Administrators

The Monthly Pulse – Administrators (Sept. 2022)

The Monthly Pulse

Industry News

Intensive Care Unit Bypass for Robotic-Assisted Single-Vessel Coronary Artery Bypass Grafting

The Story

An ultra-fast-track protocol after cardiac surgical procedures could reduce hospital stays and costs, according to research. A recent study shows that of 215 patients who underwent coronary artery bypass grafting, 156 received conventional recovery whereas 59 candidates received an ICU-bypass protocol involving a recovery room and floor care. The ICU-bypass group saw a 15% reduction in total inpatient costs.

What You Should Know

While there were significant cost savings associated with the ultra-fast-track protocol, adverse events did not differ between groups. Although the study is limited, it suggests an ICU-bypass protocol could be a feasible way to reduce costs without introducing risk for certain cardiac procedures.

Millennial Physicians Are Setting Healthier Standards for Work-Life Balance

The Story

Recent research indicates millennial physicians are prioritizing work/life balance, and are less likely to accommodate punishing schedules. Oftentimes, misconceptions circulate about the generation being less driven, but findings suggest that they’re just more inclined to embrace better time management strategies, and to balance their career responsibilities with family and personal lives.

What You Should Know

Millennials’ preference for flexibility makes sense, since increased symptoms of burnout are associated with more working hours. For this reason, many are seeking roles that offer shift work, which allow for more clearly defined lines between work and family time. With that in mind, a flexible work schedule isn’t the only factor physicians need for a healthy work/life balance. More restorative downtime, the ability to derive meaning from their work, and having a safety net such as onsite childcare if primary childcare falls through could also help physicians feel more balanced.

Should Bilateral Internal Thoracic Arteries be Used in Patients with Chronic Kidney Disease?

The Story

The debate over which conduits to use for coronary artery bypass graft is long and ongoing. While there’s good evidence to suggest that arterial conduits stay open longer than venous, there are questions about using both the right and left internal thoracic arteries. There are many factors to consider when deciding which option to use. One recent study sought to determine whether bilateral thoracic arteries should be used in patients with chronic kidney disease by retrospectively analyzing data for more than 2,000 patients.

What You Should Know

Using a bilateral internal thoracic artery (BITA) strategy was not associated with increased mortality, nor was there a greater risk for hospital readmission due to cardiovascular events. Some research suggests there are potential advantages of BITA grafting, so this finding could hold promise for doctors who prefer to use the approach.

Leadership Reflections

Trust
I have always appreciated the wisdom in the saying, “Trust takes years to build, seconds to break, and forever to repair.” Certainly being reliable and dependable builds a solid level of trust over time, and I know through personal experience how quickly it can be broken. Recently I’ve been wondering whether trust always takes years to build and forever to repair, and whether practicing these characteristics could help:

Credibility - gaining the knowledge and skills needed to become an expert in your role
Intimacy - deeply understanding and respecting others and providing a safe space for sharing
Integrity - doing what is right, even when it’s difficult
Other-orientation - focusing on the needs of others over self-interest

I’m starting to consider whether trust gained and lost is less about time and more about quality. There will certainly be times when we make mistakes and break trust. Rather than taking years to build and forever to repair, perhaps consistently demonstrating the traits above can help build a reservoir of quality trust that will allow us to repair trust more quickly when broken. I’d love to hear your experiences with building, breaking and/or repairing trust!