 Please Fill out this form in English and upload all PDF format for the files.
If you have any companions, please combine all tickets in to one PDF file and upload. You should do it for Visas too.
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Name : |
anahid |
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Surname : |
maleki |
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From : |
Monday, June 4, 2018 |
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To : |
Saturday, September 1, 2018 |
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Position : |
Assistant professor |
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School/Research center : |
School of Medicine |
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subject : |
pediatric anesthesia |
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Venue : |
paris |
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Sabbatical Leave Period : |
3 months |
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Country : |
France |
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Certification : |
http://gsia.tums.ac.ir/images/UserFiles/42203/Forms/280/certificate_5.pdf |
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1.Brief summary of Leave : |
To visit Necker hospital ,located in central paris, I have spent there for 3 months and attended in different parts to obtain the information that seemed necessary.they are included:pediatric operating room, fetus operating room, pre anesthetic ward, recovery, pain ward,outpatient operating room, pediatric MRI,Endoscopy,Broncoscopy, spine surgery,neuroradiology under anesthesia,Robotic surgery,Anesthesia consultant clinics and rounds,pediatric day report and conferences among team. My assessment about the quality of the residency program and patient arrangement and discipline in this major referral center in comparison to our hospital is critical,as we shall see. Regarding Anesthetic Expertise for Management ill patients ,minor difference can be seen between Necker hospital and our hospital, but in term of pain control and Regional anesthesia,unfortunately,our actions are very poor. And in patient arrangement , operating room schedule,discipline,Respecting to patients rights and their parents and for more important issue ,the matter of silence and peace in operating room and wards a huge gap between our center and this hospital that needs to be changed by a really quick action and major planand . They study about problems occurred for their patients in surgery time and after and they change and modify their programs according to their problems. Furthermore , in Necker hospital the officials always consider The problems occurred during and after surgery time for the patients in order to make change and modify their plans related to the current problem occurred. Another point is, the residents there,are never forced to study a big volume of materials of reference book, instated they try to study more practical methods and materials in Anesthesia. In Necker hospital,more practical methods are conducted to have more qualified education for their residents, for instance , they have published a special book,named( neckler), that contains significant and key points for each surgery , anesthesia , pain control and drugs. Every resident has to carry this small handbook in his/her pocket while they are in the operating room. Another important difference refers to the devices and technologies available in operating room and patient practice. Some of these medical instruments are not too expensive so it would be possible for us to provide them in our operating rooms but some may cost higher.However, due to some surgeries such as scoliosis , the preparation of some devices is felt necessary for our hospital. Also I noticed that , in this hospital there are 20 MRIs every day but interestinglys just 2 or 3 of these pediatric MRIs are applied under Anesthesia . It appears to me that we must take some serious actions like:altering and promoting our instruments and methods since this noticeable in near future regarding to high speed rate of new technology growth in the field of Anesthesia, will be anticipated to increase rapidly. All of operating rooms in this hospital are equipped with sonography devices for blocking and for all patients they do block for post operative pain .For Major surgery they monitor BIS and Brain Oxygen , and for all of surgery they monitor tempreture, all of rooms have force air blanker for pediatric thermoregulation because hypothermia in pediatric is very dangerous. Indeed, the current trend we use in our practice and education would be confined in a boundary of some routine procedures ,since we have left behind in many fields and approaches. So it is vital for our residents to learn these new technics and approach to improve their job.for example we don’t have pain clinic in our hospital wherease its necessary for chronic pain and cancer pain . we don’t have any team for control acute pain in hospital and I think it must be done at tne first stage. The basic change that I have felt ,would be vital and in favour of our ward , is making some changes in our schedules ,having to say , NPO time will not long last and creates some agitation for children and their parents . In fact Schedule needs to be presented to operating room from before .In Necker hospital the operation list is usually presented by the next week ,Beside,every patient time must be controlled and managed beforehand in order to prevent of any congestion and irregularity in front of operating room and also to avoid any dissatisfaction and any problems like failure to handling. Sadly ,Some of these changes can not be achieved without allocation a specified budget and resources which seems to be impossible in the current time but a number of them , as it was mentioned before ,don’t need enormous budjet for investing them , arrangement and management are just required. Overall, I hope that we would be able to take some actions along helping furthermore the patients and residents in our country |
