Annual digest - Part 1 | TopMedTalk

Join us at the International Anesthesia Research Society (IARS) and Society of Critical Care meeting in Honolulu, Hawaii. Here we look at the Anesthesia Patient Safety Foundation (APSF) and speak about the latest advancements and key discussions from the conference. Major topics include the risks and management of intraoperative hypotension, gaps in patient communication, and new research findings. The conversation highlights the importance of continuous monitoring, the Delphi method used in their research, and future directions for APSF, including public campaigns and emerging technologies. Kate Leslie and Mike Grocott speak with their guest, Daniel J. Cole, MD, the president of the Anesthesia Patient Safety Foundation (APSF)

The Society of Critical Care Medicine (SCCM) is the largest non-profit medical organization dedicated to promoting excellence and consistency in the practice of critical care. This piece is presented from their annual conference this year. Presented by Desiree Chappell and Monty Mythen with their guest Manu Malbrain, CMO of Medaman, an initiative that seeks to optimize the use of data in hospitals, combined with a position as professor of Critical Care Research at the First Department of Anesthesiology and Intensive Therapy of the Medical University of Lublin in Poland. He is a co-founder and president of the International Fluid Academy (IFAD), the co-founder, past president, and current treasurer of the Abdominal Compartment Society (WSACS), author and co-author of more than 386 peer-reviewed articles, reviews, comments, editorials, book chapters, and books on abdominal compartment syndrome (ACS) and rational fluid use. His cumulative h-index is 63 on Scopus and 85 on GoogleScholar (with a total of 37000 citations). We mention WSACS | WSACS - and recommend it again here. You can find him here: https://twitter.com/manu_malbrain https://www.linkedin.com/in/manu-malbrain-53574313

This piece discusses significant advancements and ongoing challenges in anesthesia and perioperative medicine. Our guest shares his journey from his training days at the University of Basel to his influential work in patient safety across Europe; including pioneering efforts with incident reporting and simulation training inspired by collaborations with NASA. The conversation delves into the evolution of safety practices, the emphasis on human factors over technological advancements, and the complexities of teamwork and communication in the operating room. They explore the importance of standardized procedures, the necessity of adaptability in unstandardized situations, and the role of interdisciplinary collaboration in enhancing patient outcomes. We mention the Helsinki Decleration on Patient Safety in Anasethesiology (link below) and touch on the dissemination and integration of safety principles, the financial implications of quality and safety issues in hospitals, and the future direction of patient safety initiatives, emphasizing the need for continued investment in training and teamwork. Presented by Desiree Chappell with her guest, Sven Stander,  Senior leading physician in Intensive Care Medicine; Clinical Research, Intensive Care, Anesthesiology at The University Hospital Zurich. Link to the Helsinki Declaration on Patient Safey in Anaesthesiology is here: https://esaic.org/patient-safety/helsinki-declaration-on-patient-safety-in-anaesthesiology/

This piece is part four of a four part series on “Implementation, what works and what doesn’t?”. Part one is here: https://topmedtalk.libsyn.com/joyce-yeung-why-dont-we-implement-trial-results-ebpom-world-congress Part two is here: https://topmedtalk.libsyn.com/professional-organisations-the-ebb-and-flow-of-eras-ebpom-world-congress And part three is here: https://topmedtalk.libsyn.com/implementation-what-works-and-what-doesnt-nhs-leader-perspective-incentives-and-penalties-ebpom-world-congress The recording is taken from the Evidence Based Perioperative Medicine (EBPOM) World Congress. For more about EBPOM and the incredible work they do go here: www.ebpom.org The Q&A session, Chaired by John Whittle, features; Imogen Fecher-Jones, Lead Nurse Perioperative Services, University Hospital Southampton, Joyce Yeung, Professor of Anaesthesia and Critical Care Medicine at the University of Warwick, Tim Miller, Professor of Anesthesiology at Duke University Medical Center and David Probert, Chief Executive Officer at University College London Hospitals NHS Foundation Trust.

