Trend Assessment for Cranial Stabilization
Cranial stabilization and positioning are critical elements necessary to facilitate successful surgical procedures for patients with both cerebrovascular disease and traumatic brain injuries (TBI). Cerebrovascular diseases refer to a group of conditions that affect blood flow and blood vessels in the brain such as aneurysms, stenosis and thrombosis. TBI’s include a group of head injuries associated with skull fractures and hematomas ("University of michigan," n.d.). Both of these issues require stabilization and positioning of the head in order to facilitate the required surgical procedure. Failure to stabilize the head properly, results in a ...view middle of the document...
The development of head and neck stabilization equipment continues to evolve. Although continuous improvement efforts are ongoing the equipment itself continues to be predicated on precise measurements and a strict discipline regarding setup. Failure to adhere to these strict regimens during preoperative activities can result in complication prior to and during the surgical procedure (Lorenzo, Momi, Conti, Votta, Riva & Fava, 2013).
Cranial stabilization equipment is designed to provide rigid skeletal fixation by holding a patients skull and neck in a fixed position. To facilitate proper head placement neurosurgeons rely on a combination of headrest, skull clamp, base unit, pins and screws. The two primary manufacturers of these medical devices are Integra Lifesciences and Pro Med Instruments. Both companies offer an ale cart menu using various materials and functionality in order to support stabilization. Products are designed for the broad spectrum of affected persons from pediatrics through adults. Size, shape and bone density of a person’s skull are critical attributes a surgeon must consider when selecting stabilization equipment.
Recent trending of safety related outcomes associated with Integra Lifesciences (ILS) stabilization equipment has dropped significantly over the last year. This assessment will examine this downward trend associated with safety related cranial events using Integra Lifesciences Mayfield products. Over the last year, the ratio of MDR’s has shifted from 6 out of every 10 complaints to 2 out of every 10 complaints resulting in a potentially harmful event. This is a desirable outcome, however ILS cannot explain what is driving the change. Understanding the driving force will allow ILS to standardize the change in support of continued successful patient outcomes. To support this research, complaint and safety information, from ILS, will be used to test hypotheses surrounding implementation of a new training program beginning in 2013 and the impact surrounding new resident placement within neurosurgical facilities. This assessment will conclude with a discussion of study outcomes and any associated study limitations.
Managers in all businesses are required to deal with employee turnover. In many industries employees leave and are replaced at various points throughout the year. Other industries have a more cyclical turnover schedule. Huckman, Song and Barro (2014) define cohort turnover as “the simultaneous exit of a large number of experienced employees and a similarly sized entry of new workers”. Examples of this type of turnover can be seen in political administrations and military units changed out during combat. Cohort turnover can cause operational disruptions and the loss of tacit information.
In the medical profession cohort turnover occurs when new residents are placed into hospitals. Residency represents a new physician’s first assignment following medical school,...