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2.List the objectives of your sabbatical leave as listed in your proposal and indicate how completely they were met : |
pediatric operating room and pain clinic-anesthesia ward -journal and morning report |
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3.Acheivements(Publications,research,et.al.) : |
Report |
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4.Assessment of Value of Sabbatical leave(benefits,faculty development,future professional activities,...) : |
To visit Necker hospital ,located in central paris, I have spent there for 3 months and attended in different parts to obtain the information that seemed necessary.they are included:pediatric operating room, fetus operating room, pre anesthetic ward, recovery, pain ward,outpatient operating room, pediatric MRI,Endoscopy,Broncoscopy, spine surgery,neuroradiology under anesthesia,Robotic surgery,Anesthesia consultant clinics and rounds,pediatric day report and conferences among team. My assessment about the quality of the residency program and patient arrangement and discipline in this major referral center in comparison to our hospital is critical,as we shall see. Regarding Anesthetic Expertise for Management ill patients ,minor difference can be seen between Necker hospital and our hospital, but in term of pain control and Regional anesthesia,unfortunately,our actions are very poor. And in patient arrangement , operating room schedule,discipline,Respecting to patients rights and their parents and for more important issue ,the matter of silence and peace in operating room and wards a huge gap between our center and this hospital that needs to be changed by a really quick action and major planand . They study about problems occurred for their patients in surgery time and after and they change and modify their programs according to their problems. Furthermore , in Necker hospital the officials always consider The problems occurred during and after surgery time for the patients in order to make change and modify their plans related to the current problem occurred. Another point is, the residents there,are never forced to study a big volume of materials of reference book, instated they try to study more practical methods and materials in Anesthesia. In Necker hospital,more practical methods are conducted to have more qualified education for their residents, for instance , they have published a special book,named( neckler), that contains significant and key points for each surgery , anesthesia , pain control and drugs. Every resident has to carry this small handbook in his/her pocket while they are in the operating room. Another important difference refers to the devices and technologies available in operating room and patient practice. Some of these medical instruments are not too expensive so it would be possible for us to provide them in our operating rooms but some may cost higher.However, due to some surgeries such as scoliosis , the preparation of some devices is felt necessary for our hospital. Also I noticed that , in this hospital there are 20 MRIs every day but interestinglys just 2 or 3 of these pediatric MRIs are applied under Anesthesia . It appears to me that we must take some serious actions like:altering and promoting our instruments and methods since this noticeable in near future regarding to high speed rate of new technology growth in the field of Anesthesia, will be anticipated to increase rapidly. All of operating rooms in this hospital are equipped with sonography devices for blocking and for all patients they do block for post operative pain .For Major surgery they monitor BIS and Brain Oxygen , and for all of surgery they monitor tempreture, all of rooms have force air blanker for pediatric thermoregulation because hypothermia in pediatric is very dangerous. Indeed, the current trend we use in our practice and education would be confined in a boundary of some routine procedures ,since we have left behind in many fields and approaches. So it is vital for our residents to learn these new technics and approach to improve their job.for example we don’t have pain clinic in our hospital wherease its necessary for chronic pain and cancer pain . we don’t have any team for control acute pain in hospital and I think it must be done at tne first stage. The basic change that I have felt ,would be vital and in favour of our ward , is making some changes in our schedules ,having to say , NPO time will not long last and creates some agitation for children and their parents . In fact Schedule needs to be presented to operating room from before .In Necker hospital the operation list is usually presented by the next week ,Beside,every patient time must be controlled and managed beforehand in order to prevent of any congestion and irregularity in front of operating room and also to avoid any dissatisfaction and any problems like failure to handling. Sadly ,Some of these changes can not be achieved without allocation a specified budget and resources which seems to be impossible in the current time but a number of them , as it was mentioned before ,don’t need enormous budjet for investing them , arrangement and management are just required. Overall, I hope that we would be able to take some actions along helping furthermore the patients and residents in our country |
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Additional material may be attached in response to the above summary : |
http://gsia.tums.ac.ir/images/UserFiles/42203/Forms/280/report.pdf |
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Department Head/Research Center Chair : |
Dr mohareri |
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Any Related to Report File : |
http://gsia.tums.ac.ir/images/UserFiles/42203/Forms/280/report_1.pdf |