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  1. Book ; Online ; E-Book: The ERAS® Society Handbook for Obstetrics and Gynecology

    Nelson, Gregg / Ramirez, Pedro T. / Dowdy, Sean C. / Wilson, R. Douglas / Scott, Michael J.

    2022  

    Author's details edited by Gregg Nelson, Pedro T. Ramirez, Sean C. Dowdy, Dougls R. Wilson, Michael J. Scott
    Keywords Electronic books
    Language English
    Size 1 Online-Ressource (xxviii, 340 Seiten), Illustrationen
    Publisher Elsevier Academic Press
    Publishing place Loondon
    Publishing country United States
    Document type Book ; Online ; E-Book
    Note Description based on publisher supplied metadata and other sources
    Remark Zugriff für angemeldete ZB MED-Nutzerinnen und -Nutzer
    HBZ-ID HT021401143
    ISBN 978-0-323-91825-1 ; 9780323912082 ; 0-323-91825-5 ; 0323912087
    Database ZB MED Catalogue: Medicine, Health, Nutrition, Environment, Agriculture

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  2. Article ; Online: Sentinel lymph node biopsy in high-risk endometrial cancer: The dénouement.

    Glaser, Gretchen E / Dowdy, Sean C

    Gynecologic oncology

    2024  Volume 182, Page(s) A1–A2

    MeSH term(s) Humans ; Female ; Sentinel Lymph Node Biopsy ; Sentinel Lymph Node/pathology ; Lymph Node Excision ; Endometrial Neoplasms/surgery ; Endometrial Neoplasms/pathology ; Lymph Nodes/pathology ; Neoplasm Staging
    Language English
    Publishing date 2024-01-19
    Publishing country United States
    Document type Editorial
    ZDB-ID 801461-9
    ISSN 1095-6859 ; 0090-8258
    ISSN (online) 1095-6859
    ISSN 0090-8258
    DOI 10.1016/j.ygyno.2024.03.012
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Hospital quality reporting in the pandemic era: to what extent did hospitals' COVID-19 census burdens impact 30-day mortality among non-COVID Medicare beneficiaries?

    Pollock, Benjamin D / Dowdy, Sean C

    BMJ open quality

    2023  Volume 12, Issue 1

    Abstract: Objectives: Highly visible hospital quality reporting stakeholders in the USA such as the US News & World Report (USNWR) and the Centers for Medicare & Medicaid Services (CMS) play an important health systems role via their transparent public reporting ... ...

    Abstract Objectives: Highly visible hospital quality reporting stakeholders in the USA such as the US News & World Report (USNWR) and the Centers for Medicare & Medicaid Services (CMS) play an important health systems role via their transparent public reporting of hospital outcomes and performance. However, during the pandemic, many such quality measurement stakeholders and pay-for-performance programmes in the USA and Europe have eschewed the traditional risk adjustment paradigm, instead choosing to pre-emptively exclude months or years of pandemic era performance data due largely to hospitals' perceived COVID-19 burdens. These data exclusions may lead patients to draw misleading conclusions about where to seek care, while also masking genuine improvements or deteriorations in hospital quality that may have occurred during the pandemic. Here, we assessed to what extent hospitals' COVID-19 burdens (proportion of hospitalised patients with COVID-19) were associated with their non-COVID 30-day mortality rates from March through November 2020 to inform whether inclusion of pandemic-era data may still be appropriate.
    Design: This was a retrospective cohort study using the 100% CMS Inpatient Standard Analytic File and Master Beneficiary Summary File to include all US Medicare inpatient encounters with admission dates from 1 April 2020 through 30 November 2020, excluding COVID-19 encounters. Using linear regression, we modelled the association between hospitals' COVID-19 proportions and observed/expected (O/E) ratios, testing whether the relationship was non-linear. We calculated alternative hospital O/E ratios after selective pandemic data exclusions mirroring the USNWR data exclusion methodology.
    Setting and participants: We analysed 4 182 226 consecutive Medicare inpatient encounters from across 2601 US hospitals.
    Results: The association between hospital COVID-19 proportion and non-COVID O/E 30-day mortality was statistically significant (p<0.0001), but weakly correlated (r
    Conclusions: For non-COVID patient outcomes such as mortality, evidence-based inclusion of pandemic-era data is methodologically plausible and must be explored rather than exclusion of months or years of relevant patient outcomes data.
    MeSH term(s) Humans ; Aged ; United States/epidemiology ; Medicare ; Quality Indicators, Health Care ; Reimbursement, Incentive ; Retrospective Studies ; Censuses ; Pandemics ; COVID-19 ; Hospitals
    Language English
    Publishing date 2023-03-20
    Publishing country England
    Document type Journal Article
    ISSN 2399-6641
    ISSN (online) 2399-6641
    DOI 10.1136/bmjoq-2023-002269
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Surgeon-administered transversus abdominis plane block in gynecologic surgery-is it time to tap out?

