Fast track surgery, a strategy to improve operational efficiency in a high-complexity hospital in Latin America.

UNLABELLED: Fast Track surgery is designed to optimize time in low-complexity procedures, thus improving efficiency in care provision, and preserving patient safety. METHOD: Before and after intervention study in a surgical setting, with failure mode and effects analysis, identification and prioritization of improvement opportunities, process measurement before the intervention, improvement implementation, practical application, process measurement after the intervention, and surgical time comparisons. RESULTS: With the Fast Track program, 19% of the operating room capacity available was freed per day; before surgical FastTrack implementation, 50% of the procedures started 23 minutes behind schedule. After the Fast Track program was implemented, procedures start 5 minutes ahead of schedule. Anesthesia induction time was reduced by 50%, and skin-to-skin surgical time dropped by 28%. The number of surgical procedures performed in the day increased by 33-50%. There were noincidents or adverse events. CONCLUSIONS: Fast Track surgery is a useful strategy for improving operating room efficiency and reducing surgical time. Procedures start on time, with increased timely care, patient and practitioner satisfaction, and lower service costs.

Salud oral en discapacitados / Oral health for the disabled

La salud oral en pacientes con necesidades especiales ha representado un reto para el profesional de la salud oral a través de la historia, pues las diferentes discapacidades físicas y cognitivas limitan la adecuada remoción de placa dentobacteriana, llevando consigo el desarrollo de enfermedades orales de alta prevalencia en esta población, como la caries dental y la enfermedad periodontal. Con este artículo se pretende presentar al odontólogo información relevante a cerca de las enfermedades bucales prevenibles de origen dentobacteriano y las principales necesidades de las personas en condición de discapacidad referentes a su higiene oral. Del mismo modo, se enfatiza en los métodos de remoción de placa mecánicos y químicos estudiados en esta población, para actualizar los conocimientos y así contribuir en gran medida a la práctica clínica, para ofrecer una adecuada atención odontológica a dichos pacientes. Es necesario el desarrollo de nuevos implementos de higiene oral enfocados a la población discapacitada que faciliten el control de la placa dentobacteriana, para contribuir a la prevención de las enfermedades orales más prevalentes.

Oral health in patients with special health care needs is a challenge for the professional practitioner. Physical and mental disabilities limit adequate plaque removal, leading to the development of high prevalence of oral diseases in this population such as dental caries and periodontal disease. The aim of this article is to present relevant data concerning dentobacterial preventable oral diseases and their main oral healthcare needs. In addition, it emphasizes chemical and mechanical plaque removal systems that have been studied in this population, to update knowledge and contribute to clinical practice and in the same way, to help the dentist to render an adequate dental care to these patients. The development of new oral hygiene devices is needed, focused on the disabled population which facilitate easy plaque control, and prevent the most prevalent oral diseases.

Salud oral en discapacitados / Salud oral en discapacitados

La salud oral en pacientes con necesidades especiales ha representado un reto para elprofesional de la salud oral a través de la historia, pues las diferentes discapacidades físicas ycognitivas limitan la adecuada remoción de placa dentobacteriana, llevando consigo el desarrollo deenfermedades orales de alta prevalencia en esta población, como la caries dental y la enfermedadperiodontal.