Recorded at Evidence Based Perioperative Medicine (EBPOM) in London last year this presentation is the third of a series of four sessions under the heading: “Implementation – what works and what doesn’t?”. This piece is the third talk in the series, the first is here: https://topmedtalk.libsyn.com/joyce-yeung-why-dont-we-implement-trial-results-ebpom-world-congress The second is here: https://topmedtalk.libsyn.com/professional-organisations-the-ebb-and-flow-of-eras-ebpom-world-congress Next week we will release the panel discussion. In this talk we get an NHS leader’s perspective on the challenges and obstacles in implementing new innovations within the NHS. Drawing from his extensive experience, David Probert highlights the impact of funding reductions, increasing waiting lists, and strict performance metrics on healthcare delivery. He uses case studies, including robotic surgery, to illustrate successful strategies for gaining approval for innovations, emphasizing the importance of aligning proposals with leadership priorities, utilizing first-mover advantage, and integrating patient care systems. Presented by David Probert, Chief Executive Officer at University College London Hospitals NHS Foundation Trust.

Recorded at Evidence Based Perioperative Medicine (EBPOM) in London last year this presentation is the second of a series of four sessions under the heading: “Implementation – what works and what doesn’t?”. This piece is the second talk in the series, the first is here: https://topmedtalk.libsyn.com/joyce-yeung-why-dont-we-implement-trial-results-ebpom-world-congress There is one more presentation to come and then we will release a fascinating panel discussion to conclude. In this presentation we cover the historical development and implementation of Enhanced Recovery After Surgery (ERAS); key milestones from Henrik Kellett's pioneering work in the late 1990s, to the formation of the ERAS Study Group and subsequent international efforts. Also, the differences in implementation between countries, particularly the coordinated efforts in the UK through the NHS and the more fragmented approach in the USA. There’s an emphasis on the importance of protocol adherence, auditing, and feedback and barriers to implementation such as lack of agreement with evidence, organizational challenges, and institutional hurdles. Presented by Timothy Miller, Professor of Anesthesiology at Duke University Medical Center. Timothy completed his anesthesia training in Nottingham, UK followed by a fellowship in cardiothoracic anaesthesia at Glenfield Hospital, Leicester, UK. He is a fellow of the Royal College of Anaesthetists. He then joined the Department of Anesthesiology at Duke University Medical Center. His clinical interest is management of the high-risk surgical patient undergoing non-cardiac surgery. His practice is varied and involves general, vascular, major urology and thoracic anesthesia, as well as anaesthesia for transplantation. He founded and is co- director of the Enhanced Recovery After Surgery (ERAS) program at Duke.

Recorded at Evidence Based Perioperative Medicine (EBPOM) in London last year this presentation is part of a series of talks given under the session heading: “Implementation – what works and what doesn’t?”. This piece is part one of four, with two more presentations to come and then a fascinating panel discussion to conclude. This first session focuses on the implementation of clinical trials, covering research methodologies, clinical implementations, and their challenges, and looking at the lengthy process of translating medical discoveries into clinical practice, emphasizing the ethical obligation to disseminate trial results effectively. The under-representation of certain demographics in trials, the gap between research findings and clinical practice, and the need for better communication strategies is stressed alongside solutions, including training for researchers, involving key stakeholders from the start, and the role of funders in supporting effective dissemination and implementation of research findings. Our presenter is, Joyce Yeung, Professor of Anaesthesia and Critical Care Medicine at the University of Warwick. She is Theme Lead of the Emergency, Prehospital, Perioperative and Critical Care Trials group within Warwick Clinical Trials Unit. Clinically she holds appointments as a Consultant in Critical Care Medicine at University Hospital Birmingham NHS Foundation Trust. Joyce is Director of UK Perioperative Medicine Clinical Trials Network. She is joint Clinical Speciality Lead for Anaesthesia, Perioperative Medicine and Pain for West Midlands Comprehensive Research Network. She is also the Chair of Resuscitation Council UK Immediate Life Support Subcommittee and is a member of Scientific and Education Committee at European Resuscitation Council. She serves as expert systematic reviewer and International Liaison Committee on Resuscitation taskforce member. Joyce is Chief Investigator for a major grant examining the impact of volatile versus intravenous anaesthesia in non-cardiac surgery (VITAL trial). Her research interests are applied health research and clinical trials including improving perioperative patient outcomes, chronic pain, post-operative cognitive dysfunction, and resuscitation. For more information about EBPOM and the conferences they are organising this year please go to www.ebpom.org