    Nelson, Gregg / Dowdy, Sean C

    American journal of obstetrics and gynecology

    2023  Volume 228, Issue 5, Page(s) 491–493

    MeSH term(s) Humans ; Female ; Bupivacaine ; Anesthetics, Local ; Gynecologic Surgical Procedures ; Abdominal Muscles ; Surgeons ; Pain, Postoperative ; Analgesics, Opioid
    Chemical Substances Bupivacaine (Y8335394RO) ; Anesthetics, Local ; Analgesics, Opioid
    Language English
    Publishing date 2023-03-24
    Publishing country United States
    Document type Editorial ; Comment
    ZDB-ID 80016-8
    ISSN 1097-6868 ; 0002-9378
    ISSN (online) 1097-6868
    ISSN 0002-9378
    DOI 10.1016/j.ajog.2023.03.001
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Missed opportunities in hospital quality measurement during the COVID-19 pandemic: a retrospective investigation of US hospitals' CMS Star Ratings and 30-day mortality during the early pandemic.

    Pollock, Benjamin D / Devkaran, Subashnie / Dowdy, Sean C

    BMJ open

    2024  Volume 14, Issue 2, Page(s) e079351

    Abstract: Objectives: In the USA and UK, pandemic-era outcome data have been excluded from hospital rankings and pay-for-performance programmes. We assessed the relationship between US hospitals' pre-pandemic Centers for Medicare and Medicaid Services (CMS) ... ...

    Abstract Objectives: In the USA and UK, pandemic-era outcome data have been excluded from hospital rankings and pay-for-performance programmes. We assessed the relationship between US hospitals' pre-pandemic Centers for Medicare and Medicaid Services (CMS) Overall Hospital Star ratings and early pandemic 30-day mortality among both patients with COVID and non-COVID to understand whether pre-existing structures, processes and outcomes related to quality enabled greater pandemic resiliency.
    Design and data source: A retrospective, claim-based data study using the 100% Inpatient Standard Analytic File and Medicare Beneficiary Summary File including all US Medicare Fee-for-Service inpatient encounters from 1 April 2020 to 30 November 2020 linked with the CMS Hospital Star Ratings using six-digit CMS provider IDs.
    Outcome measure: The outcome was risk-adjusted 30-day mortality. We used multivariate logistic regression adjusting for age, sex, Elixhauser mortality index, US Census Region, month, hospital-specific January 2020 CMS Star rating (1-5 stars), COVID diagnosis (U07.1) and COVID diagnosis×CMS Star Rating interaction.
    Results: We included 4 473 390 Medicare encounters from 2533 hospitals, with 92 896 (28.2%) mortalities among COVID-19 encounters and 387 029 (9.3%) mortalities among non-COVID encounters. There was significantly greater odds of mortality as CMS Star Ratings decreased, with 18% (95% CI 15% to 22%; p<0.0001), 33% (95% CI 30% to 37%; p<0.0001), 38% (95% CI 34% to 42%; p<0.0001) and 60% (95% CI 55% to 66%; p<0.0001), greater odds of COVID mortality comparing 4-star, 3-star, 2-star and 1-star hospitals (respectively) to 5-star hospitals. Among non-COVID encounters, there were 17% (95% CI 16% to 19%; p<0.0001), 24% (95% CI 23% to 26%; p<0.0001), 32% (95% CI 30% to 33%; p<0.0001) and 40% (95% CI 38% to 42%; p<0.0001) greater odds of mortality at 4-star, 3-star, 2-star and 1-star hospitals (respectively) as compared with 5-star hospitals.
    Conclusion: Our results support a need to further understand how quality outcomes were maintained during the pandemic. Valuable insights can be gained by including the reporting of risk-adjusted pandemic era hospital quality outcomes for high and low performing hospitals.
    MeSH term(s) Humans ; Aged ; United States/epidemiology ; COVID-19/epidemiology ; Pandemics ; Medicare ; Retrospective Studies ; Centers for Medicare and Medicaid Services, U.S. ; Reimbursement, Incentive ; Hospitals
    Language English
    Publishing date 2024-02-05
    Publishing country England
    Document type Journal Article
    ZDB-ID 2599832-8
    ISSN 2044-6055 ; 2044-6055
    ISSN (online) 2044-6055
    ISSN 2044-6055
    DOI 10.1136/bmjopen-2023-079351
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  6. Article: Enhanced recovery after surgery for ovarian cancer.

