737 citations
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TL;DR: Clinicians will find the recommendations in these revised CPGs useful in their daily work and can be reassured that the recommendations have been vetted thoroughly by the most rigorous scientific process, so that cardiovascular clinicians worldwide may deliver optimal, standardized care.
Abstract: AAA
: abdominal aortic aneurysm
ACEI
: angiotensin converting enzyme inhibitor
ACS
: acute coronary syndromes
AF
: atrial fibrillation
AKI
: acute kidney injury
AKIN
: Acute Kidney Injury Network
ARB
: angiotensin receptor blocker
ASA
: American Society of Anesthesiologists
b.i.d.
: bis in diem (twice daily)
BBSA
: Beta-Blocker in Spinal Anesthesia
BMS
: bare-metal stent
BNP
: B-type natriuretic peptide
bpm
: beats per minute
CABG
: coronary artery bypass graft
CAD
: coronary artery disease
CARP
: Coronary Artery Revascularization Prophylaxis
CAS
: carotid artery stenting
CASS
: Coronary Artery Surgery Study
CEA
: carotid endarterectomy
CHA2DS2-VASc
: cardiac failure, hypertension, age ≥75 (doubled), diabetes, stroke (doubled)-vascular disease, age 65–74 and sex category (female)
CI
: confidence interval
CI-AKI
: contrast-induced acute kidney injury
CKD
: chronic kidney disease
CKD-EPI
: Chronic Kidney Disease Epidemiology Collaboration
Cmax
: maximum concentration
CMR
: cardiovascular magnetic resonance
COPD
: chronic obstructive pulmonary disease
CPG
: Committee for Practice Guidelines
CPX/CPET
: cardiopulmonary exercise test
CRP
: C-reactive protein
CRT
: cardiac resynchronization therapy
CRT-D
: cardiac resynchronization therapy defibrillator
CT
: computed tomography
cTnI
: cardiac troponin I
cTnT
: cardiac troponin T
CVD
: cardiovascular disease
CYP3a4
: cytochrome P3a4 enzyme
DAPT
: dual anti-platelet therapy
DECREASE
: Dutch Echocardiographic Cardiac Risk Evaluation Applying Stress Echocardiography
DES
: drug-eluting stent
DIPOM
: DIabetic Post-Operative Mortality and Morbidity
DSE
: dobutamine stress echocardiography
ECG
: electrocardiography/electrocardiographically/electrocardiogram
eGFR
: estimated glomerular filtration rate
ESA
: European Society of Anaesthesiology
ESC
: European Society of Cardiology
EVAR
: endovascular abdominal aortic aneurysm repair
FEV1
: Forced expiratory volume in 1 second
HbA1c
: glycosylated haemoglobin
HF-PEF
: heart failure with preserved left ventricular ejection fraction
HF-REF
: heart failure with reduced left ventricular ejection fraction
ICD
: implantable cardioverter defibrillator
ICU
: intensive care unit
IHD
: ischaemic heart disease
INR
: international normalized ratio
IOCM
: iso-osmolar contrast medium
KDIGO
: Kidney Disease: Improving Global Outcomes
LMWH
: low molecular weight heparin
LOCM
: low-osmolar contrast medium
LV
: left ventricular
LVEF
: left ventricular ejection fraction
MaVS
: Metoprolol after Vascular Surgery
MDRD
: Modification of Diet in Renal Disease
MET
: metabolic equivalent
MRI
: magnetic resonance imaging
NHS
: National Health Service
NOAC
: non-vitamin K oral anticoagulant
NSQIP
: National Surgical Quality Improvement Program
NSTE-ACS
: non-ST-elevation acute coronary syndromes
NT-proBNP
: N-terminal pro-BNP
O2
: oxygen
OHS
: obesity hypoventilation syndrome
OR
: odds ratio
P gp
: platelet glycoprotein
PAC
: pulmonary artery catheter
PAD
: peripheral artery disease
PAH
: pulmonary artery hypertension
PCC
: prothrombin complex concentrate
PCI
: percutaneous coronary intervention
POBBLE
: Peri-Operative Beta-BLockadE
POISE
: Peri-Operative ISchemic Evaluation
POISE-2
: Peri-Operative ISchemic Evaluation 2
q.d.
: quaque die (once daily)
RIFLE
: Risk, Injury, Failure, Loss, End-stage renal disease
SPECT
: single photon emission computed tomography
SVT
: supraventricular tachycardia
SYNTAX
: Synergy between Percutaneous Coronary Intervention with TAXUS and Cardiac Surgery
TAVI
: transcatheter aortic valve implantation
TdP
: torsades de pointes
TIA
: transient ischaemic attack
TOE
: transoesophageal echocardiography
TOD
: transoesophageal doppler
TTE
: transthoracic echocardiography
UFH
: unfractionated heparin
VATS
: video-assisted thoracic surgery
VHD
: valvular heart disease
VISION
: Vascular Events In Noncardiac Surgery Patients Cohort Evaluation
VKA
: vitamin K antagonist
VPB
: ventricular premature beat
VT
: ventricular tachycardia
Guidelines summarize and evaluate all available evidence, at the time of the writing process, on a particular issue with the aim of assisting health professionals in selecting the best management strategies for an individual patient with a given condition, taking into account the impact on outcome, as well as the risk–benefit ratio of particular diagnostic …
1,353 citations
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05 Jun 2013
TL;DR: The knowledge and tools exist to put the health system on the right course to achieve continuous improvement and better quality care at a lower cost, and a better use of data is a critical element of a continuously improving health system.
Abstract: America's health care system has become too complex and costly to continue business as usual. Best Care at Lower Cost explains that inefficiencies, an overwhelming amount of data, and other economic and quality barriers hinder progress in improving health and threaten the nation's economic stability and global competitiveness. According to this report, the knowledge and tools exist to put the health system on the right course to achieve continuous improvement and better quality care at a lower cost.The costs of the system's current inefficiency underscore the urgent need for a systemwide transformation. About 30 percent of health spending in 2009--roughly $750 billion--was wasted on unnecessary services, excessive administrative costs, fraud, and other problems. Moreover, inefficiencies cause needless suffering. By one estimate, roughly 75,000 deaths might have been averted in 2005 if every state had delivered care at the quality level of the best performing state. This report states that the way health care providers currently train, practice, and learn new information cannot keep pace with the flood of research discoveries and technological advances.About 75 million Americans have more than one chronic condition, requiring coordination among multiple specialists and therapies, which can increase the potential for miscommunication, misdiagnosis, potentially conflicting interventions, and dangerous drug interactions. Best Care at Lower Cost emphasizes that a better use of data is a critical element of a continuously improving health system, such as mobile technologies and electronic health records that offer significant potential to capture and share health data better. In order for this to occur, the National Coordinator for Health Information Technology, IT developers, and standard-setting organizations should ensure that these systems are robust and interoperable. Clinicians and care organizations should fully adopt these technologies, and patients should be encouraged to use tools, such as personal health information portals, to actively engage in their care.This book is a call to action that will guide health care providers; administrators; caregivers; policy makers; health professionals; federal, state, and local government agencies; private and public health organizations; and educational institutions.
1,324 citations