PubMed Health⌕ Search

PubMed · 17055953

What is surgery?

Abstract

Progress in surgical science has been characterized by a continuous cycle of innovation from bedside to bench to bedside. Beginning 30,000 years ago with the first bone needles to surgical lasers and robotics of today, each quantum leap has resulted from the convergence of technical advances and creative surgeons, but always defined by an attitude of care toward the sick. One of the most innovative pediatric surgeons, Dr. Mark Ravitch, elucidated some simple yet profound principles in the precise answer to the question "What is Surgery?" This section outlines some simple concepts summarized as "Ravitch's Rules," which provide a useful framework for clarity in understanding the past and illuminating the road ahead. Surgeons must be thoughtful in how they define themselves and their craft, ignoring technological advances at their own peril.

Explore related subjects

Keep this discovery

Explore connections, maps & timelines

BibTeXRIS

Thomas M Krummel. 2006. What is surgery?. https://doi.org/10.1053/j.sempedsurg.2006.07.002

Cite the original work for its findings. Save a collection to share your selection of sources.

KEEP EXPLORING

Related citations

Effects of technological interventions on the safety of a medication-use system.

PURPOSE: A study was conducted to assess the effects and outcomes of implementing new technology into the medication-use process. METHODS: A pharmacy computer system, automated dispensing cabinets, and point-of-care products were implemented. The hypotheses of the study were that system errors in each phase of the medication-use process would decrease with the implementation of each technological application and that workload measures, such as staffing and inventory levels, would increase. Using a scripted questionnaire, interviews of participating staff (registered nurses, licensed practical nurses, nursing-unit clerks, pharmacists, pharmacy technicians, physicians, and physician assistants) were conducted to determine their impressions of the safety of the medication-use system before and after the implementation of technology. All hospitalwide errors were reported monthly between November 2002 and July 2005 by the number of errors per 1000 patient days and were categorized by error type. The accuracy of the medication administration record was examined; the pharmacy dispensing process was evaluated for accuracy, timeliness, and system changes; the accuracy of medication administration was observed; and staffing changes were also evaluated. RESULTS: Because of the technology implementation, the accuracy of patient identification was introduced, process changes and technological design identified potential failure modes in the medication administration process, inventory increased, turn-around time to process medication doses in the pharmacy decreased, accuracy of medication administration increased, and the staffing of nurses and pharmacists increased. CONCLUSION: Implementation of new technology into the medication management system standardized the medication administration processes, decreased turnaround time for processing medication orders, and increased accuracy of medication administration to patients.

Diffusion of Innovation↗

How to develop a business case for quality.

OBJECTIVE: To describe the steps in developing a business case for quality-enhancing interventions (QEIs) in health care. ANALYSIS: The development of a business case for QEIs in health care involves 11 steps. These steps include (1) describing the intervention, (2) determining perspective, (3) identifying the effects of the intervention on quality, (4) designing the study, (5) identifying and measuring cash flows, (6) considering the effects of capacity constraints, (7) selecting a measure of return on investment, (8) determining the time horizon for the analysis, (9) determining the discount rate, (10) adjusting costs and savings for inflation, and (11) determining organizational readiness for business case development. A checklist offers guidance on assessing readiness for the business case. CONCLUSION: The absence of a 'business case' for quality is frequently cited as the reason health care organizations do not implement QEIs, despite decades of careful research demonstrating their effectiveness. Our continuing commitment to advancing the discipline of business case analysis is based on a belief that delineating the cost and economic implications of investments in QEIs is a critical threshold issue to widespread adoption of evidence-based quality improvements. We believe it is appropriate and timely to consider how best to standardize approaches and move the field of business case analysis forward.

Diffusion of Innovation↗