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As the prevalence of total hip and total knee arthroplasty procedures increase over the next decades, hospitals seek opportunities to improve quality outcomes while simultaneously limiting costs and mitigating risks of complications. The Joint Commission's Advanced Total Hip and Total Knee Replacement (THKR) certification is one of the highest quality standard certification programs in the nation and is the only one that collaborates with the American Academy of Orthopedic Surgeons. To obtain THKR certification, several requirements based on evidence-based clinical practice guidelines must be met. The process is described from initial identification of stakeholders to ongoing efforts to retain certification. Joint Commission THKR certification was awarded after rigorous review and on-site visit. Compliance with advanced care standards from the time of orthopedic consultation through postsurgical follow-up was reviewed. Joint Commission THKR certification provides supporting evidence of the institutions journey in processes toward delivering high quality clinical care. A multidisciplinary team with ongoing collaboration is necessary to obtain and retain certification. [ABSTRACT FROM AUTHOR]

BackgroundMaster clinicians are recognized as multidimensional experts in clinical medicine. Studying their formative clinical activities could generate insights to guide medical trainees and early career clinicians.ObjectivesTo investigate which early career activities were adopted more commonly by master clinicians than their matched peers and to characterize master clinicians' early career activities across institutions and specialties.Subjects and methodsWe surveyed master clinicians at seven medical centres about their early career activities. For master clinicians in the Department of Medicine (DOM), we also surveyed matched internist peers.ResultsOf 150 master clinician respondents, 65% were internists (DOM); 35% practiced in other specialties. Compared to their internist peers, there was a trend toward internist master clinicians reading more about their patients' conditions (6.0 vs. 4.8 h per week), reading more case reports (4.0 vs. 2.1 per month), engaging in more frequent teaching duties and devoting less time to research.ConclusionsThe early career activities identified in this study can be adopted by clinicians pursuing clinical excellence and promoted by training programs that seek to foster life-long learning.

Background: Master clinicians are recognized as multidimensional experts in clinical medicine. Studying their formative clinical activities could generate insights to guide medical trainees and early career clinicians. Objectives: To investigate which early career activities were adopted more commonly by master clinicians than their matched peers and to characterize master clinicians' early career activities across institutions and specialties. Subjects and Methods: We surveyed master clinicians at seven medical centres about their early career activities. For master clinicians in the Department of Medicine (DOM), we also surveyed matched internist peers. Results: Of 150 master clinician respondents, 65% were internists (DOM); 35% practiced in other specialties. Compared to their internist peers, there was a trend toward internist master clinicians reading more about their patients' conditions (6.0 vs. 4.8 h per week), reading more case reports (4.0 vs. 2.1 per month), engaging in more frequent teaching duties and devoting less time to research. Conclusions: The early career activities identified in this study can be adopted by clinicians pursuing clinical excellence and promoted by training programs that seek to foster life‐long learning. [ABSTRACT FROM AUTHOR]

There has been growing interest in the past century in improving understanding of the development and treatment of psychopathology of children, with increasing government funding of research in the past two decades. However, child and adolescent psychiatry excellence in clinical care has not been well-documented in the existing literature. This article provides examples of clinical excellence in paediatric mental health to supplement existing guidelines for the clinical practice of paediatric psychiatry. A review of the literature identified 204 unique peer-reviewed articles that were then further evaluated for applicability and relevance to the definition of clinical excellence as outlined by the Miller-Coulson Academy of Clinical Excellence (MCACE). Cases were then identified and selected for each domain of clinical excellence as they apply to child and adolescent psychiatry and to provide a model for patient care. Clinical excellence in child and adolescent psychiatry has not previously been defined or extensively documented. The Miller-Coulson Academy of Clinical Excellence (MCACE) has developed a systematic method to measuring excellence in clinical care and created a definition of clinical excellence. The MCACE defined the domains of clinical excellence as communication and interpersonal skills, professionalism and humanism, diagnostic acumen, skilful negotiation of the healthcare system, knowledge, scholarly approach to clinical practice, exhibiting a passion for patient care and modelling clinical excellence, and collaborating with investigators to advance science and discovery. There are numerous case examples in the literature that represent mastery in paediatric psychiatry in these areas. Clinicians in paediatric mental health will likely benefit from future research on evidence-based approaches to training and education in these domains of clinical excellence. [ABSTRACT FROM AUTHOR]