This is part two of a two part program covering some of the most listened to pieces we've done in the last 12 months. We'd love you to check out part 1, which is here: https://topmedtalk.libsyn.com/annual-digest-part-1-topmedtalk In this piece we cover and reflect upon the following podcasts: "The evolution of the Impella device in anesthesia, critical care, and perioperative medicine” https://topmedtalk.libsyn.com/the-evolution-of-the-impella-device-in-anesthesia-critical-care-and-perioperative-medicine-anes24 Is Trauma Informed Care part of your perioperative process? https://topmedtalk.libsyn.com/is-trauma-informed-care-part-of-your-perioperative-process-topmedtalk ROCKet Trial and PANDOS | Euroanaesthesia 2024 https://topmedtalk.libsyn.com/rocket-trial-and-pandos-tmt-at-ea24 "Patient Safety and Quality: New Standards in Anesthesia | #ANES24" https://topmedtalk.libsyn.com/patient-safety-and-quality-new-standards-in-anesthesia-anes24 And “Perioperative medicine in focus | EBPOM 24” https://topmedtalk.libsyn.com/perioperative-medicine-in-focus-ebpom-24

This is the first of a two part program which covers some of the most listened to pieces we've done in the last 12 months. If you want to follow up on these conversations and get the full detail, for free, follow these links here: "Cardiovascular risk evaluation for non-cardiac surgery, guidelines" - https://topmedtalk.libsyn.com/cardiovascular-risk-evaluation-for-non-cardiac-surgery-guidelines-ebpom-24 ”Should we delay surgery for prehabilitation?” - https://topmedtalk.libsyn.com/should-we-delay-surgery-for-prehabilitation-prehabilitation-world-congress ”The importance of intraoperative hypotension” - https://topmedtalk.libsyn.com/the-importance-of-intraoperative-hypotension-aana-2024 “Behavioural change vs Psychological interventions: which is key in prehabilitation?” - https://topmedtalk.libsyn.com/behavioural-change-vs-psychological-interventions-which-is-key-in-prehabilitation-prehabilitation-world-congress "Perioperative patient safety and post-operative ward monitoring" - https://topmedtalk.libsyn.com/perioperative-patient-safety-and-post-operative-ward-monitoring-topmedtalk

In this piece we cover frailty in perioperative and end-of-life care, the assessment of frailty, the challenges of clinical momentum, multidisciplinary team meetings, and the importance of palliative approaches. The conversation also delves into the trajectories at the end of life and the impact of electronic medical records in automating frailty measurement. The episode concludes with reflections on living a healthy life and the dignity of end-of-life care. This piece comes from our coverage of the Perioperative Medicine Special Interest Group Meeting in Melbourne, Australia. Presented by Kate Leslie and Desiree Chappell with their guests Jai Darvall, Associate Professor, anaesthetist and intensive care specialist at the Royal Melbourne Hospital in Australia, where he is co-lead of the perioperative medicine service within the Department of Anaesthesia and Pain Management; and Chuan-Whei Lee, anaesthetist and pain medicine specialist at Royal Melbourne Hospital, and joint clinical lead of perioperative medicine in the Department of Anaesthesia and Pain Management, clinical senior lecturer in the Department of Critical Care, University of Melbourne; and supervisor of training for the Faculty of Pain Medicine, ANZCA.