Louisville, Ky. Smaller, rural hospitals may be quicker and more efficient at implementing surgical safety initiatives than their larger, urban counterparts, and are capable of providing a standard of surgical care that is at par with major hospitals that provide a comprehensive array of care services, according to an 18-month series of studies led by researchers from the University of Louisville Department of Surgery.
"The quality and standard of care in rural and small-town America is an important issue that gets a lot of attention in the mainstream media these days, and research efforts to measure and enhance surgical quality have largely omitted smaller town hospitals that care for a very high proportion of the American population," said Hiram C. Polk, M.D., former chair of the University of Louisville Department of Surgery, and the Ben A. Reid, Sr. Professor of Surgery at UofL. "These studies sought to address some of these previously unaddressed issues."
The results of these studies were published in the July issue of the American Journal of Surgery.
The investigators used the surgical safety tool "the expanded surgical time out" as a template by which to collect their data, Polk said. This is a method by which all participants in a surgical procedure, including, in some cases, the patient, take a moment to clarify critical details about the procedure that is about to take place.
"The basic surgical time-out includes identifying the correct patient, correct surgery and correct site," said Susan Galandiuk, M.D., professor of surgery at UofL and senior investigator on the first study, which served to define the current culture regarding surgical safety and quality initiatives. "The expanded time-out looks at preoperative timing and choice of antibiotics and discontinuation of postoperative prophylactic antibiotics, additional criteria for diabetics or other ill patients, or factors that come into play if a surge
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