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Re: Department rooms nomenclature

on Tue Apr 03, 2018 4:16 pm
7 in our place involves a janitor too, in order to prepare the room for the next patient.
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Re: Department rooms nomenclature

on Tue Apr 03, 2018 4:25 pm
QEUH wrote:7 in our place involves a janitor too, in order to prepare the room for the next patient.

Hehe, sure. There are also a looooot of other staffs, like orderlys and other personnell. Just trying to ease up the sequence.
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Re: Department rooms nomenclature

on Tue Apr 03, 2018 4:32 pm
Fair enough! 8ts a complex pattern.
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Re: Department rooms nomenclature

on Tue Apr 03, 2018 10:54 pm
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Dysp did you just said that in Denmark there is no anästhesiologist (doctor) while the surgery is running? Thats... really strange and quit dangerous...
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Re: Department rooms nomenclature

on Wed Apr 04, 2018 8:49 am
Sparky wrote:Dysp did you just said that in Denmark there is no anästhesiologist (doctor) while the surgery is running? Thats... really strange and quit dangerous...

Never heard of that Shocked
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Re: Department rooms nomenclature

on Wed Apr 04, 2018 7:33 pm
A specialized nurse can easily maintain monitoring of the patient and also infuse anaesthetics. The drugs are prescribed by an anaesthesiologist and if any problems evolve they are on call too. An anesthesiologist is responsible for ~3 operating theatres and it works like a charm. Of course this depends on the type of procedure being done and the patient in question.
Remember that we don't have a for-profit health care system in Denmark and are thus optimized intensely. Is this dangerous? It appears not.
Surgical procedures including anaesthetics are only responsible for 1.8 % of all reported "unintended events". Source

Less than 1 out of 100,000 deaths are related to the patient being anesthetized. Source
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Re: Department rooms nomenclature

on Wed Apr 04, 2018 10:37 pm
Sparky wrote:Dysp did you just said that in Denmark there is no anästhesiologist (doctor) while the surgery is running? Thats... really strange and quit dangerous...

In Italy one anesthesiologist per operating theatre. Each health system in each country has its own peculiarities
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Re: Department rooms nomenclature

on Thu Apr 05, 2018 1:52 am
I get it dsyp a friend of mine works in denmark so i know something of the system. But i havent heard of this before. I still question those numbers u meantioned but will look into this topic.
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Re: Department rooms nomenclature

on Fri Apr 06, 2018 1:38 pm
Dysp wrote:
In the real world, an anesthesiologist would have the responsibility for the pre-op consultation and while surgery is going on, have the responsibility of several operating rooms (if anything out of the ordinary happens), while special anesthesiologist nurses would be present in the actual room and monitor the patient.
Your solution is probably better from a development perspective, but I just thought I would share how it is actually done.

Even in Australia with a not-for-profit health system anaesthetists are in every theatre for almost every procedure. The pride in me says that only a qualified and experienced doctor should be running an anaesthetic but in reality, a lot of it probably is safe enough to be monitored and an anaesthestist available overseeing a small number of active procedures but to me it's a ticking time bomb for a sentinel event should more than one or two negative events occur simultaneously.
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Re: Department rooms nomenclature

on Fri Apr 06, 2018 1:54 pm
scorpycfs wrote:
Dysp wrote:
In the real world, an anesthesiologist would have the responsibility for the pre-op consultation and while surgery is going on, have the responsibility of several operating rooms (if anything out of the ordinary happens), while special anesthesiologist nurses would be present in the actual room and monitor the patient.
Your solution is probably better from a development perspective, but I just thought I would share how it is actually done.

Even in Australia with a not-for-profit health system anaesthetists are in every theatre for almost every procedure. The pride in me says that only a qualified and experienced doctor should be running an anaesthetic but in reality, a lot of it probably is safe enough to be monitored and an anaesthestist available overseeing a small number of active procedures but to me it's a ticking time bomb for a sentinel event should more than one or two negative events occur simultaneously.

I did refer to two sources depicting actual numbers from the healthcare system. It is evident, that this approach does not result in deaths nor complications.
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Re: Department rooms nomenclature

on Sat Apr 07, 2018 3:48 am
It's always going to be a point of contention though to argue that someone who spent 6+ years at university plus 2-5 years residency then 5+ years specialising to become an anaesthetist could have the majority of their job done by a nurse or tech. It's kind of like saying the pilots of an aircraft can go and have a sleep while a stewardess monitors the cockpit. Technically it is true and safe but it makes people sad to think about... Laughing Laughing Laughing
To me, despite the numbers demonstrated, it would certainly be an element of the swiss cheese model to any sentinel event.
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Re: Department rooms nomenclature

on Sat Apr 07, 2018 1:31 pm
scorpycfs wrote:It's always going to be a point of contention though to argue that someone who spent 6+ years at university plus 2-5 years residency then 5+ years specialising to become an anaesthetist could have the majority of their job done by a nurse or tech. It's kind of like saying the pilots of an aircraft can go and have a sleep while a stewardess monitors the cockpit. Technically it is true and safe but it makes people sad to think about... Laughing Laughing Laughing
To me, despite the numbers demonstrated, it would certainly be an element of the swiss cheese model to any sentinel event.

Anaesthesiologists also maintain a lot of other assignments throughout the hospital. They are responsible for the ICU (not when overseeing operations, though) and also for numerous tasks inhouse (assessment of critical ill patients, performing complicated procedures etc). The whole ego mindset of "I've spent this and that much hours" isn't really relevant in Denmark; we care more about the patients than our egos, tbh.