Abstract Background Although there is an increasing amount of research on the use of structured behavioural assessment instruments for non-technical skills in a simulation or clinical setting, there is currently little research into how healthcare professionals experience using these instruments. The structured behavioural assessment instrument, Nurse Anaesthetists’ Non-Technical Skills-Norway, has recently been introduced to nurse anaesthesia education as a means of developing and assessing non-technical skills in clinical practice. The aim of this study was therefore to explore the experiences of Norwegian student nurse anaesthetists, their mentors and clinical supervisors on using the instrument in clinical practice. Methods This study has a qualitative descriptive design. Data was collected through semi-structured interviews with four focus groups comprising twelve student nurse anaesthetists and thirteen mentors and clinical supervisors. The interviews were recorded and then transcribed verbatim. Data was analyzed using qualitative content analysis and an inductive approach. Results Six categories were identified that represented the manifest content. One main theme: Forging a path towards clinical excellence was identified representing the latent content, and three themes that described the participants’ experiences with using the instrument: Promotion of excellent non-technical skills: Raising awareness of non-technical skills ensured professional suitability and shaping of a professional identity; internalizing the skills could lead to changes in behaviour. Promotion of cooperative learning: Mentoring was more structured, based on a common language and understanding and clearly defined roles; measurable progress enabled a more reliable and objective evaluation. Promotion of organizational acceptance: A lack of familiarity with the instrument, and challenges with scoring and the terminology impeded acceptance. Conclusion Increased awareness of non-technical skills when using Nurse Anaesthetists’ Non-Technical Skills-Norway contributes to a professionalization of the nurse anaesthetist role and mentoring/learning process in nurse anaesthesia education. Using Nurse Anaesthetists’ Non-Technical Skills-Norway promotes the ideal of clinical excellence, not only as an assessment instrument but also by guiding the student’s learning process. Despite a high level of commitment to using the instrument there is a need to promote further acceptance in the anaesthetic departments.

Experts in the field of palliative care in the United States (U.S.) have defined competence, or "good," mainly for programs, trainees, or providers of primary palliative care. Our interprofessional workgroup of palliative care specialists proposes that setting a standard for clinical excellence, or "great," applicable to palliative care specialists of all professions will elevate the field in the U.S. by providing an aspirational target usable for individual assessment and self-assessment, highlighting the common ground between team roles, and promoting a deeper understanding of teamwork, utilization, and productivity. We call for research that utilizes inclusive methods and broad representation of diverse voices to design a vivid, practical, and evidence-based definition of clinical excellence for palliative care specialists. [ABSTRACT FROM AUTHOR]

Background: Although there is an increasing amount of research on the use of structured behavioural assessment instruments for non-technical skills in a simulation or clinical setting, there is currently little research into how healthcare professionals experience using these instruments. The structured behavioural assessment instrument, Nurse Anaesthetists' Non-Technical Skills-Norway, has recently been introduced to nurse anaesthesia education as a means of developing and assessing non-technical skills in clinical practice. The aim of this study was therefore to explore the experiences of Norwegian student nurse anaesthetists, their mentors and clinical supervisors on using the instrument in clinical practice. Methods: This study has a qualitative descriptive design. Data was collected through semi-structured interviews with four focus groups comprising twelve student nurse anaesthetists and thirteen mentors and clinical supervisors. The interviews were recorded and then transcribed verbatim. Data was analyzed using qualitative content analysis and an inductive approach. Results: Six categories were identified that represented the manifest content. One main theme: Forging a path towards clinical excellence was identified representing the latent content, and three themes that described the participants' experiences with using the instrument: Promotion of excellent non-technical skills: Raising awareness of non-technical skills ensured professional suitability and shaping of a professional identity; internalizing the skills could lead to changes in behaviour. Promotion of cooperative learning: Mentoring was more structured, based on a common language and understanding and clearly defined roles; measurable progress enabled a more reliable and objective evaluation. Promotion of organizational acceptance: A lack of familiarity with the instrument, and challenges with scoring and the terminology impeded acceptance. Conclusion: Increased awareness of non-technical skills when using Nurse Anaesthetists' Non-Technical Skills-Norway contributes to a professionalization of the nurse anaesthetist role and mentoring/learning process in nurse anaesthesia education. Using Nurse Anaesthetists' Non-Technical Skills-Norway promotes the ideal of clinical excellence, not only as an assessment instrument but also by guiding the student's learning process. Despite a high level of commitment to using the instrument there is a need to promote further acceptance in the anaesthetic departments. [ABSTRACT FROM AUTHOR]

Neocolonialism has led to an imbalance in the production of knowledge and a clunky imposition of frameworks and models of practice that do not meet the needs of local communities. In contrast they can serve the central function of colonialism by draining valuable resources. Inequity of science diplomacy has diluted local voices and given precedence to colonialist knowledge and models of practice. It is argued that clinical, training and research excellence applies to those activities that meet and fulfil the clinical, training and research needs of the community in which they are embedded. Through personal reflection on contrasting Middle Eastern settings (Palestine and the UAE), the call is for the source of knowledge production and the driver for innovation to be daily clinical experiences listening to families in the community. This will result in policy and practices that are meaningful and impactful as illustrated by way of three examples: (1) a narrative approach to exploring suicide (2) an "all-hands-on-deck" clinical pathway for Autism assessments which transformed the lives of children and families with little additional resource, but with a fundamental shift in approach from "top down" to "bottom up" one as part of an organization-wide "Patient First" approach and (3) a rights-based, collective approach to developing mental health strategy. These examples are linked in terms of taking a shared "listening approach" but are applied to different levels moving from personal individual narratives to community clinical service to national strategy., Competing Interests: The author declares that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Dabbagh.)

The academic promotion process in thoracic surgery can appear nebulous to many young surgeons. However, at most institutions, clear promotion criteria exist for specific academic tracks, and they are based on factors such as clinical excellence, research/investigation, funding, education/teaching, service, health policy, diversity, equity, and inclusion (DEI), ethics, quality and safety, and health care delivery. A thorough understanding of the promotion process is the key to successful advancement in academia., Competing Interests: Disclosure The authors have nothing to disclose., (Published by Elsevier Inc.)