TopMedTalk

Learn how to inspire a team to act, create change and get things done. How important are financial incentives, emotional connection and the relative ease of change? Originally streamed live from the hugely successful EBPOM USA Dallas Master's course. Presented by Michael Englesbe , Darling Sr. & Cyrenus G. Darling Jr. Professor of Surgery, Michigan.

This panel discussion tackles, amongst others, the following questions: How can knowledge and health innovation be moved from the theoretical world and turned into practice? How do we overcome ego in the profession? How do efficient systems improve the experience of staff as well as patients? How can perioperative practitioners truly embed ideas into devolved healthcare systems? Featuring; Anna Ba...

Should prehabilitation be thought of also as "primary prevention" and used to avoid health problems occuring in the first place? If "exercise is real medicine" how do we change the culture so GPs are comfortable prescribing physical activity to patients? How can we get people to exercise more when the political mood is turning against Government interference and the so-called "nanny state"? What i...

What are the results if you apply Enhanced Recovery to obstetrics? This podcast features Desiree Chappell interviewing Dr Attila Kett , anaesthesiologist and Chairman at St Peter's University Hospital at New Jersey. Join in the debate: contact@topmedtalk.com

This piece explains how the "Getting It Right First Time" (GIRFT) project got off the ground. How does it help improve quality of care within the NHS reduce unwarranted variations, bring efficiencies and improve patient outcomes? This piece gives you the detail. Led by frontline clinicians, who are experts in the areas they review, hear how the project helps to manage services on a daily basis; sh...

"The predominant emotion was fear..."; this piece is essential listening for every TopMedTalk listener who really cares about the experience of their patients. Hear what it was like to participate in the pioneering, tailored exercise training programme, The Encourage Trial. Also, find out about "the Buddy Scheme" and how becoming a member of a local support group: SPICOS (Support for People Impact...

The patient experience can be quite passive and, as a result, people can lose temperature quickly. The consequences can be very negative, this conversation revolves around how you can keep your patients warm. This piece is taken from a longer conversation to be found here: https://www.topmedtalk.com/live-from-the-iseh-part-1/ This edition of TopMedTalk was recorded at The Institute of Sport Exerci...

This piece is a fascinating overview of Australia and New Zealand's Emergency Laparotomy Audit - Quality Improvement (ANZELA-QI). It works as an update on the initiative, provides all the background you need including explanations regarding, structure, organisation and additional support as well as answering key questions such as: Do we need it? How do you join and what happens when you do? A link...

This piece discusses how the contributors are driving better perioperative care in their clinics; the importance of getting patient records in advance; ERAS for obstetrics; challenging opioid use with the multimodal pain management; shared decision making in pain management; the importance of clear communication pathways and patient literacy. This podcast features Desiree Chappell interviewing; Dr...

Frailty is a common condition which has been topical in geriatric medicine for some time but now it is appearing in the surgical and anaesthetic literature. This talk explores how our understanding and discussion has improved regarding a condition that is still yet to have a clear, universally accepted, definition. How do we build a patient's physical reserve? What is the best way to conceptualise...

This piece focuses on the article "The malnourished surgery patient, a silent epidemic in perioperative outcomes?" which you can find here: https://journals.lww.com/co-anesthesiology/Abstract/2019/06000/The_malnourished_surgery_patient__a_silent.23.aspx The Perioperative Quality Initiative is here: www.poqi.org Presented by Desiree Chappell with Monty Mythen and their guests Jeroen Molinger , Clin...

In short; Post-Op recovery in less than 3 days with over 90% mobilised on day 1. This in depth discussion relates to the consensus paper from the Perioperative Quality Initiative, see link below. It focuses on: outcomes, length of stay and DREAMS (Drinking, Eating and Mobilising) within hours after major surgery- all key measures of compliance and success in an Enhanced Recovery Program. Monty Myt...

