scholarly journals 793 Orthopaedic Surgical Training in The Independent Sector During the COVID 19 Pandemic

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
J O'Callaghan ◽  
S Lochab ◽  
P Stanier ◽  
D Woods
Keyword(s):  
Private Sector ◽  
Surgical Training ◽  
Joint Replacement ◽  
Operating Experience ◽  
Joint Replacement Surgery ◽  
Additional Capacity ◽  
Independent Sector ◽  
Orthopaedic Training ◽  
The Impact ◽  
Training Opportunities

Abstract Introduction The COVID pandemic had led to the cancellation of elective Orthopaedics in the NHS. The aim of this study was to investigate the effect of the independent sector on orthopaedic training and the effect of the COVID pandemic on training locally. Method A retrospective review of trauma and elective operations was made between April and September of 2019 and 2020 to compare the effects of COVID on training opportunities and the additional capacity provided by the private sector. Results The impact of COVID on Surgical training at GWH has been no decrease in trauma operating experience, but a 53% decrease in elective operating experience and a 74% decrease in joint replacement operative experience during an equivalent six-month period. Use of the independent hospital has enabled 6% of the total elective surgery experience, and 11% of the joint replacement surgery experience. Discussion The private sector has provided additional capacity but a productivity of 66 cases from 48 half day lists is low (1.4 cases per list) has proved disappointing. There has been a low impact on elective training. The challenges have been faced on the elective side as trauma cases have remained consistent during the pandemic. Conclusions Use of the alliance between the private sector and NHS as a resource to provide additional training opportunities needs to be developed further in the future with incentivised guidance. Orthopaedic training will inevitably adapt to the challenges presented for the next generations of surgeons.

scholarly journals SP2.2.18UK Surgical Training in the Independent Sector During COVID-19 – A Snapshot Survey

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Valdone Kolaityte ◽  
Charlotte El-Sayed ◽  
Josh Burke
Keyword(s):  
Surgical Training ◽  
Online Survey ◽  
Elective Surgery ◽  
Final Analysis ◽  
Training Programme ◽  
Barriers To Access ◽  
Resource Requirements ◽  
Operating List ◽  
Independent Sector ◽  
Training Opportunities

Abstract Aims In response to the COVID-19 pandemic and the cancellation of elective surgery, the Independent sector (IS) has been utilised to provide COVID-light sites. On average operative log book numbers have been reduced by 50% due to a reduction in operative exposure. The Four Educational Bodies continue to support training within the independent sector. This study aimed to qualitatively assess access and barriers to UK surgical training in the Independent Sector. Methods A snap-shot online survey was distributed to ASIT members of all training specialities and grades between 21/10/2020-11/11/2020 . Data measures included participant demographics, frequency of access, participation in training opportunities including outpatient clinic, theatre lists and endoscopy and any barriers encountered. A mixture of Likert scale and short answer questions were utilised. Results 249 complete responses representing all grades and specialities were included in the final analysis (34.29% CST and 56.3% HST). 35.7% of trainees reported access to the IS. 22.9% had access to at least one operating list whilst 70.3% had none. Access to outpatient clinics and endoscopy was negligible. 75% of trainees ‘strongly agreed’ that when access was achievable, it was beneficial to their training. Multiple barriers were identified including Human Resource requirements and local service provision. Conclusions Within the sample, access to the IS has been poor. There is wide variation in barriers to access across the 4 nations and IS providers. Trainees and Trainers should maximise training opportunities in the IS. Where barriers exist, they should be reported to local Training Programme Directors.

scholarly journals Shift working reduces operative experience for trauma and orthopaedic higher surgical trainees: a UK multicentre study

2019 ◽  
Vol 101 (3) ◽  
pp. 197-202
Author(s):  
H Sevenoaks ◽  
S Ajwani ◽  
I Hujazi ◽  
J Sergeant ◽  
M Woodruff ◽  
...  
Keyword(s):  
Major Trauma ◽  
Operating Experience ◽  
Trauma Centre ◽  
Trauma Unit ◽  
Surgical Trainees ◽  
Major Trauma Centre ◽  
Full Shift ◽  
The Impact ◽  
Training Opportunities ◽  
Post Shift

