Surgical waitlist management: Perspectives from surgeons on surgical prioritization at a paediatric hospital.

Autor:	Wiebe K; Graduate Department of Philosophy, University of Toronto, Toronto, Canada.; Clinical Research, Division of Orthopedics, Department of Surgery, The Hospital for Sick Children, Toronto, Canada., Kelley S; Orthopedic Surgery, Division of Orthopedics, Department of Surgery, The Hospital for Sick Children, Toronto, Canada., Fecteau A; General Surgery, Division of General Surgery, Department of Surgery, The Hospital for Sick Children, Toronto, Canada., Levine M; Department of Anesthesia, The Hospital for Sick Children, Toronto, Canada., Blajchman I; Family and Child Centered Care Advisory Committee, The Hospital for Sick Children, Toronto, Canada., Shaul RZ; Department of Bioethics, The Hospital for Sick Children, Toronto, Canada., Kirsch R; Department of Bioethics, The Hospital for Sick Children, Toronto, Canada.; Department of Critical Care Medicine, The Hospital for Sick Children, Toronto, Canada.
Jazyk:	angličtina
Zdroj:	Paediatrics & child health [Paediatr Child Health] 2023 Oct 28; Vol. 29 (2), pp. 74-80. Date of Electronic Publication: 2023 Oct 28 (Print Publication: 2024).
DOI:	10.1093/pch/pxad067
Abstrakt:	Globally exacerbated surgical waitlists have provided the opportunity to reflect on prioritization and resource allocation decisions. The unique circumstances of paediatric surgery and consequences of surgical delay prompted the study reported in this paper. As part of a larger project to attend to prioritization in our surgical waitlists, we conducted a Quality Improvement study, the purpose of which is to understand surgeon's perspectives regarding the ethical and practical realities of surgical prioritization at our institution. The study comprises semi-structured interviews with nine full-time paediatric surgeons from a variety of subspecialties conducted at our institution, which is a tertiary paediatric hospital with ten surgical subspecialties in a publicly funded healthcare system. Participants articulated how they prioritize their waitlists, and how they understand ethical prioritization. These findings resonate with the growing public concern for ethical practice in healthcare delivery and transparency in prioritization and resource allocation practices. Specifically, more transparency, consistency, and support is required in prioritization practices. This work highlights the importance of institutional dialogue regarding surgical case prioritization. Because quality improvement work is necessarily site-specific, concrete generalizations cannot be offered. However, the insights gleaned from these interviews and the process by which they were gleaned are a valuable knowledge-sharing resource for any institution that is interested in ongoing quality improvement work. The objectives here were to clarify the goals of prioritization within the institution, improve prioritization practices, and make them more ethical and transparent. Competing Interests: All authors: No reported conflicts of interest. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed. (© The Author(s) 2023. Published by Oxford University Press on behalf of the Canadian Paediatric Society. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)
Databáze:	MEDLINE
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