To sum it up, in Denmark anaesthesiologists are not forced to sit and watch one patient sleeping, but are instead monitoring several theatres while maintaining other tasks throughout the house.
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Re: Department rooms nomenclature

on Sun Apr 08, 2018 9:17 am
Dysp wrote:
scorpycfs wrote:It's always going to be a point of contention though to argue that someone who spent 6+ years at university plus 2-5 years residency then 5+ years specialising to become an anaesthetist could have the majority of their job done by a nurse or tech. It's kind of like saying the pilots of an aircraft can go and have a sleep while a stewardess monitors the cockpit. Technically it is true and safe but it makes people sad to think about... Laughing Laughing Laughing
To me, despite the numbers demonstrated, it would certainly be an element of the swiss cheese model to any sentinel event.

Anaesthesiologists also maintain a lot of other assignments throughout the hospital. They are responsible for the ICU (not when overseeing operations, though) and also for numerous tasks inhouse (assessment of critical ill patients, performing complicated procedures etc). The whole ego mindset of "I've spent this and that much hours" isn't really relevant in Denmark; we care more about the patients than our egos, tbh.

To sum it up, in Denmark anaesthesiologists are not forced to sit and watch one patient sleeping, but are instead monitoring several theatres while maintaining other tasks throughout the house.

The ego is probably not an issue in Denmark because you're on the other side of it now but I guarantee there would have been issues during the transition. Our anaesthetists would argue patient best interests is the reason to not leave anaesthetic care to anyone below the level of doctor. I couldn't care less either way. A great example currently on the burner here is the concept of dentistry and oral health therapists. Here both disciplines require a university course use the same tools and basic procedures, the latter is shorter and with a smaller scope of practice... however, dare insinuate that there could be a bridging course to upskill therapists to dentists with a 2-3 year cross-over course and oooooooh boy, the butthurt is expressed in a big way by the australian dental association. It's all ego, turf war and protecting one's own backyard.

In Australia, anaesthesia and intensive care are kept as separate specialties and thus there is little overlap thus it is probably easier to understand why they would be nervous about the notion of anyone else doing their job (Literally almost their entire job). Pain medicine is part of the discipline though and thus plumbing and pain pumps are some of the other responsibilities around the hospital but there's usually someone rostered for pain rounds and the odd individual skilled in certain blocks (paravertebral, etc) might occasionally duck away to do one when required.

It's fascinating to learn how some of this is done around the world though. Learning about Denmark's stuff certainly is challenging some of my preconceptions about how things should be done.
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Re: Department rooms nomenclature

on Sun Apr 08, 2018 3:17 pm
scorpycfs wrote:
Dysp wrote:
scorpycfs wrote:It's always going to be a point of contention though to argue that someone who spent 6+ years at university plus 2-5 years residency then 5+ years specialising to become an anaesthetist could have the majority of their job done by a nurse or tech. It's kind of like saying the pilots of an aircraft can go and have a sleep while a stewardess monitors the cockpit. Technically it is true and safe but it makes people sad to think about... Laughing Laughing Laughing
To me, despite the numbers demonstrated, it would certainly be an element of the swiss cheese model to any sentinel event.

Anaesthesiologists also maintain a lot of other assignments throughout the hospital. They are responsible for the ICU (not when overseeing operations, though) and also for numerous tasks inhouse (assessment of critical ill patients, performing complicated procedures etc). The whole ego mindset of "I've spent this and that much hours" isn't really relevant in Denmark; we care more about the patients than our egos, tbh.

To sum it up, in Denmark anaesthesiologists are not forced to sit and watch one patient sleeping, but are instead monitoring several theatres while maintaining other tasks throughout the house.

The ego is probably not an issue in Denmark because you're on the other side of it now but I guarantee there would have been issues during the transition. Our anaesthetists would argue patient best interests is the reason to not leave anaesthetic care to anyone below the level of doctor. I couldn't care less either way. A great example currently on the burner here is the concept of dentistry and oral health therapists. Here both disciplines require a university course use the same tools and basic procedures, the latter is shorter and with a smaller scope of practice... however, dare insinuate that there could be a bridging course to upskill therapists to dentists with a 2-3 year cross-over course and oooooooh boy, the butthurt is expressed in a big way by the australian dental association. It's all ego, turf war and protecting one's own backyard.

In Australia, anaesthesia and intensive care are kept as separate specialties and thus there is little overlap thus it is probably easier to understand why they would be nervous about the notion of anyone else doing their job (Literally almost their entire job). Pain medicine is part of the discipline though and thus plumbing and pain pumps are some of the other responsibilities around the hospital but there's usually someone rostered for pain rounds and the odd individual skilled in certain blocks (paravertebral, etc) might occasionally duck away to do one when required.

It's fascinating to learn how some of this is done around the world though. Learning about Denmark's stuff certainly is challenging some of my preconceptions about how things should be done.

That's very interesting and I do think you are absolutely right about paradigme shifts... in anything!
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Re: Department rooms nomenclature

on Mon Apr 09, 2018 8:56 pm
In brazil usually anesthesia is kept separate from intensive medicine. Also we have the one-anesthesiologist-per-operating room procedure. My university's hospital is the biggest public tertiary care unit in a state as big as belgium, so the degree of complexity we had there didn't allow for more than one room.
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Re: Department rooms nomenclature

on Thu Apr 26, 2018 6:43 pm
Hi!
Are you planning to add some other departments or specialist offices among aformentioned deps?
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Re: Department rooms nomenclature

on Thu Apr 26, 2018 6:58 pm
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bombastico wrote:Hi!
Are you planning to add some other departments or specialist offices among aformentioned deps?

As far as I know, more departments and specialiations are on a wishlist, but not going to be included in first release.
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Re: Department rooms nomenclature

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