Introduction In recent years there has been a rise in the number of trauma and orthopaedics trainees working on full shift patterns. Historically, most trauma and orthopaedics trainees worked 24 hours non-resident on-call shifts. The effect of this change in shift patterns has not previously been measured. As two trusts (one trauma unit, one major trauma centre) in our region underwent a change to full shift working, we assessed the impact on the trainees’ operating experience. Methods Fifty-five logbooks were analysed across the two trusts over a two-year period, with comparisons made between pre- and post-shift working. Results Overall operating fell by 13% for trainees working full shift patterns, which was statistically significant. There was a loss of elective operating of 15% at the trauma unit and 32% at the major trauma centre for trainees doing shift work. The effect on trauma operating opportunities was mixed. Index operating was largely preserved. Conclusions Shift working significantly impacts on surgical training opportunities. We explore approaches to minimising this effect.

scholarly journals The Impact of an Independent Sector Treatment Centre on Basic Surgical Training

2012 ◽  
Vol 94 (8) ◽  
pp. 276-278
Author(s):  
PG Vaughan-Shaw ◽  
SG Chiverton ◽  
DA Rew ◽  
PH Nichols
Keyword(s):  
Surgical Training ◽  
Medical Training ◽  
Substantial Reduction ◽  
University Hospital ◽  
Full Time ◽  
Surgical Trainees ◽  
Treatment Centre ◽  
Independent Sector ◽  
The Uk ◽  
The Impact

The reorganisation of postgraduate medical training in the UK as a result of Calman reforms, the New Deal and the implementation of the European workingTime regulations (EwTr) has led to a substantial reduction in working hours and a fall in operative experience for surgical trainees. The move of large volumes of minor and intermediate NHS surgical caseload into independently run hospitals and specialist centres (of which the Southampton NHS Treatment Centre, an independent sector treatment centre (ISTC) is a well-established example) has also radically altered the basic surgical training environment. The Southampton ISTC is run on contract by Care UK and is medically staffed by a mix of full-time Care UK employees from the UK and abroad as well as by visiting consultants from University Hospital Southampton NHS foundationTrust (UHSFT).

Changing practice to increase rates of spinal anaesthesia for total joint replacement

2021 ◽  
pp. 175045892097014
Author(s):  
Susan E Eklund ◽  
Alina Vodonos ◽  
Sheila M Ryan-Barnett
Keyword(s):  
Spinal Anaesthesia ◽  
Joint Replacement ◽  
Total Joint Replacement ◽  
Care Pathway ◽  
Interrupted Time Series ◽  
Tertiary Hospital ◽  
Interrupted Time Series Analysis ◽  
Choice Data ◽  
Joint Replacement Surgery ◽  
The Impact

Background Neuraxial anaesthesia for lower extremity total joint replacement surgery has several advantages over general anaesthesia; however, we encountered resistance to routine use of spinal anaesthesia and standardised analgesic regimens at our large, tertiary hospital. Our Perioperative Surgical Home led to multidisciplinary education and enhanced communication to change practice, with the purpose of increasing rates of neuraxial anaesthetics for these surgeries. Methods Team members from anaesthesia, nursing and surgery participated in the development and adoption of the care pathway. After implementation, we performed a retrospective analysis to examine the impact of the pathway on primary anaesthetic choice. Data were analysed using Student’s t-test and interrupted time series analysis. Results The rate of neuraxial anaesthetics increased following implementation of the total joint pathway. Conclusion With multidisciplinary collaboration, we were able to change practice towards spinal anaesthesia, despite a large and diverse group of practitioners.

scholarly journals P-O05 Deconstructing Operations to Improve Recording of Surgical Training Experience

2021 ◽  
Vol 108 (Supplement_9) ◽  
Author(s):  
Ffion Dewi ◽  
Darren Scroggie ◽  
Samir Pathak ◽  
Natalie Blencowe ◽  
Andrew Hollowood ◽  
...  
Keyword(s):  
Surgical Training ◽  
University Teaching ◽  
Surgical Experience ◽  
Training Experience ◽  
Suggested Approach ◽  
Worked Example ◽  
Surgical Trainees ◽  
And Performance ◽  
The Impact ◽  
Training Opportunities

