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Bien expliquer le concept de l'excellence du rendement dans le domaine chirurgical n'est pas chose simple, et ce qui d finit pr cis ment une personne hyperperformante peut faire l'objet [...]

Confirmer la comp tence en m decine et en chirurgie a toujours repr sent un d fi; c'est pourquoi l' valuation de la comp tence des m decins en exercice [...]

Confirming competency in medicine and surgery has been historically challenging, and evaluating the competency of practising physicians is a crowded minefield. Competency programs from the Royal College of Physicians and [...]

The concept of performance excellence in surgery has been difficult to fully articulate. Similarly, the precise definition of a hyperperformer can be debated, but commonly involves elements of excellent problem [...]

Comme l'Internet et la t l phonie cellulaire avant elle, la technologie r cente des r seaux sociaux a le pouvoir de r volutionner la m decine. Dans le domaine [...]

Similar to the preceding introduction of new technologies such as the Internet and cellphones, social media has the potential to revolutionize the field of medicine. While some surgeons remain both [...]

Background: Day-of surgery cancellation (DOSC) is considered to be a very inefficient use of hospital resources and results in emotional stress for the patient. To examine opportunities to minimize the incidence of preventable cancellations--an indicator of quality of care--we assessed the incidence of and reasons for DOSCs over 3 months among inpatients and outpatients at a trauma orthopedic service. Methods: This was a prospective study of 2 cohorts of patients, inpatients and outpatients, scheduled for emergent orthopedic surgery at a Canadian tertiary level 1 trauma centre from Jan. 1 to Mar. 31, 2020. Patient demographic characteristics, injury characteristics, delays until surgery and reasons for DOSCs were recorded. Results: A total of 185 patients (100 males and 85 females with a mean age of 54 yr) were included in the study. There were 98 outpatients and 87 inpatients. Seventy-five (40%) of the scheduled procedures in the outpatient group and 34 (30%) of those in the inpatient group were cancelled. In both groups, more than 85% of the cancellations were because of prioritization of a more urgent orthopedic or nonorthopedic surgical case. The average operative delay for the outpatient group was 11.4 days, compared to 3.8 days for the inpatient group (p < 0.001). Conclusion: High DOSC rates were observed among both outpatients and inpatients. The main reason for delaying surgery was prioritization of a more urgent surgical case. Providing the orthopedic trauma service with a dedicated OR opened 6 days per week, along with extended hours of OR services to 1700 daily, might be effective at minimizing DOSCs. Contexte : Les annulations de chirurgie le jour même (ACJM) sont considérées comme une utilisation très inefficace des ressources, sans compter qu'elles entraînent souvent un stress émotionnel chez le patient. Pour explorer les moyens de réduire l'incidence des annulations évitables, un indicateur de la qualité des soins, nous avons mesuré l'incidence des ACJM et leurs motifs sur une période de 3 mois chez des patients hospitalisés ou non, dans un centre de traumatologie orthopédique. Méthodes : Il s'agit d'une étude prospective de 2 cohortes de patients, hospitalisés et non hospitalisés, qui devaient subir une intervention orthopédique urgente dans un centre de traumatologie canadien de niveau 1 entre le 1 (er) janvier et le 31 mars 2020. Les caractéristiques démographiques des patients, les caractéristiques des lésions, les reports de chirurgie et les motifs des ACJM ont été consignés. Résultats : En tout, 185 patients (100 hommes et 85 femmes, âgés en moyenne de 54 ans) ont été inclus dans l'étude qui comptait 98 patients non hospitalisés et 87 patients hospitalisés. Soixante-quinze (40%) des interventions prévues dans le groupe hospitalisé et 34 (30%) dans le groupe non hospitalisé ont été annulées. Dans les 2 groupes, plus de 85% des annulations ont été attribuées à la priorisation de cas plus urgents de chirurgie, orthopédique ou autre. Le report moyen des interventions dans le groupe de patients non hospitalisés a été de 11,4 jours, contre 3,8 jours dans le groupe de patients hospitalisés (p < 0,001). Conclusion : Des taux élevés d'ACJM ont été observés chez les patients hospitalisés et non hospitalisés. Le principal motif du report des chirurgies était la priorisation de cas plus urgents. Mettre à la disposition du service de traumatologie orthopédique un bloc opératoire dédié ouvert 6 jours sur 7 et prolonger les heures de fonctionnement des blocs opératoires à 1700 par jour pourrait réduire efficacement les ACJM., An estimated 312.9 million surgical procedures are performed every year around the globe, making surgery one of the costliest domains in health care. (1) In 2012, Canadian surgeons performed more [...]

Le professionnalisme est généralement défini par l'adoption d'un comportement fiable, intègre, responsable et qui vise l'excellence. Des qualités comme la compétence, l'efficacité, le savoir, le souci du travail bien fait, [...]

Professionalism is broadly defined as conducting oneself with responsibility, integrity, accountability, and excellence. Additional domains within the realm of professionalism include competence, efficiency, knowledge, conscientiousness, respect, and confidence. Taken as [...]

Les opinions exprimees dans cet editorial sont celles de l'auteur et ne representent pas necessairement celles de l'Association medicale canadienne ou ses fliales. Presque tout le monde a deja experimente [...]

The views expressed in this editorial are those of the author and do not necessarily refect the position of the Canadian Medical Association or its subsidiaries. By now, most of [...]

Recently, there have been several excellent Canadian stuthes looking at gender bias in surgery. They have examined bias at many levels. More specifically, they explored physician referrals, outcomes for similar [...]

Plusieurs excellentes études canadiennes récentes se sont penchées sur les préjugés sexistes en chirurgie. On y a analysé ces biais sous différents angles. Plus précisément, ces études ont mis l'accent [...]

Les opinions exprimées dans cet éditorial sont celles de l'auteur et ne représentent pas nécessairement celles de l'Association médicale canadienne ou ses filiales., On le sait, il y a un historique d'écart salarial entre hommes et femmes en médecine. Apparemment, nous tardons à rectifier la situation. Un article (1) publié récemment ne fait [...]

The views expressed in this editorial are those of the author and do not necessarily reflect the position of the Canadian Medical Association or its subsidiaries., We know there has been a difference in pay between males and females in medicine. Apparently, we have not made headway in rectifying this issue. A recent article (1) has [...]

During the Great War, McGill University fielded a full general hospital to care for the wounded and sick among the Allied forces fighting in France and Belgium. The unit was designated No. 3 Canadian General Hospital (McGill) and included some of the best medical minds in Canada. Because the unit had a relationship with Sir William Osler, who was a professor at McGill from 1874 to 1885, the unit received special attention throughout the war, and legendary Canadian medical figures, such as John McCrae, Edward Archibald and Francis Scrimger, VC, served on its staff. The unit cared for thousands of victims of the war, and its trauma care advanced through the clinical innovation and research demanded by the nature of its work. Although No. 3 Canadian General Hospital suffered tragedies as well, such as the deaths of John McCrae and Osler's only son Revere, by the war's end the McGill hospital was known as one of the best medical units within the armies in France., The news on Aug. 4, 1914, that the British Empire had declared war on Germany flashed across the whole of the Empire, and patriotic enthusiasm exploded to support what was [...]

Physician burnout is the new catch phrase. Recognized as a problem for years, burnout has now become more relevant. It is the sheer volume of cases that has beccome a [...]