"The father of prehabilitation" reflects on where the discipline is now and where it used to be, from new kid on the block to being touted now as the word of the moment. How has this change come about? Is it the focus value based care? Is it the fact we're becoming more patient focused? Is it fair to say this is an evidence led focus brought about by more information and understanding regarding lo...

Prehabilitation is about planned pathways, preparing our patients for a journey which we as practitioners have already travelled. 4.2 million deaths are attributable to surgery each year globally, this presents a huge opportunity to improve the world for those who focus on perioperative surgery and prehabilitation. On the financial side, complications from surgery are proven to put costs up. It's...

"Enhanced recovery after bariatric surgery" - was originally streamed live from the Charles Sammons Cancer Center, Dallas, during EBPOM-USA 2019 on www.topmedtalk.com Hear this excellent talk, for free, on this podcast. If you'd like to attend an event like this ensure your next click is here: www.ebpom.org/meetings If you have any comments or questions you'd like to send to the team email: contac...

This piece starts with some words from patients; prehabilitation is "a set of actions that can be taken in advance of treatment to ease your passage through cancer". This vital talk explains how prehabilitation can leave cancer patients feeling personally empowered and ready to live well. Living is one thing, how do we get people to enjoy 'living well'? Further to this how do we do that in such a...

This piece gets into the detail regarding one of the big talking points in perioperative medicine over the last year or so; what is the impact of intraoperative hypotension on post operative outcomes? Further discussion encompases the modern uses of a pulmonary artery catheter. If you enjoyed hearing Andy Shaw's take on these topics further listening can be found here; https://www.topmedtalk.com/h...

Should we still measure urine output? How useful is permissive oliguria? Presented by Professor Monty Mythen and Dr Joff Lacey featuring guests Dr Tim Miller from Duke University Medical Centre and John A. Kellum , Tenured Professor, Critical Care Medicine from The University of Pittsburgh.

This panel discussion reacts to various questions from the online audience and those in attendance. Questions include; Is there any good evidence for the use of wearable tech in prehabilitation? How come, if the evidence is almost there, prehabilitation is not yet included in every pathway? In this respect, is change just around the corner? How do we have patients are partners rather than passive...

This piece focuses on the "Wessex Fit-4-Cancer Surgery Trial"; a unique multi-centre, efficacy pragmatic, factorial design, randomised controlled trial, with patient informed development and process evaluation "You wouldn't run a marathon without preparing," why would you want an operation where you don't get ready for a physically stressful event such as surgery? Prehabilitation is an obvious adv...

How important is it to screen patients for anaemia before surgery? Has anaemia fallen off the health care agenda? We begin with a conversation about patients who are anaemic and then turn to why this is sometimes not checked enough. Monty Mythen mentions UK University students appear to suffer from the condition more these days and Lori Heller points out that treating the condition, as part of pat...

Hear how you can transform your practice through team leadership, courage and a finely tuned awareness of the financial aspects of what you are trying to achieve. How can growth be tempered to suit the long term vision of a company? Why is teambuilding so crucial to large organisations? Can we determine the direction in which healthcare is evolving overall? Is 'population health in the perioperati...

Why does the complex pain patient need 'perioperative pain medicine' to optimize outcomes of surgery? This piece faces the realities behind a perioperative approach which tries to prevent or manage cases of complex regional pain syndrome (CRPS) during surgery and the postoperative period. Should chronic pain be seen as a nervous system disorder? How do we deal with patients who catastrophise their...

The Hypotension Prediction Index (HPI) Monitor takes 2.6 million features from a single waveform which it then applies to 150 million different wave forms looking for factors which can predict hypotension. It's the first fully approved foray into predictive analyitics for the world of anaesthesia. This conversation looks at how it works and how it is being adopted in detail. Presented by Desiree C...

This episode of The Perioperative Coach reflects on the pain management discussions being had by the American Society of Enhanced Recovery (ASER) and its members. For further reading see the articles in Perioperative Medicine Journal: https://perioperativemedicinejournal.biomedcentral.com/articles/10.1186/s13741-017-0064-5 This conversation taken from a longer piece to be found here: http://www.to...