Abstract Background A new outcomes-based curriculum is soon to be implemented for UK surgical trainees. Performance will be evaluated against the standard expected of a new consultant. Accurate recording of operative experience and performance will therefore be crucial to demonstrate achievement of this standard. The current eLogbook system for recording surgical experience has many benefits including simplicity and accessibility, but may misrepresent actual experience because most operations are considered as a whole; unlike some colorectal operations, involvement in steps within many upper gastrointestinal (UGI) operations cannot be recorded. Methods Impact on training by the COVID-19 pandemic led to discussion and identification of cultural and logistical barriers to accurate recording of experience. To address these, a modification to enhance the current eLogbook system was developed by trainees and trainers at a university teaching hospital. An existing typology was used to deconstruct common UGI operations into their component steps, which can be recorded at this more detailed level.  Results The modified deconstructed logbook concept is described using a worked example, which can be applied to any operation. We also describe the integration of a component-based training discussion into the surgical team brief and debrief; this complements the deconstructed logbook by promoting a training culture. Conclusions Using the described techniques, trainees of all levels can comprehensively and accurately describe their surgical experience. Senior trainees will benefit from recording complex operations which they are not expected to complete in their entirety, whilst less experienced trainees will benefit from the ability to record their involvement in more basic parts of operations. The suggested approach will reduce misrepresentation of experience, encourage proactive planning of training opportunities, and reduce the impact of crises such as pandemics on surgical training.

scholarly journals Influence of music on work performance during joint replacement surgery, attitudes of surgical team members

2021 ◽  
Vol 2 (2 (290)) ◽  
pp. 1-10
Author(s):  
Aurelija Zybartaitė ◽  
Lina Gedrimė
Keyword(s):  
Operating Room ◽  
Joint Replacement ◽  
Work Performance ◽  
Point Of View ◽  
Surgical Team ◽  
Team Members ◽  
Joint Replacement Surgery ◽  
Replacement Surgery ◽  
Operating Team ◽  
The Impact

Progress is constantly being made in almost all areas of life, including medicine. For this reason, various measures are being introdu-ced to make any work done more efficient, easier, more productive. Music can be used in medicine, especially in the operating room, as its effect on the members of the operating team is extremely positive. And while this is acknowledged, there is not much research on this topic – the impact of music on members of the operating team.Object – is the influence of music on work performance during joint replacement, from the point of view of surgical team members.Problem – is whether music during endoprosthesis surgery can increase the productivity of surgical team members?Aim – to analyze the influence of music on the performance of work during endoprosthesis operations, from the point of view of the members of the operating team – was aimed at implementing the research objectives:1) to review the peculiarities of joint endoprosthesis operations; 2) to reveal the influence of music on work in the operating room from the point of view of team members;3) to study the influence of music on the quality of work during joint arthroplasty.Methods: The method of questionnaire survey was chosen to study the attitude of the members of the operating team to the influence of music on the work productivity in the operating room. The questionnaire is considered to be the most appropriate method for explaining people’s opinions and behavior, and it is based on reliability.This was related to the aims of this study - to analyze the impact of music on performance during endoprosthesis operations. The study was conducted by submitting questionnaires to 100 members of the operating team (surgeon-operator, anesthesiologist, resuscitator, anesthesiologist, resident, anesthesia and intensive care nurse, operating nurse, and operating assistant) working in health care facilities. It should be noted that during the data collection, the members of the operational team filled in the questionnaires remotely - links to the online uploaded questionnaire were sent to each respondent. This method of conducting the study was chosen due to the current situation in Lithuania - the COVID-19 pande-mic.Results of the study. The study revealed that joint replacement surgery is seen as a complicated procedure, which is complicated by team changes, because it often increases tension, affects everyone’s joint work, feels general discomfort, becomes more difficult to concentrate, increa-ses the likelihood of errors. In order to make teamwork smoother, attention should be paid to the organization of work, the fostering of interperso-nal relationships, the assessment of one’s own characteristics and peculiarities of communication, and the stronger fostering of the work envi-ronment. Music can be an effective and valuable tool for making a positive impact on operational team members. Music can help reduce anxiety, encourage relaxation, suppress the response to stressful situations, and increase the effectiveness of actions. It is very important that the music is selected in the right genre to suit the members of the operating team.

Investment climate and government turnover in russian regions

2014 ◽  
pp. 88-117 ◽  
Author(s):  
G. Syunyaev ◽  
L. Polishchuk
Keyword(s):  
Economic Development ◽  
Theoretical Model ◽  
Private Sector ◽  
Authoritarian Regimes ◽  
Russian Regions ◽  
Investment Climate ◽  
Regional Data ◽  
Endogenous Property Rights ◽  
The Impact

We study the impact of Russian regional governors’ rotation and their affiliation with private sector firms for the quality of investment climate in Russian regions. A theoretical model presented in the paper predicts that these factors taken together improve “endogenous” property rights under authoritarian regimes. This conclusion is confirmed empirically by using Russian regional data for 2002—2010; early in that period gubernatorial elections had been canceled and replaced by federal government’s appointments. This is an indication that under certain conditions government rotation is beneficial for economic development even when democracy is suppressed.

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