Roushanak Shayesteh-Kheslat

Universität des Saarlandes, Saarbrücken, Saarland, Germany

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Publications (3)1.72 Total impact

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    ABSTRACT: Introduction: Work densification caused by lack of young surgeons with increased clinical documentation keeps surgeons busy. It is proven by many studies that surgeons work significantly longer hours per week and deal with a larger amount of medical and non-medical documentation than staff members in conservative disciplines. The aim of the study was to investigate surgeons work distribution in a surgical university department and to evaluate by means of a work sampling analysis whether it can be standardised and slimmed down by systematic use of IT-supported, process-managed work-flow. In addition the data obtained are compared wuith those from other studies on similar topics. Methods: Based on the results of an independent pilot observational study, 21 surgeons (14 residents, 7 staff surgeons) had to document over a 10-day period in a self-observation once in an hour their actual activity in a two dimensional matrix concerning medical activity (13 items) and patient contact (5 items). After the study, each physician had to estimate his / her own work distribution. Real percentages of the self-observation study were compared to the physicians' estimates of work distribution. IT-supported clinical pathways have been implemented since 2004 in our department. Results: Over a ten-day evaluation period (1830 observation points), surgeons spent 30.2 % of their activity in the operating theatre or on direct patient care. During 13.9 % they were in meetings and they spent 10.8 % of their time on documentation. Time needed for studying medical records (9.2 %) and ward rounds (9.0 %) ranged in a similar way. There was a significant accordance of estimated and real work distribution concerning the 5 most frequent daily activities. In only 14 % there was no direct patient relationship. Conclusion: Application of work sampling analysis in surgery is a valid procedure for the evaluation of work flows in the course of personal observations. Surgeons working time in a hospital is limited. To achieve a maximum of direct patient care, clinical documentation has to be optimised by process automatisation within the context of IT-supported clinical pathways. Surgeons are able to estimate very exactly the distribution of their daily activities so that data of working time estimations is valuable.
    Zentralblatt für Chirurgie 05/2012; · 0.69 Impact Factor
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    ABSTRACT: Prostheto-ureteral fistula after aortic graft surgery is a potentially life-threatening, rare pathology. We report the successful treatment of a prostheto-ureteral fistula that caused hematuria with hemorrhagic shock in two patients by explantation of aortic prosthetic grafts and implantation of a silver-bonded prosthetic graft (Intergard S, Intervascular). These cases show that this surgical procedure is effective, and that straightforward diagnostic procedures are necessary to initiate correct therapeutic approach without delay. Various different possible risk factors for the formation of a prostheto-ureteral fistula are also discussed.
    Annals of Vascular Surgery 08/2010; 24(6):823.e5-9. · 1.03 Impact Factor
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    ABSTRACT: Les fistules prothéto-urétérales après chirurgie aortique prothétique sont une pathologie rare et potentiellement mortelle. Nous rapportons le traitement réussi d’une fistule prothéto-urétérale qui a causé une hématurie avec choc hémorragique chez deux patients par explantation des prothèses aortiques et implantation d’une prothèse enduite d’argent (Intergard S, Intervascular®). Ces cas prouvent que cette opération est efficace, et que des procédures de diagnostic adaptées sont nécessaires pour un traitement adapté sans délai. Différents facteurs de risque possibles pour la formation d’une fistule prothéto-urétérale sont également discutés.
    Annales de Chirurgie Vasculaire 08/2010; 24(6).