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PubMed2005

Accuracy of three-dimensional CT angiography for preoperative vascular evaluation of laparoscopic living renal donors.

PURPOSE: A retrospective review of preoperative three-dimensional (3D) CT and the operative findings during laparoscopic donor nephrectomy. PATIENTS AND METHODS: Fifty-four consecutive patients underwent laparoscopic donor nephrectomy. Of these patients, 51 had preoperative 3D reconstructed CT scans. Each radiologic report was compared with the operative report. RESULTS: The 3D CT correctly identified the arteries in 98% of the patients and the veins in 96%. CONCLUSIONS: Preoperative CT angiography can accurately identify the renal vasculature.

Adolescent↗

PubMed2005

Developing a simulation-based training program for medical first responders.

A major stumbling block for widespread incorporation of simulators into EMT training includes the limited availability of curricula infrastructure linking the key components of skills, scenarios, and measures as well as the expertise required to run such programs. To meet these needs we are developing a training program for first responders that uses mannequin-based simulator technology effectively to fill the identified training need for valid meaningful scenarios that can be integrated into the curriculum and are applicable for a variety of EMT skill levels. The program will provide detailed scenarios, instructions for administering the program, and measures for performance feedback. Each scenario will exercise a combination of task work and cognitive skills and the set of scenarios will span all of the higher-level skills that have been identified as benefiting from targeted training.

Computer Simulation↗

PubMed2002

Error reduction and performance improvement in the emergency department through formal teamwork training: evaluation results of the MedTeams project.

OBJECTIVE: To evaluate the effectiveness of training and institutionalizing teamwork behaviors, drawn from aviation crew resource management (CRM) programs, on emergency department (ED) staff organized into caregiver teams. STUDY SETTING: Nine teaching and community hospital EDs. STUDY DESIGN: A prospective multicenter evaluation using a quasi-experimental, untreated control group design with one pretest and two posttests of the Emergency Team Coordination Course (ETCC). The experimental group, comprised of 684 physicians, nurses, and technicians, received the ETCC and implemented formal teamwork structures and processes. Assessments occurred prior to training, and at intervals of four and eight months after training. Three outcome constructs were evaluated: team behavior, ED performance, and attitudes and opinions. Trained observers rated ED staff team behaviors and made observations of clinical errors, a measure of ED performance. Staff and patients in the EDs completed surveys measuring attitudes and opinions. DATA COLLECTION: Hospital EDs were the units of analysis for the seven outcome measures. Prior to aggregating data at the hospital level, scale properties of surveys and event-related observations were evaluated at the respondent or case level. PRINCIPAL FINDINGS: A statistically significant improvement in quality of team behaviors was shown between the experimental and control groups following training (p = .012). Subjective workload was not affected by the intervention (p = .668). The clinical error rate significantly decreased from 30.9 percent to 4.4 percent in the experimental group (p = .039). In the experimental group, the ED staffs' attitudes toward teamwork increased (p = .047) and staff assessments of institutional support showed a significant increase (p = .040). CONCLUSION: Our findings point to the effectiveness of formal teamwork training for improving team behaviors, reducing errors, and improving staff attitudes among the ETCC-trained hospitals.

Attitude of Health Personnel↗