    Dowdy, Sean C

    Clinical advances in hematology & oncology : H&O

    2019  Volume 17, Issue 4, Page(s) 217–219

    MeSH term(s) Analgesics, Non-Narcotic/therapeutic use ; Analgesics, Opioid/adverse effects ; Analgesics, Opioid/therapeutic use ; Carcinoma, Ovarian Epithelial/physiopathology ; Carcinoma, Ovarian Epithelial/surgery ; Clinical Protocols ; Edema/chemically induced ; Edema/physiopathology ; Enteral Nutrition ; Female ; Fluid Therapy/adverse effects ; Guideline Adherence ; Humans ; Ovarian Neoplasms/physiopathology ; Ovarian Neoplasms/surgery ; Pain, Postoperative/drug therapy ; Postoperative Care/methods ; Postoperative Care/standards ; Randomized Controlled Trials as Topic ; Sodium/adverse effects ; Sodium/pharmacokinetics ; Water-Electrolyte Balance
    Chemical Substances Analgesics, Non-Narcotic ; Analgesics, Opioid ; Sodium (9NEZ333N27)
    Language English
    Publishing date 2019-06-12
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2271951-9
    ISSN 1543-0790
    ISSN 1543-0790
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 6505: Show issues Location:
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  7. Article: Quality corner: Safely using cephalosporins in almost all patients with penicillin allergies: Mini-review and suggested protocol to improve efficacy and surgical outcomes.

    Boitano, Teresa K L / Virk, Abinash / Michael Straughn, J / Dowdy, Sean C

    Gynecologic oncology reports

    2024  Volume 53, Page(s) 101389

    Abstract: Surgical site infections (SSI) are one of the most common gynecologic oncology postoperative complications and they have a significant deleterious impact on the healthcare system and in patients' outcomes. Cefazolin is the recommended antibiotic in women ...

    Abstract Surgical site infections (SSI) are one of the most common gynecologic oncology postoperative complications and they have a significant deleterious impact on the healthcare system and in patients' outcomes. Cefazolin is the recommended antibiotic in women undergoing gynecologic surgical procedures that require that require prophylaxis. However, 10-20% of patients may report a penicillin allergy which can result in administration of a less effective antibiotic. This quality review evaluated the literature around this common perioperative issue and demonstrated that healthcare teams should consider the implementation of a protocol to safely use cefazolin in most patients with a penicillin allergy. Overall, literature shows this is a safe adjustment and would improve antimicrobial stewardship, decrease SSI rates, avoid acute kidney injury, and increase cost savings.
    Language English
    Publishing date 2024-04-09
    Publishing country Netherlands
    Document type Journal Article ; Review
    ZDB-ID 2818505-5
    ISSN 2352-5789
    ISSN 2352-5789
    DOI 10.1016/j.gore.2024.101389
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  8. Article ; Online: Translating the Leapfrog Safety Letter Grade to a Percentile: Unlock Your Hospital's Door to Quality Improvement With This Easy "Quality Hack".

    Pollock, Benjamin D / Poe, John D / Dowdy, Sean C

    Journal of patient safety

    2022  Volume 18, Issue 7, Page(s) 702

    MeSH term(s) Hospitals ; Humans ; Quality Improvement ; Translating
    Language English
    Publishing date 2022-02-03
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2394324-5
    ISSN 1549-8425 ; 1549-8417
    ISSN (online) 1549-8425
    ISSN 1549-8417
    DOI 10.1097/PTS.0000000000000994
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.A 6583: Show issues Location:
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  9. Article ; Online: Level I evidence establishes enhanced recovery after surgery as standard of care in gynecologic surgery: now is the time to implement!

    Nelson, Gregg / Dowdy, Sean C

    American journal of obstetrics and gynecology

    2020  Volume 223, Issue 4, Page(s) 473–474

    MeSH term(s) Enhanced Recovery After Surgery ; Female ; Genital Neoplasms, Female ; Gynecologic Surgical Procedures ; Humans ; Italy ; Standard of Care
    Language English
    Publishing date 2020-09-25
    Publishing country United States
    Document type Editorial ; Comment
    ZDB-ID 80016-8
    ISSN 1097-6868 ; 0002-9378
    ISSN (online) 1097-6868
    ISSN 0002-9378
    DOI 10.1016/j.ajog.2020.07.048
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  10. Article ; Online: Enhanced Recovery After Surgery and Acute Postoperative Pain Management.

    Kalogera, Eleftheria / Dowdy, Sean C

    Clinical obstetrics and gynecology

    2019  Volume 62, Issue 4, Page(s) 656–665

    Abstract: Enhanced recovery pathways were first developed in colorectal surgery and have since been adapted to other surgical subspecialties including gynecologic surgery. Mounting evidence has shown that the adoption of a standardized perioperative pathway based ... ...

    Abstract Enhanced recovery pathways were first developed in colorectal surgery and have since been adapted to other surgical subspecialties including gynecologic surgery. Mounting evidence has shown that the adoption of a standardized perioperative pathway based on evidence-based literature reduces length of hospital stay, reduces cost, reduces opioid requirements with stable to improved pain scores, and accelerates return to normal function as measured by validated patient reported outcomes measurements. The many elements of enhanced recovery may be distilled into 3 concepts: (1) optimizing nutrition before and after surgery, recognizing that nutritional status directly impacts healing; (2) opioid-sparing analgesia, considering the current American prescription opioid crisis and the importance of pain control to regaining functional recovery; and (3) maintenance of euvolemia before, during, and after surgery. Evidence supporting enhanced recovery is presented with reference to international guidelines which were formed based on systematic reviews. Change management and the use of auditing are discussed to assure that patients derive the greatest improvement in surgical outcomes from implementation of an enhanced recovery pathway.
    MeSH term(s) Acute Pain/therapy ; Analgesics/therapeutic use ; Enhanced Recovery After Surgery ; Female ; Gynecologic Surgical Procedures/adverse effects ; Gynecologic Surgical Procedures/rehabilitation ; Humans ; Pain Management/methods ; Pain, Postoperative/therapy ; Patient Reported Outcome Measures
    Chemical Substances Analgesics
    Language English
    Publishing date 2019-06-24
    Publishing country United States
    Document type Journal Article
    ZDB-ID 391207-3
    ISSN 1532-5520 ; 0009-9201
    ISSN (online) 1532-5520
    ISSN 0009-9201
    DOI 10.1097/GRF.0000000000000475
    Database MEDical Literature Analysis and Retrieval System OnLINE

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